What's the current value of your doctor

Lately, I have been telling my friends that my 401K is now a "101K." In fact, I am not sure why my money was yanked out of my paycheck all these years. Oh well, the upside is that I get to work until I am...say, 82! I hope I can still count to 30 and...inform patients where the hair-care isle is! (Sorry for the dangling participle)

So...as you would guess, lately, I have been thinking about value. It would be wise of you to do the same;not about your 401k or any other financial instrument, but about your doctor. Open up "that statement" every once in a while and peek at the value of your physician. Set up some reasonable expectations, just like the performance of your favorite mutual fund. Remember, his or her past performance, is not an indication of future returns! Or is it?

Physicians like us are to some extent creatures of habit and certainly risk averse! They may not realize it, but they often approach the practice of medicine in 3 interesting ways. Remember, this is my perspective on calling on these guys for nearly 20 years and of course, everyone is entitled to my opionion (...tongue in cheek noted!)

Firstly, they sometimes look at your problem by sheer intution. In other words, they draw upon their education, expertise, and experience where no trails have been blazed. So, it is wise to choose a doctor that at the end of the day, is gifted and trusts himself on some tough calls. (Oh, they have to know when to tag out of the wresting match and bring in somebody that really knows whats going on).

Secondly, he works with the odds...not the kind out here at the Greyhound dog track, but he does have a little info in the white jacket (occasionally shared by a pharmaceutical representative) regarding probabilities. "Hey, let's try this therapy out for size; see if you PROBABLY get better!" The point is, make sure he or she is aware of a reasonable and positive outcome. This is very important, especially if your life has been shattered with the diagnosis of cancer.

Finally, the incredible strides in technology has given your doctor the tremendous gift of precision. In other words, a diagnosis can be indisputable (I think the spelling is correct). Today's imaging procedures correctly diagnose, say a wrist fracture, 99.99999% of the time. Thus, the precision is evaluated, not the ability of the doctor or his intuition...see above.

So please, go ahead. Next time you watch your physician write something on that little prescription pad, ask him how he has made that snap decision. Who knows? YOU might get a little extra time with your doctor!  Then come and see me. I will fill the prescription and tell you to...take as directed!

Blake

"Blake...this is a big deal"

"Blake...this is a big deal!"  Words I can never erase from my consciousness!   That's what the trauma surgeon said after working my daughter up at Sacred Heart Hospital (no, not the one in "Scrubs") in Spokane, Washington, a week prior to Halloween, last year.  Silly me...I thought that she was being admitted for a simple arthroscopic procedure on her left hip.  As it turned out, the big deal (after CTs and MRIs, and X-rays, and a nuclear bone scan) came down to either Ewing's Sarcoma (bone cancer) or Osteomyelitis of the femur (infection in the thigh bone). 

I won't bore you with details of the next 16 days of trauma drama, but neither diagnosis is a picnic in the park and surely the Sarcoma thing (cancer) is a certain death sentence.  Oh, did I mention the excruciating pain associated with the diagnosis?   (One can't technically die of pain, but most men would have come close in comparison to my unbelievably courageous daughter, Michelle. By the way, she will be 16 years old on August 10th).

So...why all the melodrama? Because there is a point or two here I would like to make with the readers.  Remember I eluded to the importance of solid patient advocacy in my 1st ever blog? Okay Moms... please listen up! Never and I mean never let a physician talk you out of your "mother's intuition," when you know something isn't right with your child.  Better still, don't let your husband/father off the hook either.  Got it?  Take that mother's skill set further and start thinking like a doctor or should I say, STOP thinking like a  certain doctor that screwed up with my Michelle just prior to getting the "big deal news" previously mentioned.   

Tragically, the doctor made 3 critical errors. To this day,  this jack-ass (and I use the term in the most literal sense of a stubborn foolish animal) has no idea of the consequences of his actions. Oh sure, my wife informed him at a later date of his unprofessional performance, but his apology over the phone was driven more from the advice of his risk manager than from his heart.  

So, you ask what are these errors.  The first mistake is termed "search satisfaction" by some.   This doctor looked no further than the MRI in front of him.   He paid little attention to the pain my daughter was being subjected to during his examination.  I would have guessed the sweat left on the examination table might have clued him in.  He narrowly connected the pain with a 15 year "actor" looking for a narcotic fix.  Secondly, he committed what is called an "attribution error."  In short, if a doctor sees 8 drug-seeking patients in a row, then the number 9 must also be a drug seeker. Heaven forbid, if number 9 has legitimate pain.  Finally, he was "anchored" to his own ego.  Hey Mr. Doctor, "Weigh anchor, look a bit deeper, and diagnose your own 'big deal'!"  Instead, he became the deal breaker, and in a cruel twist of irony he later informed his colleague (who happened to be the on-call doctor that night) not to admit Michelle, because the pain "was all in this girls head."  Nice...

Well, thanks for letting me fill your prescription on patient advocacy tonight.  You might need a refill or two later on.  Please,  "take as directed"...Blake

Blake's Inaugural Blog... "Smackdown" style

I am miserably full...and not from the hobo dinners I ate a couple of hours ago.  It is from all "the crow" I ate for dessert.  As of 2200 hours, I have stepped into the "Blogosphere Portal"

Waiting at the portal's other end was my family's "smackdown".  They reminded my that this blog action is not that much different than FaceBook.  That hurt and I asked them for some aloe vera gel...stat! They will quickly tell you that "Dad" has nothing good to say about FaceBook and likens the social networking site to a self-serving Christmas Letter on steroids!

So here is the deal!  I am willing to take the abuse if my blog accomplishes the following: Firstly, the approach will be well, let's just say, "NOT about me" (see me on Facebook...NOT!) However, It IS about events of late that have had a huge personal and sometime very painful impact on me and my family.  I am confident that I have enough material to blog thru oh...I don't know, maybe Arbor Day of 2013.  I will re-assess and make an informed decision about the availability of common nonsense.

Now, here is where the whole "self serving" disclaimer that comes into play.  The risk in sharing these experiences is that they may come across like the Christmas letter afore mentioned.  But, if you stick with me, the blog's subject will hopefully be singular in nature.

The arena will simply be my personal insights into patient health care (see "events of late" above for a clue).

It is my hope that as a parent of children struggling with recent health issues, a washed up drug rep with insights about big pharma, a pharmacist now standing behind the counter, and finally just a guy who is woefully disappointed into the optimal delivery of health care today, I can be your advocate in the blogosphere. If not, I am all open to a book deal!

Your Rx is waiting...Blake