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Dear CDC: I am a primary care doctor and have been a big fan for a long time. Your common sense science-based approach to problems has given me an anchor to which to give reasonable and rational recommendations for the care of my patients. You’ve (largely) stood above the clamor of the masses, the pressure …

Dear CDC Read More »

For those wanting my clinical opinions and thoughts as the COVID-19 crisis evolved, I’ve been keeping a blog on my practice website to educate my patients. Go here if interested My first possible COVID-19 case came nearly three weeks ago, before there were any cases in our city. He was a healthcare professional who presented …

Testing Times Read More »

In case you missed the news: there’s a new virus in town…and they named it after a cruddy beer!!

All of the hype surrounding the coronavirus has created a new and difficult situation for me, my staff, and on doctors around the world. How do we answer our patients who are terribly afraid of what they are hearing? China is quarantined, the Olympics might get cancelled, Oprah has been crowned Empress of civilization…OK, that Oprah thing is no true, but the rest is pretty scary. Is it hype that we should downplay, or is it seriously scary stuff that we should warn our patients, our friends, and our families about?

While my practice doesn’t accept money from insurance companies, we do serve our patients for the sake of their health. This means that we advocate on their behalf in a system that seems hell-bent on making care less accessible. Prior-auth hell is one example of this wall that has been built up between people and reasonable care. Electronic medical record hell, pharmacy trickery hell, specialist non-communication hell, bloated hospital gouging hell, media non-story hype hell, and opportunist alternative medicine hell are all contributors to the hell-fire heat we are all feeling.

The real problem was that I cared too much. I couldn’t short-change the patient once I was with them in the exam room. I couldn’t force them to only give me one problem, make them reschedule for something I could handle that day, or refuse to check the ear of the child who happened to be in the exam room with the patient. I am a caretaker. I am a giver. Yeah, I get taken advantage of because of that, but I thrive off of taking care of people. It’s what gets me out of bed in the morning. It’s what I’m on this planet to do.

And I was being robbed of that.

With so much attention to physician burnout and the high cost of care, the discussion spends far too little time talking about the lack of time most primary care docs have for their patients. Before I left my old practice (nearly 7 years ago!), I was increasingly burdened by the fact that I was increasingly being robbed of the time necessary to give good care. I was spending too much time dealing with red tape from the insurance companies and from the rules from the government aimed at “improving care.” Since quitting, I’ve yet to see more than 15 patients in any given day, and am often reminded how much my patients appreciate the time I can spend with them.

So how to pull myself out of my writer’s block? Write about or rupturing healthcare system? Write about the abuse of doctors at the hands of our insurance (and government) overlords? Write about the insanity of politics and the mutilation of common sense? Write about the royals? About Cheetos? About mutant ducks?

Whoa. Mutant ducks. Hmmm. Maybe I should start writing again. I wonder if they eat Cheetos.

I hate dealing with opioid pain medications. They are one of the worst parts of being a primary care doctor. Many patients come to my practice on chronic opioids, expecting me to continue these medications. Other patients have the expectation that any pain should be treated with a narcotic. Some people sell the stuff, others continue in current pain despite being on daily medication. There are contracts to be signed, urine to be tested, and pain management doctors to consult, most of whom don’t prescribe narcotics.

Nobody is happy. It is absolutely miserable.