Why I love house calls

Why I love house calls

I’ve always been a people watcher. Now I get paid to spy on folks. I have to ask detailed, personal questions. Sometimes I even snoop around patients’ homes.

In the 1930s nearly half of all patient visits were house calls. Now most patients are rushed through ten-minute office visits. But if I need to know what’s going on with a patient, I stop by — unannounced. Today I’m surprising Terry Wayne.

He lives in an industrial area just across from the big homeless shelter — the only house on the block. Aha! I see it. Looks like his kinda place. It’s a buy-and-sell-pawn-shop-looking compound.

Why I love house calls

I walk right in past the alien hanging on the front door.

Why I love house calls

Looking up from his chair, Terry seems overjoyed to see me. A hippie from Birmingham, Alabama, he found refuge in Eugene, Oregon. He’s been coming to my office for eight years. Now he’s giving me a tour of his place. First he poses with the gift he just got from his granddaughter: a Terry look-alike doll!

Why I love house calls

“I been upset ’cause my granddaughter just moved out with my daughter. My daughter’s homeless and two centimeters. Having her baby any day now. We’re not sure where she and her boyfriend run off to. Been losing sleep over this.”

His wife, Rhonda, shows me the room where their daughter and granddaughter were staying. I turn around and see a cookware display. He’s been paying me all these years by selling cast-iron pots and pans. “Yep. Here’s my collection I was telling you about. They’re all from the 1800s.”

Why I love house calls

Snooping around his house, I notice a lot of cool stuff:

Why I love house calls

Why I love house calls

“I pick things up at garage sales and thrift stores, then I sell ’em on eBay,” he says.

His wife leads me through a secret door into the back room where he keeps most of his collection.

“What does Rhonda think of all this?” I ask.

“She don’t mind long as the main part of the house is clean.” Terry is obviously proud of his stockpile. “Everything’s made in the USA,” he says.

Why I love house calls

Why I love house calls

Terry Wayne is diabetic. He tries to eat healthy. I check his heart while he stands by the fridge. “Cutting out ice cream and them bags of gummy worms has really helped me lose weight, doc.”

Why I love house calls

Why I love house calls

Terry exercises every day. “Been fixing up these bikes.” He takes me on a ride around the block on his quadracycle. “You know me and Rhonda’s never been on a plane. Travel makes me anxious. I need to be in my own bed at night. Even then, my brain won’t go to sleep. I have nightmares about being locked up in the South. I’m better during the day. I’m not really afraid of anything—except tornados and my government.”

Why I love house calls

While he pedals, I take a few notes on my laptop, then finish up his chart when I get home. Next morning I get this e-mail:

“I just wanted to let you know I had a great time yesterday. It was the first time I have laughed or enjoyed anything in months. I have been trying to describe Rhonda and my feelings about this whole family thing, and thanx for letting us vent on you. From what I have been searching online I think we both are experiencing pure mental anguish which is leading to both our emotional distress. It feels weird having a doctor as a friend but boy does it feel great. We both love you and your real heartfelt concern for us.”

I guess a house call is like visiting a friend you love who just happens to be a patient.

Pamela Wible pioneered the community-designed ideal medical clinic and blogs at Ideal Medical Care. She is the author of Pet Goats and Pap Smears. Watch her TEDx talk, How to Get Naked with Your Doctor

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  • DoubtfulGuest

    Nice post, Dr. Wible. :) I don’t know how I feel about surprise visits from anyone…I’m very protective of my personal space and have to work hosting guests into the limited energy budget, no matter how much I like them. But you and this patient clearly have a great relationship – love the pic of you two on the bike! And I know lots of people miss the old days when house calls were more commonplace, and doctors could make time for them.

    • http://www.idealmedicalcare.org PamelaWibleMD

      The art of medicine is knowing which patients to surprise.

      • DoubtfulGuest

        List of reasons to surprise them, please? Besides drug abuse concerns? I’ve had some really judgmental docs…lots of stuff could go wrong.

        • http://www.idealmedicalcare.org PamelaWibleMD

          Just cause I want to come over for dinner and hang out.

          • DoubtfulGuest

            Good save! Some patients are welcoming…in a strictly scheduled sort of way. ;)

          • http://www.idealmedicalcare.org PamelaWibleMD

            Could be anything They are thrilled to see me. SometimesI am just in the neighborhood and stop by to say hello.

          • DoubtfulGuest

            I’d welcome you, too. I’d just need advance arrangements. I like to be able to dance awkwardly around my apartment without a surprise audience.

          • http://www.idealmedicalcare.org PamelaWibleMD

            No problem.

  • http://hautuconsulting.com/ Shane Irving

    Great story… I’m sure many Docs would benefit from doing these kinds of calls at least once a week. Great way to reconnect with the essence of being a Doc and connecting with your patients.

    • http://www.idealmedicalcare.org PamelaWibleMD

      And connecting with our patients and ourselves will salvage our profession. And potentially save our lives. These people we call patients love us. Ya feel me?

      • ninguem

        Pam’s holding out. The guy in the red shirt and hat was the cabdriver.

        The patient was the green guy on the door.

        Underneath the marijuana sticker.

        “Cannabis. It’s not just for breakfast anymore.”

        • http://www.idealmedicalcare.org PamelaWibleMD

          Hahaha!!

  • ninguem

    Eugene gets the people who are too far-out for Portlandia.

    That’s what I like about the town.

    • http://www.idealmedicalcare.org PamelaWibleMD

      Yep! TRUE!!

    • buzzkillerjsmith

      I hear Eugene has a big-time PCP shortage. Is that right?

      • ninguem

        Well, Patch Adams visits the Oregon Country Fair, if that counts……….

      • http://www.idealmedicalcare.org PamelaWibleMD

        YES! The big multi-specialty group in town lost 18 primary care docs in a year or so. None to suicide thankfully.

        • ninguem

          Where are they all going? I’m not in Eugene, though I was offered a practice position there once. Maybe I should have taken it.

          (…..I just bring my passport and visit from time to time…..)

          Or maybe it’s just as well that I didn’t take it, if they’re all leaving.

          • http://www.idealmedicalcare.org PamelaWibleMD

            Eugene is great with the right employer. Yourself.

  • buzzkillerjsmith

    Are you in a concierge practice?

    • http://www.idealmedicalcare.org PamelaWibleMD

      Nope. Ideal medical clinic designed by the community. No annual fees. Still take insurance. Have about 20% uninsured. And most of them will NOT sign on with Obamacare.

      • buzzkillerjsmith

        Ok. How many patients on your panel? How many do you see per day?

        • http://www.idealmedicalcare.org PamelaWibleMD

          No more than 8 per half day. At most 11 on a super busy day. I only work half days. 500 patient panel (active patients) and 400 or so inactive files.

      • querywoman

        Does your community give you any financial support?
        I don’t doubt that you work with your patients who don’t have any money or have very little. You have to pay your rent, keep the place,and keep a certain amount of medical supplies.
        I assume you are able to make a living.
        But, when I click on the, “Ideal Medical Clinic,” link on your site, I see some doctors who are charging over $3000 for a two hour visit.
        Of course, what some other doctor chooses to do is not your problem. In a free country, they can charge what they want as long as they can get it.
        But, do most doctors have a greater responsibility to the society around them, the people who can’t pay almost $4000 for two hours of their time?

  • guest

    Very nice story. After reading this I’m worried about his granddaughter and her kids too!

    • http://www.idealmedicalcare.org PamelaWibleMD

      They are okay. They reconnected shortly after the story.

  • http://www.idealmedicalcare.org PamelaWibleMD

    Thank you! Next photoessay is titled:

    House Call on a Hundred-Foot Cliff

    That’s a wild one too!

  • ninguem

    Pamela, that guy has my father’s barometer.

    How did he manage to go to New England to get it?

    And that credenza with the lamps on it. Under the TV and next to the door with the alien.

    It looks very familiar.

    Ask him if he found my high school graduation disco suit in the left-hand cabinet.

    • http://www.idealmedicalcare.org PamelaWibleMD

      I love his house. I live an OCD clutter-free life so his house feels oddly therapeutic to me.

  • toolate

    You seem to confuse friends and patients. I don’t know how you get away with it in this day and age. It’s worrisome that you don’t seem to be aware of the difference.

    He seems mentally ill. The ol’ ‘schizophrenia masquerading as an eccentric/hippy’. Seems to have semi-successfully self treated himself via his lifestyle. Good for him, I guess, though not sure he’s happy:

    “I need to be in my own bed at night. Even then, my brain won’t go to sleep. I have nightmares about being locked up in the South. I’m better during the day. I’m not really afraid of anything—except tornados and my government.”

    I don’t disagree for one second with mentally ill living at peace in their own home and choosing their own lifestyle. But you seem unaware of what it is you’re treating, or not treating. If he had chest pain would you be like: “oh, how cool, let me massage his chest for him”?

    And should you be posting your patient’s confidential information online?

    • DoubtfulGuest

      I’ve raised similar questions in the past, although I have a bit more moderate take on what’s okay. I see some really nice aspects mixed in with concerning ones…

      • toolate

        I edited my post because it’s not right to discuss specific people online, even though it’s not my patients, it’s just wrong.

        • DoubtfulGuest

          Good thing we have that option. I’ve put my foot in my mouth several times on this blog. Thank you for thinking of it, because I didn’t. I’d assumed the patient gave informed consent for this post?

          • http://www.idealmedicalcare.org PamelaWibleMD

            Yes. Patient signed HIPPA consents and publishing consents. And they are genuinely excited that their story may inspire other doctors to love their careers and their patients too.

            So . . . what is the concern?

          • ninguem
          • DoubtfulGuest

            Yay for informed consent! Lots of patients decide to share their stories for good reasons, I suppose.

            My concerns…nothing I haven’t brought up before. The bike pic is sweet. Also docs and patients sharing a meal together, perfectly fine. Kind of a universal gesture of goodwill.

            The “Tsk, tsk” Index on this post is not too high, all things considered.

          • http://www.idealmedicalcare.org PamelaWibleMD

            Oh good. . . relieved.

        • DoubtfulGuest

          Should I delete my responses? We’re lacking context now. I don’t understand why your post is missing.

    • http://www.idealmedicalcare.org PamelaWibleMD

      In a small town your friends are your patients and your patients are your friends. Unless you just hide in your house or fly out of town to make friends.

      What’s the problem?

      • toolate

        Ethics. Boundaries. Complications.

        It requires thought, not denial.

        • DoubtfulGuest

          Particularly when stakes are high for the patient, i.e. life-threatening situations.

          • toolate

            Or for the doctor, i.e. personality disorders, or paranoid psychosis.

            There is no absolute prohibition for doctors against friendship with their patients – except for psychiatrists. But it is always complicated. It’s not 1950 anymore.

          • DoubtfulGuest

            Yes, I would like to see more progress/nuance in these discussions. Friendship can be great, but lots of stuff to think about, in depth.

          • http://www.idealmedicalcare.org PamelaWibleMD

            I am happy to answer direct questions if anyone is concerned about how safe it is to be friends with patients. btw, We are not going out to dinner together, mall shopping, spending holidays together. Friends as in friendly acquaintances, not best friends, not lovers, not unethical. So . . .again . . what exactly is the problem. . . ?

          • DoubtfulGuest

            Sharing community stuff, like you said in a previous post. I don’t see a problem with that. I’ve avoided specifics because I don’t want to ask about confidential matters with your patients.

            But one thing that jumps out at me from ethical papers I’ve read, is how do you maintain objectivity with a friend in big decisions like surgery or end-of-life care? But then I know from experience that many doctors aren’t nearly as objective as they try to be, regardless of circumstances.

            When I read your posts, I always have a positive response to some extent. But I feel uneasy at the same time, largely based on some of my own experience with doctors, that has limited relevance here.

            I DO agree with you that doctors’ feelings matter, they should be with their communities, and they need some care and appreciation in return from their patients to make it all worthwhile. I ALSO see potential for unintentionally putting the doctor’s needs ahead of the patient’s needs at critical decision-making junctures.

          • http://www.idealmedicalcare.org PamelaWibleMD

            Yet another reason doctors need a good therapist and weekly counseling sessions. I have been going weekly for years. I process my needs with my therapist and not my patients. I approach them with clarity and with the least personal baggage possible.

            The problem: (an example) overworked doctors in failing marriages with PTSD and incredible stress who may start complaining to patients or trying to somehow get their needs met from patients.

            I feel pretty grounded and centered. I know right from wrong. I do what feels right with individual patients. Never had any major problems.

            I believe we heal each other. Patients are mirrors. And we reflect their lives back to them. The more real and vulnerable we can be with them the more authentic they will be with us. Always a better chance to help someone if they are willing to be transparent and accessible with us.

          • DoubtfulGuest

            And for toolate’s example…let’s trot out that old chestnut called “The Patient Misinterprets Something.” I’m not going to label this patient, let’s say s/he’s a perfectly well-intentioned individual who has some boundary confusion because of previous bad experiences or brain chemistry issues. It’s often said that doctors should avoid not only behaving inappropriately, but also *creating the appearance of* doing so.

            How do you avoid giving mixed messages? I’m not even getting into clichés about sex…let’s just leave it at messages about your availability for friendship. Would a patient who is confused automatically get the boot? Or do you periodically reflect on how you come across to patients, take the time to explain and clarify? Either a needy patient or a needy doctor could end up sort of ‘mining’ the other person’s emotions and energy, feeding off them without realizing they’re causing harm. On your side, I also see harm for both in being too distant. It’s very complicated.

          • http://www.idealmedicalcare.org PamelaWibleMD

            I go with my intuition and heart in these matters. What’s right? What’s ethical? What’s healing?It is not an intellectual exercise for me. I am myself 100% of the day. I am not acting one way at work and then acting another way at home. So . . .what you see is what you get – ME. I believe in professional closeness over professional distance and it is therapeutic for patients.

            Have I ever encountered a problem? Yes. Once thatI can recall. A patient became very attached to me. Then when I had to reduce my hours and did not have as much time to spend in my office, she felt abandoned by me. She called and explained all of this to me. Ultimately she told me it was therapeutic for her as she was overcoming her childhood abandonment issues through our relationship. So good ending but rough going for a while.

            You know people do come to use for emotional and spiritual healing. Not just physical issues. You can not use guidelines and evidence-based medicine in all areas. Sometimes you follow your heart and soul without a fear roadmap. That makes some people nervous, I suspect.

            Thoughts?

          • DoubtfulGuest

            Did you keep taking care of this patient? Did you reassure her that you were still there for her as her doctor? On a previous post you mentioned for awhile you seemed to attract anxious patients and then when your own emotional health improved you attracted healthier patients (as though they’re more desirable, patient population-wise). So, what happened to the anxious patients? Did you all get healthier together, or…?

            The following heart and soul business, well I notice most of the criticism you get seems to be from male doctors? Some things in life are probably harder for women, others harder for men. It seems that men are more easily accused of things, even if they only mean to be polite and friendly. We women get away with a lot, by invoking our supposed innate tendency to be more nurturing and expressive.

            I don’t know what the right answer is, but I have been on the wrong side of a doctor’s emotional needs. Nothing inappropriate at all, it’s just that my whole value as a person was reduced to my ability to shake hands and thank him, because he was starved for appreciation. When I had a serious medical need and complications arose, there was no actual rapport or trust between us to keep him from throwing me under the bus.

          • http://www.idealmedicalcare.org PamelaWibleMD

            I never fire anyone unless they do something really bad (forge Rx, screaming at me and failing to take anger management classes are two that come to mind). I always allow the patient to fire me and move on if they feel it necessary. This is what she did.

            I love psych patients. I just attract a lot less anxious patients now. I think because I am healthier.

            Male: female dynamic. Yes. A male colleague told me if he had published my book with the women and the goat pics, he thinks he would have been arrested.

            I’m sorry that you suffered under the care of your previous doctors. btw, I am not claiming to be perfect. I’ve screwed up – and learned from every one of those instances.

          • DoubtfulGuest

            Thank you. It has been hanging over my head for seven years.

          • ninguem

            You want a thought? Here’s a thought.

            http://www.pulitzer.org/archives/6414

            Dorothy Rabonowitz got a Pulitzer for reporting this true story.

            This is what CAN happen.

            This is Eugene. In a clinic like that, do you not get people walking in claiming to have Morgellon’s disease or Wilson’s Syndrome (not Wilson’s disease), asking for megadose thyroid or narcotics, etc.

            Do you ever have to say “no” to patients like this? They’ve never become vengeful?

          • DoubtfulGuest

            I’ve read this one before. The gold lamé raincoat. This is nightmare material.

          • http://www.idealmedicalcare.org PamelaWibleMD

            Doctors are controlled and intimidated by nightmare material.

          • DoubtfulGuest

            Yes, and are female doctors quite so vulnerable to these kinds of accusations as are male doctors?

          • http://www.idealmedicalcare.org PamelaWibleMD

            Lots of things CAN happen. I refuse to be driven by fear. I live from my heart. I use my brain properly too. Some may dispute this. My mom (a psychiatrist) has never understood me.

            I have said no to lots of patients. I have never had a vengeful patient strike back.

            Have you?

          • DoubtfulGuest

            You have a point. Many doctors automatically assume that patients with a history of abuse are going to pull this kind of thing. No matter how polite, respectful or appropriate they try to be. No matter how serious their medical situation might be. Because of something they didn’t ask for and can’t do anything about.

            I’ll just get this out of the way to save time: “Sadly, because of the actions of a few bad apples, patients will continue to suffer…”

          • ninguem

            Have I been on the receiving end of a complaint from a vengeful patient?

            Absolutely.

            Wilson’s syndrome. Only industrial-strength triiodothyronine will help. My refusal triggered a Medical Board complaint.

            I had to deal with it.

            And FWIW I respect your not being driven by fear.

            Just remember this sort of thing can happen.

            Doubtful Guest, I can’t say as I’ve seen formal statistics, but I daresay the male physicians are more likely to be targets of bad-faith complaints from PATIENTS.

            Now the second part of this is HOSPITALS.

            Pam, are you still on staff anywhere in town?

            Personal friend, and physician, female, was run out of town by competing (male) physicians who also were employed by hospital, and female doc was independent.

            I will guess that if the source of complaint is a patient, the male physicians are a bigger target.

            I will also guess that if the source of complaint is a hospital and/or medical staff, the female physicians may more likely be the “outsider” and become a target.

            I have absolutely no formal statistics to base this on, so accept it as my opinion and nothing more.

            And yes, as Pam said, if a male doc had done the goat thing with woman in lithotomy position and all that, the male doc would likely have been in serious trouble.

          • http://www.idealmedicalcare.org PamelaWibleMD

            Was on staff. Chose not to renew my privileges a few years back because they raised the staff dues from $300 to $700 per year. And here’s the kicker:
            They only did that for “courtesy” physicians ( 25 admits/yr) did not get an increase!!

            I only had like 2 admits per year so a total financial loss. I told a few other “courtesy” docs in town and the dermatologist told me to call:

            1-800-U-R-FUCKED

            I thought it was a joke. But she told me to call. YES, it does lead to the billing department at the (catholic) hospital. I found the entire incident discourteous and inhospitable so I opted out of being on staff. Still see my patients in the hospital – socially – on my quadracycle. :))

            Please do not censor or flag this. It’s a true story.

          • ninguem

            Maybe it’s really 1-800-U-R-LIBERATED

            Did you find any repercussion from dropping “privileges”? Insurance participation, that sort of thing.

            …..scare quotes because the “privileges” are really “burdens”…..

            I labored under the impression that you needed hospital “privileges” for insurance participation, but when I call and ask directly, I have yet to find an insurance that requires this anymore.

            I’m keeping privileges so far, out of habit. Wondering if I should drop them completely.

            Has your lack of hospital privileges affected you in any way?

            Oh, and BTW, specifically, are you in Medicare, Medicaid (Oregon Health Plan), or any sort of Medicare/Medicaid mangled care plan?

          • http://www.idealmedicalcare.org PamelaWibleMD

            With hospitalists on every corner, primary care docs do not need to maintain hospital privileges for insurance contracts. You just need a plan of action for patients who plan to get admitted.

          • http://www.idealmedicalcare.org PamelaWibleMD

            Also no longer take OHP though I NEVER turn patients away for insurance reasons. Anyone who wants to see me can and I will make it work for them.

          • EmilyAnon

            Wow, what a story. During my colonoscopy there was an anesthesiologist and nurse in the room. Or can a doctor do the procedure alone while the patient is under. Otherwise wouldn’t there be witnesses to rebut the patient’s abuse claim.

          • ninguem

            He had a nurse, who floated about the endoscopy suite. She’d help the doc, she’d check in a new patient, she would look in on someone who had just had the scope done.

            So that nurse was not there every second of the procedure, but could pop in at any time.

          • http://www.idealmedicalcare.org PamelaWibleMD

            rebut the colonoscopy? good one.

          • EmilyAnon

            haha. Is there a code for that?

          • NormRx

            I just read the story at your link about Dr. Griffin. It makes me sick that such an injustice can happen in this country. I had two buddies that were accused of rape many years ago. Neither case went to trial as it was readily determined that both women were lying. I think a doctor would be a fool to do an examination on a woman without a chaperone. Yes, the vast majority of time there will be no problems. But, all it takes is one time and your life and career is over.

          • DoubtfulGuest

            Tried to reply to you, Norm, but it wasn’t going through. In a nutshell, this is bad for patients, also.

          • http://www.idealmedicalcare.org PamelaWibleMD

            Once a woman with a history of sexual abuse accused me of molesting her breasts. She had apparently never had a thorough breast exam.
            Nothing ever came of this. Residency director was able to diffuse the situation.

          • Suzi Q 38

            I remember “back in the day,” a doctor showing up at my apartment. I had to lie and tell him I was leaving.
            Back then our business cards had our names, addresses, and phone numbers on them, LOL.

          • DoubtfulGuest

            Argh, I don’t like anyone just stopping by. I have to get into “social interaction mode” first, have to plan for it. And yeah, the personal safety issue. There’s at least one 70′s-tastic home safety video on YouTube (probably too lengthy to post here), but one of those ran through my head as I read your comment. Yikes!

          • Rob Burnside

            On my way to the ER soon, DG. Just wanted to say “Keep up the good work” and don’t forget Best Foot Forward on 9/26. RB

          • DoubtfulGuest

            Oh no, I thought you said you were feeling better? Did you call your PCP? I hope they fix you up soon. I ran the idea by you before to make BFF a guest post? Seems like a public health issue to me.

          • Rob Burnside

            Scary runs of PVCs, DG. Better now, after some fluids, at little O2, and rest. A good lesson in stress management. Don’t know how the folks in healthcare are doing it, day in and day out. Certainly, we can all use a Best Foot Forward Day! Stay tuned…

    • http://www.idealmedicalcare.org PamelaWibleMD

      So you think that doctors and patients can not be friends? Why the heck not?

      • toolate

        Do you think they can be lovers?

        • http://www.idealmedicalcare.org PamelaWibleMD

          NO

          • http://www.idealmedicalcare.org PamelaWibleMD

            Do you?

          • DoubtfulGuest

            This is all a bit confusing. I would have asked toolate’s question like “Where is the boundary line?”. But you’ve told us directly on previous posts that you like to provoke questions and you are deliberately trying to get people thinking about taboos in medicine. So you get some very blunt questions and…they’re gone?

          • http://www.idealmedicalcare.org PamelaWibleMD

            For those who are wondering I was asked if it is ok to be lovers with patients.

            Answer: NO.

          • DoubtfulGuest

            Of course, but why was it bad for toolate to ask? I wonder who flagged toolate’s posts.

          • http://www.idealmedicalcare.org PamelaWibleMD

            No idea. I took it as a relevant question. It’s not like it is never happened before. Kind of like suicide, these challenging topics need to be discussed in the light of day with no shame.

            Geez, if I felt like I had met my soulmate who walks in for an initial appointment, I’d end the patient-physician relationship and just tell they guy I think we may have a deeper connection to explore.

            What’s wrong with that?

          • DoubtfulGuest

            I would prefer to receive care from a doc who thinks this stuff through with self-awareness, rather than one who goes “EWW!!!” to a question and flags it, and shoves their own thoughts and feelings down into their subconscious. But maybe the flaggers weren’t docs?

          • http://www.idealmedicalcare.org PamelaWibleMD

            Only Kevin knows the real story I think . . .

          • DoubtfulGuest

            Huh…Something weird always seems to happen in these discussions. From a patient perspective, it’s hard to understand.

          • DoubtfulGuest

            What’s the deal? Dr. toolate tried to reply to me and it’s gone already. Pffft!

          • Suzi Q 38

            But if it doesn’t work out, and you break up with him, could he ever be your patient?
            Worse yet, could he turn you in to the state medical board?

            All because you “crossed the line”and took a chance on love.

            That being said, I believe it sometimes happens, because we are all human.

          • DoubtfulGuest

            And actually…I’m 99.9% sure what toolate asked you was do YOU think it is okay? Something’s fishy here…

          • http://www.idealmedicalcare.org PamelaWibleMD

            I don’t think it is ok.

          • DoubtfulGuest

            Got it. :) Not saying *you* are fishy, sorry…Just wanted to make sure the deleted comments were accurately portrayed. I kind of wanted to see what tl’s deleted reply to me said. I’m perplexed by the comment-flagging. I thought this poster had some important ideas to share.

            It didn’t look like anyone here was saying it’s okay.

          • toolate

            Why the heck not?

  • EmilyAnon

    Dr. Pam, someone should clone you.
    You’d be very welcome in L.A.

    • http://www.idealmedicalcare.org PamelaWibleMD

      Really? I thought the fast-paced life rules there. People would want house calls on a quadracycle? In L.A.?

      • EmilyAnon

        There’s the Venice Beach boardwalk where your quadracycle would fit right in. Lots of performance artists there who would benefit from a bicycling doctor. Like the guy who entertains by walking on broken glass and had a serious mistep. Bled for 30 minutes before the paramedics could maneuver through the walkstreets to get to him.

        And the nearby free clinic for women that gets lots of $upport from the rich and famous. Just a thought if you ever get ‘itchy feet’.

  • ninguem

    Is this guy’s house near the Ninkasi Brewery?

    Tell him I’m coming over.

    • http://www.idealmedicalcare.org PamelaWibleMD

      Yep. Pretty close.

      • ninguem

        Total Domination IPA all round.

        • http://www.idealmedicalcare.org PamelaWibleMD

          Is that a beer or ya talking Independent Physician Association?

          • ninguem

            Sometimes I think IPA is the official beer of Oregon.

  • http://www.idealmedicalcare.org PamelaWibleMD

    Hahaha! But we need to see how you REALLY live.

  • Suzi Q 38

    Sure, a doctor could stop by…but I am not sure that I would be home.
    Please call first. If you don’t care if you make a special trip and then miss me, it’s all good.
    Because of you, I become more transparent with my students. They are all adults.
    My husband and I invited a student, his wife, and son to the Dodger game last week. Another student and her husband invited us over for dinner. They are from China, so this will be an interesting cultural exchange.
    I needed a ride back home from the airport, so two students have offered to pick me up and five me a ride home in a couple of weeks.

    Interesting story, I like the pictures and your friend is a unique character.
    Totally different and enjoyable.

  • DoubtfulGuest

    I’m always slightly calmer without chaperones, because I feel reassured that the doctor trusts me and is focused on my medical problem. I’ve never asked them not to bring one and they often do, but the implication makes me feel kind of bad.

  • traumadoc

    Hello! i have been doing house calls since 1988! Love it!! i leave half days every sunday for the infirm and elderly…

    • http://www.idealmedicalcare.org PamelaWibleMD

      traumatic YOU are my hero! Wow!

  • DoubtfulGuest

    Why are all of a certain poster’s comments being deleted? What’s going on? I never saw any implication that anyone was in favor of anything inappropriate. Maybe I’m missing something but it looks to me like a misunderstanding. I had a rough time when I was new here, too. Online communication is challenging. I hope decisions are being made based on factual information.

    • http://www.kevinmd.com kevinmd

      That particular user deleted his/her own comments. They were not deleted by the moderator.

      Kevin

      • DoubtfulGuest

        All of them? Many look recently deleted by the poster but the some appear to have been deleted by the moderator, including a reply to me that I never got to see. Thanks for your time. This is weird.

    • EmilyAnon

      Doubtful, by default only the “best” comments are displayed when you first open the thread. Click on ‘newest’ or ‘oldest’, then more comments come up. Maybe you’ll find what you’re looking for there.

      • DoubtfulGuest

        Thanks, Emily. No dice, the comments are gone even from there. But I hadn’t noticed this before so appreciate it. :)

    • Suzi Q 38

      Some of my posts don’t get in either, LOL.
      They sometimes are deleted by the moderator.

      Yes, I think I am “moderated,” because someone has complained about me, LOL. There is no little flag to the right of my name.

      I am not bitter, because maybe I hurt someone’s feelings when verbally “sparring” on this website; or I have said something a little “off color.”

      There was a time when certain doctors got to say whatever they wanted (negative and rude posts about patients) and didn’t like it if I had a different opinion, which I sometimes do.

      I had to protest, because I felt that only one side was allowed to speak and say negative things.

      They have been better and the doctors of late have not been as sensitive.

      If Kevin deletes you, you would not even see your post at all.

      • DoubtfulGuest

        There are certain words that, especially if appearing together in the same post, seem to make it get stuck in moderation for awhile. I was referring to the same article Norm referenced, not saying anything negative toward him at all. I just didn’t have the patience to wait and see if my post would show up, and I thought if it could come across the wrong way on such an emotionally charged topic, better not.

        The gist was, because of people who do things like this, nice patients (most of us) are forced to think and worry about all kinds of things that are implied when the doctor brings in a chaperone. I wasn’t talking about well-person pelvic exams. I had a rheumatologist do a thorough exam with no chaperone and it felt like…a normal doctor visit. I had already been accused of faking my illness by other doctors and I had a weird sense of calm and relief that this one wasn’t thinking I was creepy. It was oddly very helpful to me during a bad time, and it turned out later that I was quite sick. I’d never ask doctors not to protect themselves, but only to be more understanding of patients’ feelings while they’re doing so.

        I think we all get flagged now and then. I’m not sure it’s always doctors, and I don’t know that someone even has to be logged in or registered to be able to flag a post. I also think it takes more than one person to get rid of a post. I have seen many doctors complain about their posts being deleted.

      • DoubtfulGuest

        Whoops, I was replying to the wrong thing, sorry. That’s what happens when I reply from my Disqus profile instead of the original post. I thought you were talking about my own comment being moderated, on that article Norm was talking about. I should add, “thorough” exam, means patient in gown but nothing private. Sigh…I once read about a patient who thought a doctor was trying to kiss her when he approached her for a fundoscopic exam. I don’t even know what to say to that.

        On to what you’re talking about, I wanted to make sure this doctor didn’t get kicked out because of any baseless accusation. I don’t know the back-story. It seemed like that person was actually being more conservative than Dr. Wible. Although I appreciate that Dr. Wible is trying to create a space for shame-free discussions. And it seemed like this one was a bit more productive. Except I guess it was supposed to be free of shame for everyone except that poster who asked an uncomfortably direct question…

  • Suzi Q 38

    Dr Wimble,
    You have an interesting life.

    • http://www.idealmedicalcare.org PamelaWibleMD

      That’s an understatement.

      7th grade yearbook predicted everything. Kid signed: “To a weird girl. Stay that way.”

  • Suzi Q 38

    No problem.