Taxes. Doing taxes feels like a financial rectal exam.  I hate doing taxes.  Yeah, I don't like getting rectal exams either. It's not that I resent paying the government for the fine services they render and the high quality of elected officials we have. It's not the existence of taxes I hate; it's just doing taxes make me feel extremely insecure.  Sharing my personal and business finances with my accountant and the ...

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I was talking with a few friends not long ago.  Our conversation somehow got to the issue of authority, and what exactly respect for authority looks like.  One of them, trying to make a point, turned to me and asked: "So you surely deal with people who don't listen to what you have to say.  What do you do when your patients don't take the medications you prescribe?" I think he ...

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My last post discussed the wide gulf between health care and the rest of the world in the area of customer service.  To sum up what took over 1,000 words to express: Customer service in health care totally sucks because the system promotes that suckiness and does nothing to penalize docs who make people wait, ignore what they say, rush through visits, and over-charge for their care.  We ...

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No, customer service in the U.S. is terrible when it comes to health care.  No, the customer service in the U.S. health care system is horrendous.  No, health care has the worst customer service of any industry in the U.S. There.  That seems about right. What makes me utter such a bold statement?  Experience.  I regularly hear the following from people when they come to my practice:

Three (and a half) years ago, when I left my old practice, I was near burnout.  I was exhausted, not because of the amount of time I was spending -- it was actually about the same, if not less than I had worked before -- but because of an ever-increasing gulf between me and my patients.  I have always tried to give care that focused on the person with me ...

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I had a patient last week who was a real pain in the ass.  Wait.  No.  He was actually a really nice guy.  He wasn't a pain in the ass; he had a real pain in the ass.  Literally. I was initially concerned about a pilonidal cyst, given the unfortunate fact that he was previously afflicted with this condition (which I consider to be incontrovertible proof of Satan).  But, fortunately to ...

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2015 was a hard year for my father.  He's a remarkably healthy 89 year old, with no diabetes, no hypertension, and (most importantly) he's got a sharper mind than I do on most days.  Perhaps that's a low bar to cross, but it's pretty good for him.  I think this is from all the crossword puzzles he's done over the years. Dad's troubles started around the middle of the year when ...

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October 1, 2015 is a huge day to the medical community.  It is a day that will live in infamy.  It is the object of dread, of diaphoresis, of doom.  October 1 is ICD-10 day.  This view was further bolstered when I went to the CMS (Government Medicare) website; there was actually a doomsday countdown timer at the top of the page. For those still unaware, ICD-10 is the 10th iteration of ...

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I recently attended (and spoke at) the Concierge Medicine Assembly in Atlanta.  My role was to give the perspective of a "successful" direct primary care (DPC) practice.  This being the second such conference in three weeks, I've learned that my panel of 600+ patients and survival for two and a half years puts me in the higher ranks of solo DPC practices.  The Atlanta conference was actually a combination conference, catering to ...

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shutterstock_138982304 I got a call from a patient who had a family member sick and in the ICU.  She wondered if I could come over "to offer support."  Even though the family member wasn't a patient, I thought it would be good to go. The ICU brought on flashbacks to my residency years, in which I spent a lot of time in the ICU. ...

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