The janitor approached my office manager with a very worried expression.  "Uh, Brenda ..." he said, hesitantly. "Yes?" she replied, wondering what janitorial emergency was looming in her near future. "Uh ...well ... I was cleaning Dr. Lamberts' office yesterday and I noticed on his computer ..."  He cleared his throat nervously, "Uh ... his computer had something on it." "Something on his computer? You mean on top of the computer, or on ...

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She looked at me, eyes pleading, telling me without needing to say a word: I am not lying to you. I am not crazy. I am not making this up. I sighed. "We've done the work-up and know this is not your heart. I don't think there are a lot more tests that can be run." I studied her expression, trying to discern what she wanted to hear from me. I've come ...

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Sorry for the long gap between blog posts. I have been distracted by the volume of work that I have had to do.  Is that a good thing? Yes. Is it a bad thing?  Certainly. I recently heard an interview of Mark Cuban, the owner of the Dallas Mavericks basketball team, billionaire entrepreneur, and one of the "sharks" on the show "Shark Tank." The show involves entrepreneurs the opportunity to pitch ...

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Hi.  This is doctor Rob, and you have reached my blog.  If you are here to read my blog, then continue to do so.  If this is an emergency, please call 911. That is one of my pet-peeves.  Every single doctor's office I call I am told the same thing: "If this is a true emergency, please hang up and dial 911."  I even got that message when I called the ER. When I ...

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As an incurable compulsive introspect, I tend to brood, ponder, contemplate, and (of course) muse on "big ideas," such as:

  • What makes people choose things which cause themselves harm?
  • Are some people better people than others, or are they just more skilled at hiding their problems?
  • Is pain really a bad thing, or is our aversion to it a sign of human weakness?
  • Does God ever wear a hat?
  • Do dogs watch Oprah?
  • Why did I ...

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How's my practice doing? I am now up to nearly 400 patients, and while Jamie and I have talked about hiring a new staff person, we seem to be hitting our stride in this different practice model and have not yet been overwhelmed.  New patients are coming with regularity, some still coming from my old practice and many others through word-of-mouth from satisfied patients.  Yes, people still seem very satisfied with ...

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My older brother is also a doctor, but not a PCP like me.  He's a specialist: a limnologist.  If you have problems with blue-green algae in your lake, he's the man to see.  Limnology is the study of lakes, and fittingly, Bill works in the "Land of a Thousand Lakes" as a professor in fresh water ecology. I'm not sure he's thinking of switching over to direct-care limnology.  I've been afraid ...

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Lately I've gotten hooked on watching the reality TV show, the Deadliest Catch.  It's astounding to me what these guys go through to catch crab in the Bering Sea. One of the recurring themes on the show is the new crop of "greenhorns" -- new recruits to the profession of working crab boats -- that try to show they can hack "the world's most dangerous job" each year.  They often come with ...

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Things are going well with the practice, but I am being wrung a bit dry.  That's the reason for my dip in writing.  I am putting a lot of energy and emotion into the practice, and I don't have a whole lot left at the end of the day.  I have always been one to write out of passion and convictions -- I write because I believe what I am ...

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To what end? Those three words have become something of a mantra, a mission, a philosophy of care.

  • To what end do I prescribe a medication?
  • To what end do I make a diagnosis?
  • To what end do I order tests?
  • To what end am I documenting?
  • To what end is there a patient record?
  • To what end do I send a person to a specialist?
  • To what end do patients need to come to see me in ...

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