I really like Van Morrison.  If I need to be lifted up on a Friday afternoon I'll play a greatest hits album and will quickly be smiling.  One of my favorite songs is Days Like This. You would expect when someone says "there will be days like this," they are complaining about days when everything goes wrong and you just have to endure to the end, hoping that "the sun comes up ...

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I recently went hiking in a beautiful national park outside of Columbia, SC. This park was in a swampy area and contained all sorts of wildlife (called “critters” down here) and plant life (called “trees and those other things” down here). When I was young, my dad would take us kids on hikes through the Adirondack Park in New York, and so being on hikes in nature hits my soul ...

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Hi, I’m Rob.  I’m a recovering doctor. Yeah, I know I used that line once before, but it’s a special day for me today.  Humor me.  Five years ago today I earned my last money from an insurance company.  Yep, today is my five-year sobriety date. Five years. That was before the Affordable Care Act, before the Cubs won the World Series.  Before anyone knelt for the national anthem, and ...

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The consultant note read:

Weight 250 lbs. BMI 40.3.  Patient is morbidly obese.  Counseled on the dangers of excess weight.  Counseled to increase exercise and decrease calories.
I walked into her room.  She smiled at me as I walked in, a lovely smile that reached her eyes.  I scanned her record.  She was in my office for an ankle injury.  Blood pressure normal.  Weight 248 lbs., BMI 40. When I looked back at ...

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"Wait. When did you say you started that medication?" "Two weeks ago." "And when did you say you started having those symptoms?" "Uh ... about ... let me think ... it was — two weeks ago." This kind of circumstance is my holy grail. It is the ultimate moment where I connect the dots. It has happened several times recently where patients have had chronic symptoms and have related to me that they have ...

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I was really anxious.  My father's legs were getting weaker and his pain was worsening.  He had been having pain for quite a while, and that pain was often disabling in its severity, but the weakness was alarming. Dad went to the neurosurgeon, who was also alarmed at the weakness, but didn't feel that the problem was surgical in nature.  When I heard this I broke one of my most tightly-held ...

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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:

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