Your Doctor And You: Contemporary Changes To The Doctor Patient Relationship

Your doctor and you together form a vital alliance for your health.

This relationship, like any, is going through some changes due to outside pressure from societal changes. Here are two main topics to discuss:


Yelp Reviews
As someone, a drug rep, said in the break room, during our discussion, 'You don't even need to look to ads to find a restaurant. You just say what region you are in, and look at Yelp, and go by the reviews.'

I scanned the room. Not one but TWO caregivers with awful reviews were present. I enjoy working with them both. And I acted dumb. I said, 'Does anyone really look at those reviews on themselves online, anyway? I do, but there is nothing there for me.'

They both had.

One--who is an oral surgeon who has Yelp reviews saying everything from he is too old to practice to he's in it only for the money--mentioned that once those reviews are up there is nothing you can do. There is no defense. He says his office really works on the wait times, because that is important to people. What he didn't know is I changed my plans for my son's oral surgery procedure to another specialist my orthodontist friend referred because of those online reviews--they were scathing, and I didn't want to take a chance with my son, even through I've known and adored working with this dental surgeon for years...and seen his skills in the O.R. as I anesthetize his patients.

The other, an OB-Gyn, was on call and cross covering for her colleague, who warned that a certain patient had drug-seeking behavior. (That's when people will lie and cheat and do anything to get a prescription for more pain meds). Sure enough, the patient called the physician, the physician did exactly what their colleague said to do with these patients, and the result is now online forever--she didn't even see me, I had so much pain, she is the worst doctor, she was rude, etc, etc.

When I was a professor, we were routinely evaluated by our students. The students did not know how critical it was to our advancement that we had 'good evaluations'. However, it was known by the department that some students are rather vindictive--so if there was a 2 or lower with no evidence to support it, the score was dropped from our permanent records. It was policy to counteract vindictiveness on the part of the students in the anesthesia program.

Often, it is because there is request for compensation for services rendered that lead to bad Yelp reviews on physicians, and other health providers. I follow them, but with a grain of salt. For example, in my choice of doctors for my thyroid, the one I wanted had reviews about the wait and the ease of making appointments. I thought against my initial choice because I didn't want to have trouble being seen.

In everything, use your intuition, your inner guidance, and heart.

Remember ridicule is one of the most potent weapons in the arsenal of the dark forces on the planet.


Obamacare
This is based on what I have overheard in the doctor's lounge and the doctor's dining room--
payments are now seventy percent of Medicare.

As you know, in certain parts of the country, the southwest/Arizona areas in particular, where due to the inability to make enough money to support a practice, many primary care doctors are REFUSING to accept Medicare patients. The retirees in those areas must drive three hours to Las Vegas to see a doctor.

And this is at Medicare Rates.

Apparently the Gold, Silver and Bronze 'levels' of Obamacare correspond to 'how much copayment the patient pays you'.

And there is concern about reimbursement due to the nature of the very high deductibles with the plan.

Hospital administration has encouraged participating physicians to 'collect the co-payment before seeing the patient'. This is because many patients do not pay their bills, and it goes to collection, which is expensive and doesn't always produce compensation.

Now there is a 'strategy' of sorts, where the smart doctors don't submit the billing until the patient has met their deductible--which they won't pay. Then they submit it. And all the other doctors who have submitted billing before are on the hook trying to find how to get the deductible actually paid to them.

It is a disaster in the making.

I also know with declining reimbursements, care is getting more limited. The gastroenterologist and I make about the same with, for example, a procedure such as upper GI endoscopy. But over there, a case I was assigned to, I got told to 'go for a coffee break' because the patient's insurance had denied anesthesia in favor of nurse conscious sedation. Either way, I didn't get paid. At least by not doing the case I did not expose myself to risk of something else going on with the patient that could lead to malpractice.

Every doctor taking care of a patient always is making a subtle assessment of benefit versus risk of treatment to the patient; what the patient does not know, is that at the same time, the doctor is weighing the benefit to risk of being sued by that patient at the same time. Every interaction opens up the risk for malpractice, even when the physician does not get paid. When the risk is too great the physician will refer out to another colleague and decline to treat the patient. Some patients are at very high risk for complications, and as the likely outcome is estimated, the physician decides that course to take for both of them.

I call this the 'post-wallet biopsy' era in medicine--those days of 'wallet-biopsy' are long over, and survival of the practice is now the number one factor on the physician's mind; mind you, there are lots of HMO's and big box organizations that are waiting in the wings for the practice to fail, to step in, and buy out the practice, making the physician an employee.


I hope you don't mind seeing it from inside the system.

Now it's time for some breakfast! I'm hungry.

P.S. BTW, there is a psychic who is coming to the area. Her readings are one hundred dollars and hour on the phone and two hundred dollars and hour in person. This is way more than an office visit would be paid in cash--it's about sixty-five dollars to see a physician, of course, it's a different kind of personal, and doesn't take an hour. It's about twenty minutes.


Aloha and Mahalos,
Namaste,

Reiki Doc

You Are My Life by Michael Jackson

http://youtu.be/YMcBmZw5Kh8

Spirit Has A Sense Of Humor On The Solstice

This morning I wrote about something sad.

Today Spirit cheered me up big time!

Mama 'Floor', our housekeeping staff in the O.R., stopped me on my way in and said, 'I have something to tell you. Remember yesterday, how we talked about, you-know-him?'

I didn't have any idea who.

'You know, that surgeon? Him?' she gestured with her hands and looked like she had a big secret to spill.

I pretended like I knew.

She said one day about four years ago, in the Doctors Lounge, this same surgeon expressed openly to the room, 'there is this new doctor. I really like her a lot and I might be interested in her--but she is a Lesbian!' And the whole room said, 'yes, right, don't mess with that! Leave her be.'

Then I recalled yesterday's conversation. There is a surgeon who was just divorced when I started work.  He was attracted to me. But as someone new to work, and as a single mother, the risk of having a relationship, or even worse, have it end badly in the workplace was too much for me to even consider. I had to think of something quick before he asked me out.

I made him think I was gay.

I dropped the hint on purpose to let him come to the conclusion I preferred women!

And it worked! He left me alone. : ) we were able to work together ever since with no problem.

As I shared this, Mama 'Floor' nodded and said, 'that was smart!'

This morning she wanted me to know she had overheard his original conversation in the doctor's lounge, to let them know just how effective my plan was!

To protect both of our anonymity , let us call him 'Dr. Joe L.'

I worked with him yesterday, and also was scheduled today.

Yesterday I watched with interest as he worked. There was some bleeding and he had to reopen the wound. He reached for the surgical clip stapler and I, having had done a significant amount of surgery myself in my own training, thought, oh no that won't work--you are going to need a stick tie!  (this is when you sew through the bleeder and tie a knot about it).

No sooner had I THOUGHT it did he say, 'Wait, I need a suture!' and he did a stick tie!

The only person I told about that was my friend, Margaret, over lunch. She is one of my teachers, and she thought the telepathy was cool. She approved.

Today, as we started the case, I reached up and turned off the radio because he doesn't like music in the O.R.

Then he started to talk. His editor (he is an author) finished editing his book. It had taken a year. It will be published this August and available at all bookstores. The title is Conquering Cancer. It has information in a true Integrative Medicine manner about all treatments of cancer. He shared that eighty-five percent of all cancer is preventable: it is due to alcohol, tobacco, environmental causes. As a general surgeon and son of a surgeon he was shocked! He is also reading Eckhardt Tolle, The Power Of Now. He says it is brilliant.

I shared just a bit, that I am into 'that stuff' too. I asked what his favorite type of alternative healing is for cancer?

He said there are a million of them.

I wasn't sure whether to share or not. Then he said he had been to both hospitals he works at, and spoken with management about forming a department of integrative medicine and was flatly refused! He was dumbfounded, and countered with, 'Do you KNOW that EVERY major cancer center in the COUNTRY has a department like this?!' Again, the answer to his request was 'no' and he gave up.

I shared how the CEO laughed the vegetarian surgeon out of the office when he approached her about having local community kids make a farm to grow vegetables for the hospital--or at least, to make organic food available in the cafeteria that was not full of GMO like what is served currently.

That's when I let down my guard. I said I do Reiki. That the circulator is my Reiki student. That I blog and have over 75,000 hits--I am a writer too and internationally known!

He was impressed. I also asked about his publisher. I said I had written a book, but I didn't want to publish it on Kindle because I wouldn't get an ISBN number.

He asked what the book was about? I said, 'Well, I am a little bit of a medium' and my patients who have crossed give me messages. I keep a journal with the messages, and typed it up into a book. I call it 'Messages From My Patients' and have published it one chapter at a time for free on the blog.

He said that any way you publish it you get the number. Even on Kindle.

Then I shared how I have already brought Reiki into the O.R. I said, see the nurse circulating? She is my Reiki student! (she nodded). I said, 'I finished writing it when Eben Alexander's book came out. He has like, one story. I have so much more!' (the RN nodded more vigorously, to emphasize the point. She is also a certified yoga instructor!)

I also shared how it is my passion to create a unified Healing which takes the best from all healing practices, and how I am not asking for permission but working on an energy level: I have sent energy healing to the hospital and O.R. every day without fail for four years!

He said, 'You can't do that! The hospital makes money on those health conditions that need surgery! How can you take the BUSINESS out of medicine?'

I said, 'It WILL happen and it is going to happen in my lifetime!'  with a smile!

It turns out his wife is  very 'into' this kind of thing. She has really changed him for the better. He says, sincerely, 'I used to be all in my mind (ed--I KNOW, I am psychic and empathic!), but now the thought of doing like Eckhart Tolle says and thinking with my heart is really exciting!'

He doesn't know that for all those years, whenever he would go into a rant in the operating room, I would stop giving Reiki to the patient and start giving Reiki to HIM! Bless you, Dr. Joe L., for being one of my early 'subjects'. When you got the Reiki you would calm down, every time, and never even know why or how it happened. I gave a LOT of Reiki to you in over the years! : )

But it is his wife I give credit for the incredible transformation of him on an energy level. She has done amazing work! How else could this conversation have occurred between surgeon and anesthesia? She is also a website designer (which I need) and something else too that is important that I hope Spirit would be sending me when the time is right.

After he left the O.R., everyone in the room did high fives because of this 'win' in Spirit.

As I wheeled the patient past the desk in PACU, I heard him on the phone with his wife--'You are not going to believe this! The ANESTHESIOLOGIST in the room....!'

Happy Summer Solstice!

Aloha and Namaste,

Reiki Doc

Doctors Make Bad Patients

Yesterday I called the allergist who is helping us sort through the many allergies and sinus infections my boy has been experiencing since last October. Without antibiotics, he relapses and gets a terrible sinus infection again. Even with a three week break just to see if his immunity would kick in over the holidays, he got sicker and sicker until asthma started to kick in. I had to take two weeks off from work. Unpaid leave. No one else could get his medications right and keep the asthma under control. It was also difficult since he would get afraid and cry, which made his asthma worse. I had to distract  him and keep him content.

We got an appointment. We had a three-thirty time. We showed up at three-ten; we were early.

You know that part at the front desk where they take your copayment and your insurance card? It is called, in the business, 'the wallet biopsy'. I have to fill out those forms just like you. I dislike it.

So we sat in the waiting room and waited. We waited long enough for my boy to give me back his iPad, he was that bored.

We went into the examination room, and waited. We waited an hour. The doctor was frustrated because the boy did not improve after three weeks of antibiotics were done. I also misunderstood the plan from last time, and did not schedule intradermal allergy testing during the three weeks of antibiotics. The plan was for sinus x-ray (CT scanning is actually better, per my ENT friends), blood test for immune deficiency (Ig A deficiency, Kartagener's disease would have that too--but also situs inversus), and spirometry (blowing on a tube to measure for asthma and other lung disease).

I explained politely that I work a lot. I have a hard time getting off from work. And would it be possible to get more antibiotics, because he can't stay home this week and is just going to get sicker while we sort these things out? I also asked, politely, if there was any way we could get the spirometry test done today too? We could wait.

And wait we did.

I got on the phone to call radiology at the adjacent hospital to see if I needed an appointment for the films or could walk in--while we waited for the spirometry technician, I was on hold so long I took the 'call back' option which is like FastPass at the Land. Once on the phone, I felt like I was in an alternate Universe. The radiology clerk kept thinking I was at some clinic five miles away.
No, I am LOOKING at the Hospital; it is within walking distance from the medical office I am in.

My boy had gone from spinning in the doctors' chair to jumping on the scale just outside the spirometry room. Ever since he heard the word 'blood test' and 'needle' he could not control himself and got pseudo ADD. I would say, 'Stop it' and he would say, 'okay' and then he would do exactly what I said to stop doing again three seconds later.

It was having to schedule the spirometry test six months ago that made us stop with the work-up.

It was the nature of my work, and the unpredictable hours, that made us go to Urgent Care as our Family Doctor (they combine both).

It wasn't until the owner of the urgent care started over-testing to make more money that we stopped going to Primary Care all together.

That's right. I don't have a doctor. I am a doctor, but due to my scheduling at work, and how doctors like to double-book three months in advance, I never have the chance to go when I am sick. I have not found a pediatrician for my son for that same reason. They want an 'initial visit' --read, two hundred dollars--before you can go to them when you are sick. It takes one hour and a whole day off from work! I fired them too. (Once I tried sending Dad--he couldn't fill out the questionnaires and didn't have a copy of the insurance card for our son. I pay for all of the medical care. All of it. Even though the court said he would pay half of all the medical expenses. How do you collect? Ew.)

At the hospital, at the x-ray booth, I had to fill out more forms and undergo a second 'wallet biopsy'. I initialed and signed almost as many times as I did when I bought my car. All the little highlighted spaces on things I simply did not read.

The x-ray tech was quick, but then stalled about thirty minutes on the computer, trying to contact the radiologist with telemedicine (to look at the film remotely), and also to send the report/call the office of our doctor. I had to go look at a picture of him to make sure it got sent to the right place. Then the blood draw lady was waiting for us when we got out. She was nice but made me sit in a chair across the room instead of touching my kid while she poked him. There was a series of colored dots randomly placed on the ceiling; when he screamed she said, 'Find the red dot!'. He was faster than anyone she had ever worked with, and ran out of dots before the procedure was done. She had to improvise.

After this, he wanted the cafeteria for dinner. Yup. More Hospital Food!

I am realizing that for Raw Vegans there are next to no food options out there in standardized places. As my son tied his shoes outside Starbucks in the morning, I scanned the menus on two restaurants next door--one fine food, another a pub. Every entree had meat. Or cheese. At Target for lunch, we were both starving. He took the last cheese pizza. The next one would have been seven minutes. We didn't have seven minutes. I took the pepperoni and picked the pepperoni off. At the cafeteria, I had spinach blend, which I hate RAW--spinach doesn't agree with me, garbanzos, beets, tomatoes, and carrots with oil and vinegar. None of it was organic. I took a yoplait lemon because I needed something. It was the sugar and not the sweetener kind. I couldn't join my son in burger, fries and coke. It just didn't appeal to  my appetite.

On the good side, all of the utensils and dinnerware were paper and recyclable.

Have you ever heard of a 'decree'? Here is a link explaining them. You can make them, too. Heaven listens, and the Universe provides. http://pleiadedolphininfos.blogspot.com/2013/04/andy-bojarski-create-your-world-through.html

I just made a decree for everyone to have a chance to heal using the best technology available in the Universe.

I like my job doing anesthesia. I love helping people. But in my heart of hearts, the entire health care system is in need of radical change.

No wonder why everyone wants Integrative Medicine and Alternative Medicine! The waits are interminable, the scheduling is too slow, and insurance is a nightmare!

Did you know that the family has retained an attorney to see to it that our mother's health care needs are met? A lawyer has to work against her health care system who is tired of spending money. She has been their patient in different facilities since the day after Christmas. She has almost died three times.

It's that bad.

So make a decree. Any decree. Stand back and wait for it to happen.

It will.

I guarantee it.

And while you are waiting, be sure to give yourself a great big hug from me and my boy and my family and mother. Thank you all for your caring support through these difficult times.

Namaste,

Reiki Doc