As a West Point graduate, I have applied learnings from the Academy during my career as a Family Physician.
Duty, Honor, Country. The motto of West Point resonates in my brain and challenges my heart frequently. What is my Duty? What is the Honorable thing to do, or not do? How do I best serve my Country?
When I ask myself these questions, I often refer to the Cadet Prayer for clarification and connection to God.
"O God, our Father, Thou Searcher of human hearts, help us to draw near to Thee in sincerity and truth. May our religion be filled with gladness and may our worship of Thee be natural.
Strengthen and increase our admiration for honest dealing and clean thinking, and suffer not our hatred of hypocrisy and pretence ever to diminish. Encourage us in our endeavor to live above the common level of life. Make us to choose the harder right instead of the easier wrong, and never to be content with a half truth when the whole can be won. Endow us with courage that is born of loyalty to all that is noble and worthy, that scorns to compromise with vice and injustice and knows no fear when truth and right are in jeopardy. Guard us against flippancy and irreverence in the sacred things of life. Grant us new ties of friendship and new opportunities of service. Kindle our hearts in fellowship with those of a cheerful countenance, and soften our hearts with sympathy for those who sorrow and suffer. Help us to maintain the honor of the Corps untarnished and unsullied and to show forth in our lives the ideals of West Point in doing our duty to Thee and to our Country. all of which we ask in the name of the Great Friend and Master of all."
This post is an introduction to a series of posts titled "Duty, Honor, Doctor."
Sunday, October 12, 2014
Saturday, October 11, 2014
Family Medicine: Are We there Yet?
I celebrate the youth and energy of our new and future leaders of Family Medicine. You have the reigns. The AAFP meeting in Washington, DC launches the next phase of the transformation of Family Medicine. Health Is Primary. Energy will abound. Direction will be agreed. Movement will continue. Then we will say, "We have arrived."
NOT!
We never quite "arrive" because our patients never quite "arrive". We are with them or we don't feel like Family Physicians.
We may be content about our near "arrival" for a moment and then remember patients who haven't "arrived" yet. We lament their situation. This "unsatisfied contentment" is a point of pride in Family Medicine. The celebrations are short lived because we feel obligated to help more people. Fairness is important to us. People are important to us.
Even more than statins, bonuses, quality initiatives, CT scans, EMR's, etc.
People, People, People.
Patients, Patients, Patients.
What do you think?
NOT!
We never quite "arrive" because our patients never quite "arrive". We are with them or we don't feel like Family Physicians.
We may be content about our near "arrival" for a moment and then remember patients who haven't "arrived" yet. We lament their situation. This "unsatisfied contentment" is a point of pride in Family Medicine. The celebrations are short lived because we feel obligated to help more people. Fairness is important to us. People are important to us.
Even more than statins, bonuses, quality initiatives, CT scans, EMR's, etc.
People, People, People.
Patients, Patients, Patients.
What do you think?
Friday, October 10, 2014
Family Medicine: October
October in Family Medicine in Ohio brings another set of problems to the office. The new Medicare year starts October 1. Typically, on the business side of the practice, Medicare makes changes that result in delayed payments for a couple months. Cash flow gets stuck.
The ragweed season downshifts to the damp and moldy season outdoors and dust and mold indoors. Somehow allergies beget acid reflux and respiratory infections, aided by the start of the school year which traps coughing children in tight quarters. Upper respiratory infections sometimes make too much mucous to be tolerable and inability to breathe through the nose which causes insomnia. The URI finds the lungs and adds lower respiratory tract infection to the code list. Then the cough lasts 12-15 days, which can be really annoying (and good for business).
Added problems this October include the FDA labeling hydrocodone a Schedule II drug which makes it similar to Oxycodone in how we have to handle it. One month at a time. Patients no longer get any refills on the hydrocodone pain meds and they have to see us once monthly to get evaluated and prescribed again.
Flu shots are on more patient's minds since the threat of the Ebola virus is looming. Airport workers may become more concerned about the Ebola uncertainty as they process passengers from Africa.
Welcome to October.
The ragweed season downshifts to the damp and moldy season outdoors and dust and mold indoors. Somehow allergies beget acid reflux and respiratory infections, aided by the start of the school year which traps coughing children in tight quarters. Upper respiratory infections sometimes make too much mucous to be tolerable and inability to breathe through the nose which causes insomnia. The URI finds the lungs and adds lower respiratory tract infection to the code list. Then the cough lasts 12-15 days, which can be really annoying (and good for business).
Added problems this October include the FDA labeling hydrocodone a Schedule II drug which makes it similar to Oxycodone in how we have to handle it. One month at a time. Patients no longer get any refills on the hydrocodone pain meds and they have to see us once monthly to get evaluated and prescribed again.
Flu shots are on more patient's minds since the threat of the Ebola virus is looming. Airport workers may become more concerned about the Ebola uncertainty as they process passengers from Africa.
Welcome to October.
Friday, September 26, 2014
Patients and Family Doctors
Where are we doctors without you?
You are a health expert. You know how to get sick.
You know how to take care of your self.
Up to a point.
You know our office staff.
You know our magazines.
You know Dr Google and Web MD
You do self care well.
Up to a point.
You know your story.
You know your support system.
You know how you cope with illness and adversity.
You know what we do.
Up to a point.
We know our medical system.
We know how to doctor.
We know how to care.
We know how to comfort.
Up to a point.
We know medicines.
We know hospitals.
We know other specialists.
We know laboratories.
We know imaging centers.
Up to a point.
We know that you matter.
We know that you may need help when you're ill.
We know how to listen to your story.
We know how to validate your worth.
Up to a point.
Together, we find meaning.
For our lives.
For our illnesses.
For our coping strategies.
For our ultimate demise.
Up to a point.
We comfort each other.
We honor each other
We confide in each other.
In our own way.
Up to a point.
At the point of connection.
At the point of respect.
At the point of shared humanity.
At the point of wholehearted contentment.
At the point of God's Creation
Within which we share as patient and doctor,
Human and human, teacher and learner,
learner and teacher, steward and steward.
Heart to heart.
There is a piece of God.
You know your story.
You know your support system.
You know how you cope with illness and adversity.
You know what we do.
Up to a point.
We know our medical system.
We know how to doctor.
We know how to care.
We know how to comfort.
Up to a point.
We know medicines.
We know hospitals.
We know other specialists.
We know laboratories.
We know imaging centers.
Up to a point.
We know that you matter.
We know that you may need help when you're ill.
We know how to listen to your story.
We know how to validate your worth.
Up to a point.
Together, we find meaning.
For our lives.
For our illnesses.
For our coping strategies.
For our ultimate demise.
Up to a point.
We comfort each other.
We honor each other
We confide in each other.
In our own way.
Up to a point.
At the point of connection.
At the point of respect.
At the point of shared humanity.
At the point of wholehearted contentment.
At the point of God's Creation
Within which we share as patient and doctor,
Human and human, teacher and learner,
learner and teacher, steward and steward.
Heart to heart.
There is a piece of God.
Tuesday, September 23, 2014
Humans and Tech: Will it Work for Family Medicine?
"By People, For People" Velocity NY 2014 Keynote by Tim O'Reilly. Tim gives a great message about the human element in tech starting with healthcare.gov. We can learn a lot about the human element, leadership and tech from him.
Is this the message for Family Medicine. Get back on the horse and reconnect the human aspects of health care?
Will IT listen? I believe the people in IT will. Let's hug IT folks and move ahead together. The Human Centered Health Home (HCHH) is an example of how to apply human centering in patient care. Search this blog site for my many posts about it. One point in human centering is that we are all in this together. Human to human we can Respect, Protect, Connect, Detect, Correct our situations and Reflect on them individually and together. Posts to Define HCHH
Hug IT now! You may come up with something as good as Elation EMR (www.elationemr.com) which allows human elements of the encounter to come out. They have very helpful humans like Vanessa Rodgers and Drew Varady in their company, too, which is the essence of what Tim O'Reilly discusses above.
Hug IT now! It's time to move ahead together. Family Medicine will use it well if we develop it well. If we wait for someone else to do it, we may lose. We have the heart that the electronic part of medicine needs. Let's take the next step to prove it. Dive into an EMR and give it a heart if it's missing. Get connected to high tech, low price front line health care items, like the cell phone ecg and have more fun than you can stand.
High Tech, High Touch. Sounds like Family Medicine to me.
Hug IT now!
Is this the message for Family Medicine. Get back on the horse and reconnect the human aspects of health care?
Will IT listen? I believe the people in IT will. Let's hug IT folks and move ahead together. The Human Centered Health Home (HCHH) is an example of how to apply human centering in patient care. Search this blog site for my many posts about it. One point in human centering is that we are all in this together. Human to human we can Respect, Protect, Connect, Detect, Correct our situations and Reflect on them individually and together. Posts to Define HCHH
Hug IT now! You may come up with something as good as Elation EMR (www.elationemr.com) which allows human elements of the encounter to come out. They have very helpful humans like Vanessa Rodgers and Drew Varady in their company, too, which is the essence of what Tim O'Reilly discusses above.
Hug IT now! It's time to move ahead together. Family Medicine will use it well if we develop it well. If we wait for someone else to do it, we may lose. We have the heart that the electronic part of medicine needs. Let's take the next step to prove it. Dive into an EMR and give it a heart if it's missing. Get connected to high tech, low price front line health care items, like the cell phone ecg and have more fun than you can stand.
High Tech, High Touch. Sounds like Family Medicine to me.
Hug IT now!
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