RE: Re: what do doctors actually do

[Guest guest]

Stirring the pot?... that is always fun!

.... caring for others, with absolute empathy, according to some Buddhist

principles, is the way to happiness. Among the living, the people who do

that most fully are most revered.

So, with that perspective, perhaps health-care is not a basic human need,

BUT providing care is. And perhaps the meaning of patient-doctor

relationship is useless compared to the profound interrelationship we all

have with each other.

;-)

we are all the ripple made when the pot is stirred.

Tim

> Health care is a basic human need, depends on how you define it.

> Certain christian sects would say wrong. It is not food and water. It

> is not shelter from the elements. How far do you take it?

>

> We are all in this to help people be the best they can be. You have to

> be careful of how you define the patient relationship nowadays also.

> Much is being done in chiropractor offices, mall clinics , and in the

> Emergency Room.

>

> Just stirring the pot a little to see what floats to the top.

> Bren

>

>>

>> i've been reading about the social burden of being a doctor and

> how it relates to low overhead practice with great interest.

>>

>> there are some underlying fundamental precepts i like to keep in

> mind when discussing these things.

>>

>> they are:

>>

>> health care is not a right or privilege; it is a basic human

> need, just like food, clothing and shelter. everybody needs it.

>>

>> good health care arises from a healthy doctor-patient

> relationship. the relationship facilitates healthy choices

> resulting in good outcomes.

>>

>> any framework surrounding the doctor-patient relationship must

> be defined by the needs of the doctor-patient relationship. form

> follows function.

>>

>> just my thoughts.

>>

>> LL

>>

>>

>> ---------------------------------

>> Yahoo! Travel

>> Find great deals to the top 10 hottest destinations!

>>

>

>

>

>

>

>

>

>

[Guest guest]

to clarify, these are the precepts i have in mind when i think of this subject. i am a westerner, trained in allopathic medicaine, living in 21st century united states of america, currently the richest and most powerful country on earth, with the greatest range of disparity of income and material benefits ever. you can cut the cake any way you want. oh, btw, i am an older white male, too. LOL LL" Malia, MD" wrote: Stirring the pot?... that is always fun!... caring for others, with absolute empathy, according to some Buddhistprinciples, is the way to happiness. Among the living, the people who dothat most fully are most revered.So, with that perspective, perhaps health-care is not a basic human

need,BUT providing care is. And perhaps the meaning of patient-doctorrelationship is useless compared to the profound interrelationship we allhave with each other.;-)we are all the ripple made when the pot is stirred.Tim> Health care is a basic human need, depends on how you define it.> Certain christian sects would say wrong. It is not food and water. It> is not shelter from the elements. How far do you take it?>> We are all in this to help people be the best they can be. You have to> be careful of how you define the patient relationship nowadays also.> Much is being done in chiropractor offices, mall clinics , and in the> Emergency Room.>> Just stirring the pot a little to see what floats to the top.> Bren> >>>> i've been reading about the social burden of being a doctor and> how it relates to low overhead practice with great interest.>>>> there are some underlying fundamental precepts i like to keep in> mind when discussing these things.>>>> they are:>>>> health care is not a right or privilege; it is a basic human> need, just like food, clothing and shelter. everybody needs it.>>>> good health care arises from a healthy doctor-patient> relationship. the relationship facilitates healthy choices> resulting in good outcomes.>>>> any framework surrounding the doctor-patient relationship must> be defined by the needs of the doctor-patient relationship. form> follows function.>>>> just my

thoughts.>>>> LL>>>>>> --------------------------------->> Yahoo! Travel>> Find great deals to the top 10 hottest destinations!>>>>>>>>>>

[Guest guest]

It is more blessed to give than receive. The basic core of being human is based on relationships. "No man is an island entire to himself." I believe that those of us who walk this road less traveled by have done so by necessity. Our prior practices took us out or lessened the relationship between doctor-patient. In our practices we bring that back. It benefits both doctor and patient. n" Malia, MD" wrote: Stirring the pot?... that is always fun!... caring for others, with absolute empathy, according to some Buddhistprinciples, is the way to happiness. Among the living, the people who dothat most fully are most revered.So, with that perspective, perhaps health-care is not a basic human need,BUT providing care

is. And perhaps the meaning of patient-doctorrelationship is useless compared to the profound interrelationship we allhave with each other.;-)we are all the ripple made when the pot is stirred.Tim> Health care is a basic human need, depends on how you define it.> Certain christian sects would say wrong. It is not food and water. It> is not shelter from the elements. How far do you take it?>> We are all in this to help people be the best they can be. You have to> be careful of how you define the patient relationship nowadays also.> Much is being done in chiropractor offices, mall clinics , and in the> Emergency Room.>> Just stirring the pot a little to see what floats to the top.> Bren> >>>> i've been reading

about the social burden of being a doctor and> how it relates to low overhead practice with great interest.>>>> there are some underlying fundamental precepts i like to keep in> mind when discussing these things.>>>> they are:>>>> health care is not a right or privilege; it is a basic human> need, just like food, clothing and shelter. everybody needs it.>>>> good health care arises from a healthy doctor-patient> relationship. the relationship facilitates healthy choices> resulting in good outcomes.>>>> any framework surrounding the doctor-patient relationship must> be defined by the needs of the doctor-patient relationship. form> follows function.>>>> just my thoughts.>>>>

LL>>>>>> --------------------------------->> Yahoo! Travel>> Find great deals to the top 10 hottest destinations!>>>>>>>>>>

[Guest guest]

Bringing our humanity back into the mechanized practice of medicine will inevitably draw attention from the public.  In an era of assembly line medicine and bottom line thinking, the caring physician who can break through the high volume, high overhead "rat race" will stand out.  Cutting out the less than altruistic forces that erode our sacred patient/physician relationship is key."In a time of universal deceit, telling the truth is a revolutionary act"  - OrwellLet's tell it like it is and get back to healing!  The time is now.  PamelaPamela Wible, MDFamily & Community Medicine, LLC3575 st. #220 Eugene, OR 97405roxywible@...www.idealmedicalpractice.orgOn Mar 21, 2006, at 4:57 PM, n Bobb-McKoy wrote: It is more blessed to give than receive. The basic core of being human is based on relationships.  "No man is an island entire to himself."  I believe that those of us who walk this road less traveled by have done so by necessity.  Our prior practices took us out or lessened the relationship between doctor-patient.  In our practices we bring that back.  It benefits both doctor and patient.   n" Malia, MD" wrote: Stirring the pot?... that is always fun!... caring for others, with absolute empathy, according to some Buddhistprinciples, is the way to happiness.  Among the living, the people who dothat most fully are most revered.So, with that perspective, perhaps health-care is not a basic human need,BUT providing care is.  And perhaps the meaning of patient-doctorrelationship is useless compared to the profound interrelationship we allhave with each other.;-)we are all the ripple made when the pot is stirred.Tim> Health care is a basic human need, depends on how you define it.> Certain christian sects would say wrong.  It is not food and water.   It> is not shelter from the elements.  How far do you take it?>> We are all in this to help people be the best they can be.  You have  to> be careful of how you define the patient relationship nowadays  also.> Much is being done in chiropractor offices, mall clinics ,  and in the> Emergency Room.>> Just stirring the pot a little to see what floats to the top.> Bren> >>>> i've been reading about the social burden of being a doctor and> how it relates to low overhead practice with great interest.>>>>   there are some underlying fundamental precepts i like to keep in> mind when discussing these things.>>>>   they are:>>>>   health care is not a right or privilege; it is a basic human> need, just like food, clothing and shelter.  everybody needs it.>>>>   good health care arises from a healthy doctor-patient> relationship.  the relationship facilitates healthy choices> resulting in good outcomes.>>>>   any framework surrounding the doctor-patient relationship must> be defined by the needs of the doctor-patient relationship.  form> follows function.>>>>   just my thoughts.>>>>   LL>>>>>> --------------------------------->> Yahoo! Travel>>  Find  great deals to the top 10 hottest destinations!>>>>>>>>>>

[Guest guest]

RE being different.

Through bitter experience, I've noticed a few things:

1) Some pts just want what they want when they want it. You may not be able to "do your best for them" ie, they just want their antibiotic, etc. Perhaps they need to go somewhere else.

2) You really do NOT need to take care of the ENTIRE community, just a small percentage of it,

3) Most pts just want you to be there for them when they need you-- they don't really care about you, just them. You take care of them AND you. Then, you'll be able to be there for them as well.

Just my thoughts.

Dr Matt Levin

Re: Re: what do doctors actually do

Bringing our humanity back into the mechanized practice of medicine will inevitably draw attention from the public. In an era of assembly line medicine and bottom line thinking, the caring physician who can break through the high volume, high overhead "rat race" will stand out. Cutting out the less than altruistic forces that erode our sacred patient/physician relationship is key.

"In a time of universal deceit, telling the truth is a revolutionary act" - Orwell

Let's tell it like it is and get back to healing! The time is now.

Pamela

Pamela Wible, MD

Family & Community Medicine, LLC

3575 st. #220

Eugene, OR 97405

roxywible@...

www.idealmedicalpractice.org

It is more blessed to give than receive.

The basic core of being human is based on relationships. "No man is an island entire to himself." I believe that those of us who walk this road less traveled by have done so by necessity. Our prior practices took us out or lessened the relationship between doctor-patient. In our practices we bring that back. It benefits both doctor and patient.

n" Malia, MD" wrote:

Stirring the pot?... that is always fun!... caring for others, with absolute empathy, according to some Buddhistprinciples, is the way to happiness. Among the living, the people who dothat most fully are most revered.So, with that perspective, perhaps health-care is not a basic human need,BUT providing care is. And perhaps the meaning of patient-doctorrelationship is useless compared to the profound interrelationship we allhave with each other.;-)we are all the ripple made when the pot is stirred.Tim> Health care is a basic human need, depends on how you define it.> Certain christian sects would say wrong. It is not food and water. It> is not shelter from the elements. How far do you take it?>> We are all in this to help people be the best they can be. You have to> be careful of how you define the patient relationship nowadays also.> Much is being done in chiropractor offices, mall clinics , and in the> Emergency Room.>> Just stirring the pot a little to see what floats to the top.> Bren> >>>> i've been reading about the social burden of being a doctor and> how it relates to low overhead practice with great interest.>>>> there are some underlying fundamental precepts i like to keep in> mind when discussing these things.>>>> they are:>>>> health care is not a right or privilege; it is a basic human> need, just like food, clothing and shelter. everybody needs it.>>>> good health care arises from a healthy doctor-patient> relationship. the relationship facilitates healthy choices> resulting in good outcomes.>>>> any framework surrounding the doctor-patient relationship must> be defined by the needs of the doctor-patient relationship. form> follows function.>>>> just my thoughts.>>>> LL>>>>>> --------------------------------->> Yahoo! Travel>> Find great deals to the top 10 hottest destinations!>>>>>>>>>>

[Guest guest]

I think you are right. After all, we provide a service for the

patients. We can do a wonderful job but at the end of the day who is

there for us ? Our family. Let's not consider ourselves more important

than we actually are.

> RE being different.

>  

> Through bitter experience, I've noticed a few things:

>  

> 1)  Some pts just want what they want when they want it.  You may not

> be able to " do your best for them " ie, they just want their

> antibiotic, etc.  Perhaps they need to go somewhere else.

>  

> 2)  You really do NOT need to take care of the ENTIRE community, just

> a small percentage of it,

>  

> 3)  Most pts just want you to be there for them when they need you--

> they don't really care about you, just them.  You take care of them

> AND you.  Then, you'll be able to be there for them as well.

>  

> Just my thoughts.

>  

> Dr Matt Levin

>> Re: Re: what do doctors actually do

>>

>> Bringing our humanity back into the mechanized practice of medicine

>> will inevitably draw attention from the public.  In an era of

>> assembly line medicine and bottom line thinking, the caring physician

>> who can break through the high volume, high overhead " rat race " will

>> stand out.  Cutting out the less than altruistic forces that erode

>> our sacred patient/physician relationship is key.

>>

>> " In a time of universal deceit, telling the truth is a revolutionary

>> act "   - Orwell

>>

>> Let's tell it like it is and get back to healing!  The time is now.  

>>

>>

>> Pamela

>> Pamela Wible, MD

>> Family & Community Medicine, LLC

>> 3575 st. #220 

>> Eugene, OR 97405

>>

>> roxywible@...

>> www.idealmedicalpractice.org

>>

>>

>>

>>

>>

>>

>>

>>> It is more blessed to give than receive.

>>> The basic core of being human is based on relationships.  " No man is

>>> an island entire to himself. "   I believe that those of us who walk

>>> this road less traveled by have done so by necessity.  Our prior

>>> practices took us out or lessened the relationship between

>>> doctor-patient.  In our practices we bring that back.  It benefits

>>> both doctor and patient.

>>>  

>>> n

>>>

>>> " Malia, MD " wrote:

>>>> Stirring the pot?... that is always fun!

>>>>

>>>> ... caring for others, with absolute empathy, according to some

>>>> Buddhist

>>>> principles, is the way to happiness.  Among the living, the people

>>>> who do

>>>> that most fully are most revered.

>>>>

>>>> So, with that perspective, perhaps health-care is not a basic human

>>>> need,

>>>> BUT providing care is.  And perhaps the meaning of patient-doctor

>>>> relationship is useless compared to the profound interrelationship

>>>> we all

>>>> have with each other.

>>>>

>>>> ;-)

>>>> we are all the ripple made when the pot is stirred.

>>>> Tim

>>>>

>>>> > Health care is a basic human need, depends on how you define it.

>>>> > Certain christian sects would say wrong.  It is not food and

>>>> water.   It

>>>> > is not shelter from the elements.  How far do you take it?

>>>> >

>>>> > We are all in this to help people be the best they can be.  You

>>>> have  to

>>>> > be careful of how you define the patient relationship nowadays 

>>>> also.

>>>> > Much is being done in chiropractor offices, mall clinics ,  and

>>>> in the

>>>> > Emergency Room.

>>>> >

>>>> > Just stirring the pot a little to see what floats to the top.

>>>> > Bren

>>>> >

>>>> >>

>>>> >> i've been reading about the social burden of being a doctor and

>>>> > how it relates to low overhead practice with great interest.

>>>> >>

>>>> >>   there are some underlying fundamental precepts i like to keep

>>>> in

>>>> > mind when discussing these things.

>>>> >>

>>>> >>   they are:

>>>> >>

>>>> >>   health care is not a right or privilege; it is a basic human

>>>> > need, just like food, clothing and shelter.  everybody needs it.

>>>> >>

>>>> >>   good health care arises from a healthy doctor-patient

>>>> > relationship.  the relationship facilitates healthy choices

>>>> > resulting in good outcomes.

>>>> >>

>>>> >>   any framework surrounding the doctor-patient relationship must

>>>> > be defined by the needs of the doctor-patient relationship.  form

>>>> > follows function.

>>>> >>

>>>> >>   just my thoughts.

>>>> >>

>>>> >>   LL

>>>> >>

>>>> >>

>>>> >> ---------------------------------

>>>> >> Yahoo! Travel

>>>> >>  Find  great deals to the top 10 hottest destinations!

>>>> >>

>>>> >

>>>> >

>>>> >

>>>> >

>>>> >

>>>> >

>>>> >

>>>> >

[Guest guest]

I think you are right. After all, we provide a service for the

patients. We can do a wonderful job but at the end of the day who is

there for us ? Our family. Let's not consider ourselves more important

than we actually are.

> RE being different.

>  

> Through bitter experience, I've noticed a few things:

>  

> 1)  Some pts just want what they want when they want it.  You may not

> be able to " do your best for them " ie, they just want their

> antibiotic, etc.  Perhaps they need to go somewhere else.

>  

> 2)  You really do NOT need to take care of the ENTIRE community, just

> a small percentage of it,

>  

> 3)  Most pts just want you to be there for them when they need you--

> they don't really care about you, just them.  You take care of them

> AND you.  Then, you'll be able to be there for them as well.

>  

> Just my thoughts.

>  

> Dr Matt Levin

>> Re: Re: what do doctors actually do

>>

>> Bringing our humanity back into the mechanized practice of medicine

>> will inevitably draw attention from the public.  In an era of

>> assembly line medicine and bottom line thinking, the caring physician

>> who can break through the high volume, high overhead " rat race " will

>> stand out.  Cutting out the less than altruistic forces that erode

>> our sacred patient/physician relationship is key.

>>

>> " In a time of universal deceit, telling the truth is a revolutionary

>> act "   - Orwell

>>

>> Let's tell it like it is and get back to healing!  The time is now.  

>>

>>

>> Pamela

>> Pamela Wible, MD

>> Family & Community Medicine, LLC

>> 3575 st. #220 

>> Eugene, OR 97405

>>

>> roxywible@...

>> www.idealmedicalpractice.org

>>

>>

>>

>>

>>

>>

>>

>>> It is more blessed to give than receive.

>>> The basic core of being human is based on relationships.  " No man is

>>> an island entire to himself. "   I believe that those of us who walk

>>> this road less traveled by have done so by necessity.  Our prior

>>> practices took us out or lessened the relationship between

>>> doctor-patient.  In our practices we bring that back.  It benefits

>>> both doctor and patient.

>>>  

>>> n

>>>

>>> " Malia, MD " wrote:

>>>> Stirring the pot?... that is always fun!

>>>>

>>>> ... caring for others, with absolute empathy, according to some

>>>> Buddhist

>>>> principles, is the way to happiness.  Among the living, the people

>>>> who do

>>>> that most fully are most revered.

>>>>

>>>> So, with that perspective, perhaps health-care is not a basic human

>>>> need,

>>>> BUT providing care is.  And perhaps the meaning of patient-doctor

>>>> relationship is useless compared to the profound interrelationship

>>>> we all

>>>> have with each other.

>>>>

>>>> ;-)

>>>> we are all the ripple made when the pot is stirred.

>>>> Tim

>>>>

>>>> > Health care is a basic human need, depends on how you define it.

>>>> > Certain christian sects would say wrong.  It is not food and

>>>> water.   It

>>>> > is not shelter from the elements.  How far do you take it?

>>>> >

>>>> > We are all in this to help people be the best they can be.  You

>>>> have  to

>>>> > be careful of how you define the patient relationship nowadays 

>>>> also.

>>>> > Much is being done in chiropractor offices, mall clinics ,  and

>>>> in the

>>>> > Emergency Room.

>>>> >

>>>> > Just stirring the pot a little to see what floats to the top.

>>>> > Bren

>>>> >

>>>> >>

>>>> >> i've been reading about the social burden of being a doctor and

>>>> > how it relates to low overhead practice with great interest.

>>>> >>

>>>> >>   there are some underlying fundamental precepts i like to keep

>>>> in

>>>> > mind when discussing these things.

>>>> >>

>>>> >>   they are:

>>>> >>

>>>> >>   health care is not a right or privilege; it is a basic human

>>>> > need, just like food, clothing and shelter.  everybody needs it.

>>>> >>

>>>> >>   good health care arises from a healthy doctor-patient

>>>> > relationship.  the relationship facilitates healthy choices

>>>> > resulting in good outcomes.

>>>> >>

>>>> >>   any framework surrounding the doctor-patient relationship must

>>>> > be defined by the needs of the doctor-patient relationship.  form

>>>> > follows function.

>>>> >>

>>>> >>   just my thoughts.

>>>> >>

>>>> >>   LL

>>>> >>

>>>> >>

>>>> >> ---------------------------------

>>>> >> Yahoo! Travel

>>>> >>  Find  great deals to the top 10 hottest destinations!

>>>> >>

>>>> >

>>>> >

>>>> >

>>>> >

>>>> >

>>>> >

>>>> >

>>>> >

[Guest guest]

At the risk of coming across as too heavy-duty, here are my thoughts on this

topic:

Our connection with each other--patients, family, colleagues, etc.--is beyond

what is physical. We serve a source that is unaffected by what happens to our

bodies, our lives. There is a level of energy, for lack of a better word, that

we sort of float over during the business of our lives. If we can teach

ourselves to quiet down our minds and allow that energy to rise, we can feel

that source. It is limitless, joyful and does not change based on what is

happening to us.

It is precisely the sense of disconnection to this source why our spiritual

brothers and sisters seek our services in our clinics. I believe that a

slowed-down practice is more likely able to minister to their spiritual wounds.

But only if we our relatively healed ourselves. This is, I believe, a part of

our quest--to help elevate each other, or, more accurately, lower each other to

feel that connection and influence a slight change. The change is an enhancement

of our conscious selves to feel our deeper selves. Self-awareness. Prayer,

meditation, art, work, whatever we lose ourselves in and feel joy through.

Our role as physicians is just that: a role.

We are infinitely more. Our other task is to discover that and celebrate it. And

to influence others to feel it, too.

I had a dream when I was 17 years old where I was told this exact message. There

were 30 other people in the same room. Any of you out there?

Occasionally, rarely, I sense with my patients that we were lead to each other

so that this process can happen. When this takes place, my role as physician,

acupuncturist, etc. suddenly feels unimportant. And the connection I share with

them gives me the reassurance that I am in the right place at the right time. I

trust that I am doing my best, and then I want to go to sleep. Feels good.

Charlie

New Mountain Medicine

lin, NC

Date: Tue Mar 21 21:37:47 CST 2006

To:

Subject: Re: what do doctors actually do

Your last line struck me as so true. Let's not consider ourselves

more important than we actually are.

I have been in the business for 15 plus years and have probably

truly saved in way of lives 30-50. Maybe more, it is a hard thing to

measure. Would these people be there if I had not, maybe not, maybe

so.

What we do in primary care is hard to put a value on in many ways.

How many amputations or heart attacks have I prevented? How many

caused? How many have I prevented from going on dialysis? How many

strokes prevented? I have no way of knowing.

If we take credit for every success , we must stare every failure in

the face and also acknowledge that. I believe it is better to be

very humble in our dealings with patients.

Brent

> >>>> >>

> >>>> >> i've been reading about the social burden of being a

doctor and

> >>>> > how it relates to low overhead practice with great interest.

> >>>> >>

> >>>> >>Â Â there are some underlying fundamental precepts i like

to keep

> >>>> in

> >>>> > mind when discussing these things.

> >>>> >>

> >>>> >>Â Â they are:

> >>>> >>

> >>>> >>Â Â health care is not a right or privilege; it is a basic

human

> >>>> > need, just like food, clothing and shelter. everybody

needs it.

> >>>> >>

> >>>> >>Â Â good health care arises from a healthy doctor-patient

> >>>> > relationship. the relationship facilitates healthy choices

> >>>> > resulting in good outcomes.

> >>>> >>

> >>>> >>Â Â any framework surrounding the doctor-patient

relationship must

> >>>> > be defined by the needs of the doctor-patient

relationship. form

> >>>> > follows function.

> >>>> >>

> >>>> >>Â Â just my thoughts.

> >>>> >>

> >>>> >>Â Â LL

> >>>> >>

> >>>> >>

> >>>> >> ---------------------------------

> >>>> >> Yahoo! Travel

> >>>> >> Find great deals to the top 10 hottest destinations!

> >>>> >>

> >>>> >

> >>>> >

> >>>> >

> >>>> >

> >>>> >

> >>>> >

> >>>> >

> >>>> >

[Guest guest]

Yes!  Agree!  It is SPIRITUAL our work.Analogy:  Can you imagine a priest inserting the following folks between himself and his suffering client:nursesecretaryinsurance agentpharmacy repEMR techieCPAAttorneyand then helping the client and managing the crowd above concurrently???We are healers.  It is spiritual work.  It is an honor.Our profession is degraded when money is the bottom line, speed/productivity is rewarded and countless people are shoved between ourselves and our patient.I spoke to my prior employer last night who I have a lot of respect for (even though he would have kept my bonus had I not pursued it).  He was intrigued by my financial #s regarding my current LOVE (Low Overhead Volume) model and his HOVE (high overhead volume) model.He wanted to clarify that I really bring in $112 or so per pt on average without "ancillaries" and I believe my "ancillaries" that I end up charging for (by time - more 99214s) are in the realm of spirituality, not an unnecessary set of labs or EKG (these thing were overordered at that clinic for $$$).Testing has its place.  Most folks come for healing and that is beyond the physical realm most of the time.Regarding $$$$ and the bottom line, my prior employer (near partner had I stayed) said that I would be making around 360K (like him) had I stayed with them as my #s were close to his on productivity. He did understand why the LOVE model appealed to me though.  I told him not all docs can see thrive in his model and he concurred.  It takes a certain personailty, charisma, skill to see high numbers of patients well and remain balanced as a human being.  We certainly are not providing for their spiritual needs in 10 minute visits with ancillary staff running in and out of the room and EKG machines beeping away in a frenzied atmosphere. I just do not see it happening.Our work is at its foundation - spiritual.PamelaPamela Wible, MDFamily & Community Medicine, LLC3575 st. #220 Eugene, OR 97405roxywible@...www.idealmedicalpractice.orgOn Mar 21, 2006, at 8:31 PM, wrote: At the risk of coming across as too heavy-duty, here are my thoughts on this topic: Our connection with each other--patients, family, colleagues, etc.--is beyond what is physical. We serve a source that is unaffected by what happens to our bodies, our lives. There is a level of energy, for lack of a better word, that we sort of float over during the business of our lives. If we can teach ourselves to quiet down our minds and allow that energy to rise, we can feel that source. It is limitless, joyful and does not change based on what is happening to us. It is precisely the sense of disconnection to this source why our spiritual brothers and sisters seek our services in our clinics. I believe that a slowed-down practice is more likely able to minister to their spiritual wounds. But only if we our relatively healed ourselves. This is, I believe, a part of our quest--to help elevate each other, or, more accurately, lower each other to feel that connection and influence a slight change. The change is an enhancement of our conscious selves to feel our deeper selves. Self-awareness. Prayer, meditation, art, work, whatever we lose ourselves in and feel joy through. Our role as physicians is just that: a role. We are infinitely more. Our other task is to discover that and celebrate it. And to influence others to feel it, too. I had a dream when I was 17 years old where I was told this exact message. There were 30 other people in the same room. Any of you out there? Occasionally, rarely, I sense with my patients that we were lead to each other so that this process can happen. When this takes place, my role as physician, acupuncturist, etc. suddenly feels unimportant. And the connection I share with them gives me the reassurance that I am in the right place at the right time. I trust that I am doing my best, and then I want to go to sleep. Feels good. Charlie New Mountain Medicine lin, NC Date: Tue Mar 21 21:37:47 CST 2006 To: Subject: Re: what do doctors actually do Your last line struck me as so true.  Let's not consider ourselves more important than we actually are.  I have been in the business for 15 plus years  and have probably truly saved in way of lives 30-50. Maybe more, it is a hard thing to measure.  Would these people be there if I had not, maybe not, maybe so.  What we do in primary care is hard to put a value on in many ways.  How many amputations or heart attacks have I prevented?  How many caused?  How many have I prevented from going on dialysis?  How many strokes prevented?  I have no way of knowing.  If we take credit for every success , we must stare every failure in the face and also acknowledge that.  I believe it is better to be very humble in our dealings with patients. Brent > >>>> >> > >>>> >> i've been reading about the social burden of being a doctor and > >>>> > how it relates to low overhead practice with great interest. > >>>> >> > >>>> >>   there are some underlying fundamental precepts i like to keep > >>>> in > >>>> > mind when discussing these things. > >>>> >> > >>>> >>   they are: > >>>> >> > >>>> >>   health care is not a right or privilege; it is a basic human > >>>> > need, just like food, clothing and shelter.  everybody needs it. > >>>> >> > >>>> >>   good health care arises from a healthy doctor-patient > >>>> > relationship.  the relationship facilitates healthy choices > >>>> > resulting in good outcomes. > >>>> >> > >>>> >>   any framework surrounding the doctor-patient relationship must > >>>> > be defined by the needs of the doctor-patient relationship.  form > >>>> > follows function. > >>>> >> > >>>> >>   just my thoughts. > >>>> >> > >>>> >>   LL > >>>> >> > >>>> >> > >>>> >> --------------------------------- > >>>> >> Yahoo! Travel > >>>> >>  Find  great deals to the top 10 hottest destinations! > >>>> >> > >>>> > > >>>> > > >>>> > > >>>> > > >>>> > > >>>> > > >>>> > > >>>> >

[Guest guest]

Yes I too have had the same question as to

how you can average $112 per visit when most docs are averaging around $50/visit

& of us those using EMR’s are about $75-$80/visit.  It still makes me

wonder if you are inadvertently submitting visits under a specialist code,

hospital place of service, something to cause a drastically higher

reimbursement.  I recall the example of another doc on the list that was

getting reimbursed something like $30+ for “venipuncture” vs the

normal $3.  It was then discovered that she was submitting those as “therapeutic

phlebotomy” codes rather than standard venipuncture (oops).  I just keep

hearing the old adage in my head: if it sounds too good to be true, then it

usually is.  Oh well, I can’t spend too much mental energy wondering

about other doc’s practices but it still makes me say:  hmmm how can that

be? 

Re: what do

doctors actually do

Your last line struck me as so true. Let's

not consider ourselves

more important than we actually are.

I have been in the business for 15 plus

years and have probably

truly saved in way of lives 30-50. Maybe more, it

is a hard thing to

measure. Would these people be there if I

had not, maybe not, maybe

so.

What we do in primary care is hard to put a value

on in many ways.

How many amputations or heart attacks have I

prevented? How many

caused? How many have I prevented from going

on dialysis? How many

strokes prevented? I have no way of

knowing.

If we take credit for every success , we must

stare every failure in

the face and also acknowledge that. I

believe it is better to be

very humble in our dealings with patients.

Brent

> >>>> >>

> >>>> >> i've been reading

about the social burden of being a

doctor and

> >>>> > how it relates to low

overhead practice with great interest.

> >>>> >>

> >>>> >>Â Â there are

some underlying fundamental precepts i like

to keep

> >>>> in

> >>>> > mind when discussing

these things.

> >>>> >>

> >>>> >>Â Â they are:

> >>>> >>

> >>>> >>Â Â health

care is not a right or privilege; it is a basic

human

> >>>> > need, just like food,

clothing and shelter. everybody

needs it.

> >>>> >>

> >>>> >>Â Â good

health care arises from a healthy doctor-patient

> >>>> > relationship.Â

the relationship facilitates healthy choices

> >>>> > resulting in good

outcomes.

> >>>> >>

> >>>> >>Â Â any

framework surrounding the doctor-patient

relationship must

> >>>> > be defined by the needs

of the doctor-patient

relationship. form

> >>>> > follows function.

> >>>> >>

> >>>> >>Â Â just my

thoughts.

> >>>> >>

> >>>> >>Â Â LL

> >>>> >>

> >>>> >>

> >>>> >> ---------------------------------

> >>>> >> Yahoo! Travel

> >>>> >>Â FindÂ

great deals to the top 10 hottest destinations!

> >>>> >>

> >>>> >

> >>>> >

> >>>> >

> >>>> >

> >>>> >

> >>>> >

> >>>> >

> >>>> >

[Guest guest]

Ahmen,

I am envious of those of you living this dream

already. This has been my heart's dream since

starting medicine to have the sacred opportunity for

human connection and possibly assistance for those who

cross our paths in life (patients or otherwise). I am

also happy for the positive energy (?spring inspired)

replacing some of the desperate/depressing energies we

had a while earlier.

I still have 3 months and 1 week of 20 pts/day

residency clinics to get through but just had an

inspiration to request an extra day of clinic with

only 10 patients per day and run it without an MA to

actually gain some practice and have some direction

from my faculty (our psychologist is an amazing

healer) in the LOVE model of practice. Imagine that:

residency training where the focus is not on learning

how to manage high volume in short time.

Happy Spring to All!

-Shay

--- pamela wible wrote:

> Yes! Agree! It is SPIRITUAL our work.

>

> Analogy: Can you imagine a priest inserting the

> following folks

> between himself and his suffering client:

>

> nurse

> secretary

> insurance agent

> pharmacy rep

> EMR techie

> CPA

> Attorney

>

> and then helping the client and managing the crowd

> above concurrently???

>

> We are healers. It is spiritual work. It is an

> honor.

> Our profession is degraded when money is the bottom

> line, speed/

> productivity is rewarded and countless people are

> shoved between

> ourselves and our patient.

>

> I spoke to my prior employer last night who I have a

> lot of respect

> for (even though he would have kept my bonus had I

> not pursued it).

> He was intrigued by my financial #s regarding my

> current LOVE (Low

> Overhead Volume) model and his HOVE (high overhead

> volume) model.

> He wanted to clarify that I really bring in $112 or

> so per pt on

> average without " ancillaries " and I believe my

> " ancillaries " that I

> end up charging for (by time - more 99214s) are in

> the realm of

> spirituality, not an unnecessary set of labs or EKG

> (these thing were

> overordered at that clinic for $$$).

>

> Testing has its place. Most folks come for healing

> and that is

> beyond the physical realm most of the time.

>

> Regarding $$$$ and the bottom line, my prior

> employer (near partner

> had I stayed) said that I would be making around

> 360K (like him) had

> I stayed with them as my #s were close to his on

> productivity. He did

> understand why the LOVE model appealed to me though.

> I told him not

> all docs can see thrive in his model and he

> concurred. It takes a

> certain personailty, charisma, skill to see high

> numbers of patients

> well and remain balanced as a human being. We

> certainly are not

> providing for their spiritual needs in 10 minute

> visits with

> ancillary staff running in and out of the room and

> EKG machines

> beeping away in a frenzied atmosphere. I just do not

> see it happening.

>

> Our work is at its foundation - spiritual.

>

>

> Pamela

>

>

> Pamela Wible, MD

> Family & Community Medicine, LLC

> 3575 st. #220

> Eugene, OR 97405

>

> roxywible@...

> www.idealmedicalpractice.org

>

>

>

>

> On Mar 21, 2006, at 8:31 PM,

> wrote:

>

> >

> > At the risk of coming across as too heavy-duty,

> here are my

> > thoughts on this topic:

> >

> > Our connection with each other--patients, family,

> colleagues, etc.--

> > is beyond what is physical. We serve a source that

> is unaffected by

> > what happens to our bodies, our lives. There is a

> level of energy,

> > for lack of a better word, that we sort of float

> over during the

> > business of our lives. If we can teach ourselves

> to quiet down our

> > minds and allow that energy to rise, we can feel

> that source. It is

> > limitless, joyful and does not change based on

> what is happening to

> > us.

> >

> > It is precisely the sense of disconnection to this

> source why our

> > spiritual brothers and sisters seek our services

> in our clinics. I

> > believe that a slowed-down practice is more likely

> able to minister

> > to their spiritual wounds. But only if we our

> relatively healed

> > ourselves. This is, I believe, a part of our

> quest--to help elevate

> > each other, or, more accurately, lower each other

> to feel that

> > connection and influence a slight change. The

> change is an

> > enhancement of our conscious selves to feel our

> deeper selves. Self-

> > awareness. Prayer, meditation, art, work, whatever

> we lose

> > ourselves in and feel joy through.

> >

> > Our role as physicians is just that: a role.

> >

> > We are infinitely more. Our other task is to

> discover that and

> > celebrate it. And to influence others to feel it,

> too.

> >

> > I had a dream when I was 17 years old where I was

> told this exact

> > message. There were 30 other people in the same

> room. Any of you

> > out there?

> >

> > Occasionally, rarely, I sense with my patients

> that we were lead to

> > each other so that this process can happen. When

> this takes place,

> > my role as physician, acupuncturist, etc. suddenly

> feels

> > unimportant. And the connection I share with them

> gives me the

> > reassurance that I am in the right place at the

> right time. I trust

> > that I am doing my best, and then I want to go to

> sleep. Feels good.

> >

> > Charlie

> > New Mountain Medicine

> > lin, NC

> >

> >

> >

> > Date: Tue Mar 21 21:37:47 CST 2006

> > To:

> > Subject: Re: what do

> doctors actually do

> >

> > Your last line struck me as so true. Let's not

> consider ourselves

> > more important than we actually are.

> > I have been in the business for 15 plus years and

> have probably

> > truly saved in way of lives 30-50. Maybe more, it

> is a hard thing to

> > measure. Would these people be there if I had

> not, maybe not, maybe

> > so.

> > What we do in primary care is hard to put a value

> on in many ways.

> > How many amputations or heart attacks have I

> prevented? How many

> > caused? How many have I prevented from going on

> dialysis? How many

> > strokes prevented? I have no way of knowing.

> >

> > If we take credit for every success , we must

> stare every failure in

> > the face and also acknowledge that. I believe it

> is better to be

> > very humble in our dealings with patients.

> > Brent

> >

> > > >>>> >>

> > > >>>> >> i've been reading about the social

> burden of being a

> > doctor and

> > > >>>> > how it relates to low overhead practice

> with great interest.

> > > >>>> >>

> > > >>>> >>Â Â there are some underlying

> fundamental precepts i like

> > to keep

> > > >>>> in

> > > >>>> > mind when discussing these things.

> > > >>>> >>

> > > >>>> >>Â Â they are:

> > > >>>> >>

> > > >>>> >>Â Â health care is not a right or

> privilege; it is a basic

> > human

> > > >>>> > need, just like food, clothing and

> shelter. everybody

> > needs it.

> > > >>>> >>

> > > >>>> >>Â Â good health care arises from a

> healthy doctor-patient

> > > >>>> > relationship. the relationship

> facilitates healthy choices

> > > >>>> > resulting in good outcomes.

> > > >>>> >>

> > > >>>> >>Â Â any framework surrounding the

> doctor-patient

> > relationship must

> > > >>>> > be defined by the needs of the

> doctor-patient

> > relationship. form

> > > >>>> > follows function.

> > > >>>> >>

> > > >>>> >>Â Â just my thoughts.

> > > >>>> >>

> > > >>>> >>Â Â LL

> > > >>>> >>

> > > >>>> >>

> > > >>>> >> ---------------------------------

> > > >>>> >> Yahoo! Travel

> > > >>>> >> Find great deals to the top 10

> hottest destinations!

> > > >>>> >>

> > > >>>> >

> > > >>>> >

> > > >>>> >

> > > >>>> >

> > > >>>> >

> > > >>>> >

> > > >>>> >

> > > >>>> >

[Guest guest]

Ahmen,

I am envious of those of you living this dream

already. This has been my heart's dream since

starting medicine to have the sacred opportunity for

human connection and possibly assistance for those who

cross our paths in life (patients or otherwise). I am

also happy for the positive energy (?spring inspired)

replacing some of the desperate/depressing energies we

had a while earlier.

I still have 3 months and 1 week of 20 pts/day

residency clinics to get through but just had an

inspiration to request an extra day of clinic with

only 10 patients per day and run it without an MA to

actually gain some practice and have some direction

from my faculty (our psychologist is an amazing

healer) in the LOVE model of practice. Imagine that:

residency training where the focus is not on learning

how to manage high volume in short time.

Happy Spring to All!

-Shay

--- pamela wible wrote:

> Yes! Agree! It is SPIRITUAL our work.

>

> Analogy: Can you imagine a priest inserting the

> following folks

> between himself and his suffering client:

>

> nurse

> secretary

> insurance agent

> pharmacy rep

> EMR techie

> CPA

> Attorney

>

> and then helping the client and managing the crowd

> above concurrently???

>

> We are healers. It is spiritual work. It is an

> honor.

> Our profession is degraded when money is the bottom

> line, speed/

> productivity is rewarded and countless people are

> shoved between

> ourselves and our patient.

>

> I spoke to my prior employer last night who I have a

> lot of respect

> for (even though he would have kept my bonus had I

> not pursued it).

> He was intrigued by my financial #s regarding my

> current LOVE (Low

> Overhead Volume) model and his HOVE (high overhead

> volume) model.

> He wanted to clarify that I really bring in $112 or

> so per pt on

> average without " ancillaries " and I believe my

> " ancillaries " that I

> end up charging for (by time - more 99214s) are in

> the realm of

> spirituality, not an unnecessary set of labs or EKG

> (these thing were

> overordered at that clinic for $$$).

>

> Testing has its place. Most folks come for healing

> and that is

> beyond the physical realm most of the time.

>

> Regarding $$$$ and the bottom line, my prior

> employer (near partner

> had I stayed) said that I would be making around

> 360K (like him) had

> I stayed with them as my #s were close to his on

> productivity. He did

> understand why the LOVE model appealed to me though.

> I told him not

> all docs can see thrive in his model and he

> concurred. It takes a

> certain personailty, charisma, skill to see high

> numbers of patients

> well and remain balanced as a human being. We

> certainly are not

> providing for their spiritual needs in 10 minute

> visits with

> ancillary staff running in and out of the room and

> EKG machines

> beeping away in a frenzied atmosphere. I just do not

> see it happening.

>

> Our work is at its foundation - spiritual.

>

>

> Pamela

>

>

> Pamela Wible, MD

> Family & Community Medicine, LLC

> 3575 st. #220

> Eugene, OR 97405

>

> roxywible@...

> www.idealmedicalpractice.org

>

>

>

>

> On Mar 21, 2006, at 8:31 PM,

> wrote:

>

> >

> > At the risk of coming across as too heavy-duty,

> here are my

> > thoughts on this topic:

> >

> > Our connection with each other--patients, family,

> colleagues, etc.--

> > is beyond what is physical. We serve a source that

> is unaffected by

> > what happens to our bodies, our lives. There is a

> level of energy,

> > for lack of a better word, that we sort of float

> over during the

> > business of our lives. If we can teach ourselves

> to quiet down our

> > minds and allow that energy to rise, we can feel

> that source. It is

> > limitless, joyful and does not change based on

> what is happening to

> > us.

> >

> > It is precisely the sense of disconnection to this

> source why our

> > spiritual brothers and sisters seek our services

> in our clinics. I

> > believe that a slowed-down practice is more likely

> able to minister

> > to their spiritual wounds. But only if we our

> relatively healed

> > ourselves. This is, I believe, a part of our

> quest--to help elevate

> > each other, or, more accurately, lower each other

> to feel that

> > connection and influence a slight change. The

> change is an

> > enhancement of our conscious selves to feel our

> deeper selves. Self-

> > awareness. Prayer, meditation, art, work, whatever

> we lose

> > ourselves in and feel joy through.

> >

> > Our role as physicians is just that: a role.

> >

> > We are infinitely more. Our other task is to

> discover that and

> > celebrate it. And to influence others to feel it,

> too.

> >

> > I had a dream when I was 17 years old where I was

> told this exact

> > message. There were 30 other people in the same

> room. Any of you

> > out there?

> >

> > Occasionally, rarely, I sense with my patients

> that we were lead to

> > each other so that this process can happen. When

> this takes place,

> > my role as physician, acupuncturist, etc. suddenly

> feels

> > unimportant. And the connection I share with them

> gives me the

> > reassurance that I am in the right place at the

> right time. I trust

> > that I am doing my best, and then I want to go to

> sleep. Feels good.

> >

> > Charlie

> > New Mountain Medicine

> > lin, NC

> >

> >

> >

> > Date: Tue Mar 21 21:37:47 CST 2006

> > To:

> > Subject: Re: what do

> doctors actually do

> >

> > Your last line struck me as so true. Let's not

> consider ourselves

> > more important than we actually are.

> > I have been in the business for 15 plus years and

> have probably

> > truly saved in way of lives 30-50. Maybe more, it

> is a hard thing to

> > measure. Would these people be there if I had

> not, maybe not, maybe

> > so.

> > What we do in primary care is hard to put a value

> on in many ways.

> > How many amputations or heart attacks have I

> prevented? How many

> > caused? How many have I prevented from going on

> dialysis? How many

> > strokes prevented? I have no way of knowing.

> >

> > If we take credit for every success , we must

> stare every failure in

> > the face and also acknowledge that. I believe it

> is better to be

> > very humble in our dealings with patients.

> > Brent

> >

> > > >>>> >>

> > > >>>> >> i've been reading about the social

> burden of being a

> > doctor and

> > > >>>> > how it relates to low overhead practice

> with great interest.

> > > >>>> >>

> > > >>>> >>Â Â there are some underlying

> fundamental precepts i like

> > to keep

> > > >>>> in

> > > >>>> > mind when discussing these things.

> > > >>>> >>

> > > >>>> >>Â Â they are:

> > > >>>> >>

> > > >>>> >>Â Â health care is not a right or

> privilege; it is a basic

> > human

> > > >>>> > need, just like food, clothing and

> shelter. everybody

> > needs it.

> > > >>>> >>

> > > >>>> >>Â Â good health care arises from a

> healthy doctor-patient

> > > >>>> > relationship. the relationship

> facilitates healthy choices

> > > >>>> > resulting in good outcomes.

> > > >>>> >>

> > > >>>> >>Â Â any framework surrounding the

> doctor-patient

> > relationship must

> > > >>>> > be defined by the needs of the

> doctor-patient

> > relationship. form

> > > >>>> > follows function.

> > > >>>> >>

> > > >>>> >>Â Â just my thoughts.

> > > >>>> >>

> > > >>>> >>Â Â LL

> > > >>>> >>

> > > >>>> >>

> > > >>>> >> ---------------------------------

> > > >>>> >> Yahoo! Travel

> > > >>>> >> Find great deals to the top 10

> hottest destinations!

> > > >>>> >>

> > > >>>> >

> > > >>>> >

> > > >>>> >

> > > >>>> >

> > > >>>> >

> > > >>>> >

> > > >>>> >

> > > >>>> >