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Myria,

I agree completely with you. I think it's very easy to criticize other providers, as Ellen did, and you're right, that's what causes lawsuits. I didn't bad-mouth those physicians to the patient, but it did seem extraordinary that four specialists in gastroenterology didn't recognize post-cholecystectomy diarrhea (caused by problems with bile resorption) when they heard the history. But then, that would have required listening to the history instead of running off to do another expensive, revenue-generating colonoscopy without actually helping the patient. The use of cholestyramine has cured the problem, so I really do believe it is post-chole (20% of gallbladder removals result in this irritation of the colon by excessive bile that isn't reabsorbed at the distal ileum). In that case, Activia won't help, and in fact, the patient has been taking a pro-biotic for years without results. The pattern of the diarrhea, which I didn't elaborate in the post, is definitely not IBS and definitely more like post-chole, also. She has no pain. Just sudden, explosive, watery diarrhea, especially right after she eats a fatty meal. Anyway.

What you said about the patient who said "you keep listening" is what I hear all day long. "Never had anyone ask me so many questions." "Wow, you're really thorough." Of course, taking two hours per patient, I'm not making much money yet, either.

And of course, I make mistakes, too. We all make mistakes. We're human. It's medicine, not physics. It isn't an exact science, even if you know everything there is to know.

I could sure put in some citations, but I didn't want to be overbearing, but maybe I will one of these days.

Thanks,

Deanna

Go Egly!

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> > 's question to Berwick made it to the forum. re: power

> and influence of big pharma and big hospitals.

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> > DB praised the question and the Eglys' practice.

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> > Maybe it was because my other line was ringing that I just could not

> string together much coherence in DB's answer.

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> > Help me out here, the answer I heard involved:

> > "some hosp led, some doctor led, some other (?)forms" ... will have

> input.

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> > What did anyone else glean from this phone conference with

> Berwick?

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> > Thanks,

> > Kathleen

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> > --

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> > PATIENTS-please remember that email may not be entirely secure, and

> that Email is part of the medical record and is placed into your chart

> ( be careful what you say!)

> > Email is best used for appointment making and brief questions

> > Email replies can be expected within 24 hours-Please CALL if the

> matter is more urgent .

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> > MD

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> > ph fax

> > impcenter.org

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> > --

> > PATIENTS-please remember that email may not be entirely secure, and

> that Email is part of the medical record and is placed into your chart

> ( be careful what you say!)

> > Email is best used for appointment making and brief questions

> > Email replies can be expected within 24 hours-Please CALL if the

> matter is more urgent .

> >

> >

> > MD

> >

> >

> > ph fax

> > impcenter.org

> >

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>

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