Re: Weirdest place for a medical visit.

March 9, 2011

Fred Meyers Parking Lot

That was for an elderly paranoid patient probably with UTI delirium who wouldn't

get out of her car. I used the scent of her car to intuit the probable symptoms

of urinary frequency (or at least incontinence) Kids took her keys but couldn't

get her to budge and called me to ask my advice. I stopped by the fred meyers

parking lot after the police came and went and assessed her and counseled the

son and daughter about what to do next. The patient called it " a mexican

standoff " . She eventual got hospitalized when she decompensated further.

It was an interesting experience. I billed it as a home visit (it was where her

bathroom was at least).

I didn't get paid by her ins (UHC) or by the patient but I would do it again

(for an established patient) even if I didn't need to shop at Fred Meyers

March 9, 2011

Well not weird place but situation...child with scorpion bite came to my clinic without car in Brazil ..with irregular heart rate...I placed him in my car and drove fast ( like an ambulance to the ER)..don't want to do again!

-- lia Leite- MDPalm Beach Hello Health

March 9, 2011

My examples are not really weird, but I do visits all over my community....at my

daughter's dance lessons, at the YMCA during my son's swim practices, at my

house (frequently!), in a hotel at a dance convention, in the grocery store, and

in my barn. I work 10-2:30 during the school year, and 9-1 during the summer,

and if one of my patients can't see me during those hours, we just figure out

where to meet. :-) It works for me...and my patients.

-- Jean

>

> I've tried the DMV and the YMCA. Oh, and grocery store.

> Almost did a pap under a tree outside the clinic when we

> had to evacuate after an earthquake.

>

> Anyone got a better story?

>

> I think Stew Mones did something in a parking lot when a

> patient locked herself in the car with like some kind of

> SWAT team assembled around the vehicle.

>

> Do share. I think this is what **really** separates us from the

> big box clinics.

>

> http://www.idealmedicalcare.org/blog/forget-the-er-try-the-dmv/

>

> ~ Pamela

>

> Pamela Wible, MD

> 3575 St. #220

> Eugene, OR 97405

>

> www.idealmedicalcare.org

>

March 9, 2011

Steve’s done web and phone visits

while we were on vacation in Cooke City, MT (with dial-up internet!), from Maui,

even from a cruise ship in the Carribbean.

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info

From: [mailto: ] On Behalf Of roxywible

Sent: Wednesday, March 09, 2011

12:44 AM

To:

Subject:

Weirdest place for a medical visit.

I've tried the DMV and the YMCA. Oh, and grocery store.

Almost did a pap under a tree outside the clinic when we

had to evacuate after an earthquake.

Anyone got a better story?

I think Stew Mones did something in a parking lot when a

patient locked herself in the car with like some kind of

SWAT team assembled around the vehicle.

Do share. I think this is what **really** separates us from the

big box clinics.

http://www.idealmedicalcare.org/blog/forget-the-er-try-the-dmv/

~ Pamela

Pamela Wible, MD

3575 St. #220

Eugene, OR 97405

www.idealmedicalcare.org

March 9, 2011

I took care of my Practice in Costa Rica and have also done evisits from a cruise to Mexico. All you need is internet and Skype. Not sure if Vonage would work from anywhere in world. I would think it should though, don't you just plug in the box and away you go? People say why do you do that on vacation? Most of my pts are more like friends, I know them so well, it does not seem like a burden what so ever and I enjoy helping them anyway I can. So far no calls to parking lots yet

I've tried the DMV and the YMCA. Oh, and grocery store.Almost did a pap under a tree outside the clinic when we had to evacuate after an earthquake.Anyone got a better story?I think Stew Mones did something in a parking lot when a

patient locked herself in the car with like some kind ofSWAT team assembled around the vehicle.Do share. I think this is what **really** separates us from thebig box clinics.http://www.idealmedicalcare.org/blog/forget-the-er-try-the-dmv/

~ PamelaPamela Wible, MD3575 St. #220 Eugene, OR 97405www.idealmedicalcare.org

-- M.D.www.elainemd.comOffice: Go in the directions of your dreams and live the life you've imagined.

This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above.

If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error.

March 9, 2011

You are so cool Stew. Some families would pay a 25K/yearly retainer fee for

this type of care. Awesome.

Pamela

>

> Fred Meyers Parking Lot

> That was for an elderly paranoid patient probably with UTI delirium who

wouldn't get out of her car. I used the scent of her car to intuit the probable

symptoms of urinary frequency (or at least incontinence) Kids took her keys but

couldn't get her to budge and called me to ask my advice. I stopped by the fred

meyers parking lot after the police came and went and assessed her and counseled

the son and daughter about what to do next. The patient called it " a mexican

standoff " . She eventual got hospitalized when she decompensated further.

> It was an interesting experience. I billed it as a home visit (it was where

her bathroom was at least).

> I didn't get paid by her ins (UHC) or by the patient but I would do it again

(for an established patient) even if I didn't need to shop at Fred Meyers

>

March 9, 2011

To all you wild docs who do medical visits anywhere and

everywhere here's a challenge/request.

Send me a paragraph or two about your most dramatic case

and I'll write it up and probably do a video on it which will

promote you, your practice, and us IMPs. I think this is

just the stuff Americans need to know about. A real case

against one-size-fits-all assembly-line medicine.

You may embed the video on your website or send out

to patients as a promo/FYI sorta thing about your

practice.

And Stew, this may mean you get the niche market in

Eugene of paranoid schizophrenics who lock themselves in

cars, but, hey, it'll keep your practice interesting!

Can post your weirdest case here, of course, but please send to my

private email and let me know if it is okay to use your real name.

I'll run final piece by you for approval.

Gotta get this stuff out there!!!

Thanks!

Pamela

Pamela Wible, MD

Blog with me:) http://www.idealmedicalcare.org/blog/

Email me: roxywible@...

>

> >

> > I've tried the DMV and the YMCA. Oh, and grocery store.

> > Almost did a pap under a tree outside the clinic when we

> > had to evacuate after an earthquake.

> >

> > Anyone got a better story?

> >

> > I think Stew Mones did something in a parking lot when a

> > patient locked herself in the car with like some kind of

> > SWAT team assembled around the vehicle.

> >

> > Do share. I think this is what **really** separates us from the

> > big box clinics.

> >

> > http://www.idealmedicalcare.org/blog/forget-the-er-try-the-dmv/

> >

> > ~ Pamela

> >

> > Pamela Wible, MD

> > 3575 St. #220

> > Eugene, OR 97405

> >

> > www.idealmedicalcare.org

> >

>

> --

> M.D.

> www.elainemd.com

> Office:

> Go in the directions of your dreams and live the life you've imagined.

> This email transmission may contain protected and privileged, highly

> confidential medical, Personal and Health Information (PHI) and/or legal

> information. The information is intended only for the use of the individual

> or entity named above.

>

> If you are not the intended recipient of this material, you may not use,

> publish, discuss, disseminate or otherwise distribute it. If you are not the

> intended recipient, or if you have received this transmission in error,

> please notify the sender immediately and confidentially destroy the

> information that email in error.

>

March 9, 2011

That really is so cool... The question is why didn't the patient or at least her family see fit to pay you for such over and above services delivered on-site at the time of a crisis, where they even called you for your advice in the first place? Now perhaps they are truly poor or some other semi-understandable circumstances, but the idea of all of you being so devalued even as you go above and beyond the call of duty sure pisses me off. Not even a cake or a gift certificate to a store or nice place to eat, a batch of flowers???? Something????

Next time get your own mother out of her piss covered car while the police are surrounding her on your own and don't bother calling me about it.... I know you are a great man and bless you for doing these kind of things really.... But to not pay you a dime after UHC rejected the claim is about as inexcuseable as not answering your calls during times of emergency after hours. There has to be some sort of mutual we both have skin in the game, we both have obligations to one another as well as ourselves if this is going to work at all... Personally, I think that is Chicken CCHIT without really good cause and you are a saint for accepting such neglect and betrayal of agreed upon handshake.... I know I am in a foul mood today over other people's Borderline behaviors that have me both down and angry but to completely blow off your Primary Doc after such awesome "Curb Side" "Car Side" treatment is for the birds.

To: Sent: Wed, March 9, 2011 12:55:35 PMSubject: Re: Weirdest place for a medical visit.

You are so cool Stew. Some families would pay a 25K/yearly retainer fee forthis type of care. Awesome.Pamela>> Fred Meyers Parking Lot> That was for an elderly paranoid patient probably with UTI delirium who wouldn't get out of her car. I used the scent of her car to intuit the probable symptoms of urinary frequency (or at least incontinence) Kids took her keys but couldn't get her to budge and called me to ask my advice. I stopped by the fred meyers parking lot after the police came and went and assessed her and counseled the son and daughter about what to do next. The patient called it "a mexican standoff". She eventual got hospitalized when she decompensated further.> It was

an interesting experience. I billed it as a home visit (it was where her bathroom was at least).> I didn't get paid by her ins (UHC) or by the patient but I would do it again (for an established patient) even if I didn't need to shop at Fred Meyers>

March 9, 2011

how can I get a weekly update instead of

all the messages?

Sofia Fernandez, MD

Associate Medical Director / Medical Affairs

BD Medical - Medical Surgical Systems

1 Becton Drive, lin Lakes, NJ 07417 USA MC: 250

tel: (201)847-3201 cell:

(908)803-9985 fax: (201)847-5213

E-mail: Sofia_Fernandez@...

Website: www.bd.com

-----------------------------------------

*******************************************************************

IMPORTANT MESSAGE FOR RECIPIENTS IN THE

U.S.A.:

This message may constitute an advertisement of

a BD group's products or services or a

solicitation of interest in them. If this is

such a message and you would like to opt out of

receiving future advertisements or

solicitations from this BD group, please

forward this e-mail to optoutbygroup@....

*******************************************************************

This message (which includes any attachments)

is intended only for the designated

recipient(s). It may contain confidential or

proprietary information and may be subject to

the attorney-client

privilege or other confidentiality protections.

If you are not a designated recipient, you may

not review, use, copy or distribute this

message. If you received this in error, please

notify the sender by reply e-mail and delete

this message. Thank you.

*******************************************************************

Corporate Headquarters Mailing Address: BD

(Becton, Dickinson and Company) 1 Becton Drive

lin Lakes, NJ 07417 U.S.A.

*******************************************************************

March 9, 2011

Sofia,Sorry but there is currently no option for getting a weekly update, but you can choose to get a daily update by going to the bottom of this message and clicking on "Daily Digest". Another option is to Unsubscribe, and then go to the PracticeImprovement1 Yahoo Group website and read the posts there at your leisure. SetoAdmin

how can I get a weekly update instead of

all the messages?

Sofia Fernandez, MD

Associate Medical Director / Medical Affairs

BD Medical - Medical Surgical Systems

1 Becton Drive, lin Lakes, NJ 07417 USA MC: 250

tel: (201)847-3201 cell:

(908)803-9985 fax: (201)847-5213

E-mail: Sofia_Fernandez@...

Website: www.bd.com

-----------------------------------------

*******************************************************************

IMPORTANT MESSAGE FOR RECIPIENTS IN THE

U.S.A.:

This message may constitute an advertisement of

a BD group's products or services or a

solicitation of interest in them. If this is

such a message and you would like to opt out of

receiving future advertisements or

solicitations from this BD group, please

forward this e-mail to optoutbygroup@....

*******************************************************************

This message (which includes any attachments)

is intended only for the designated

recipient(s). It may contain confidential or

proprietary information and may be subject to

the attorney-client

privilege or other confidentiality protections.

If you are not a designated recipient, you may

not review, use, copy or distribute this

message. If you received this in error, please

notify the sender by reply e-mail and delete

this message. Thank you.

*******************************************************************

Corporate Headquarters Mailing Address: BD

(Becton, Dickinson and Company) 1 Becton Drive

lin Lakes, NJ 07417 U.S.A.

*******************************************************************

March 9, 2011

Some may see the following example as a boundary issue....I recognize it

as possibly a " boundary crossing " but definitely NOT a " boundary

violation. "

A 20 some year old opioid dependent man drove 250 miles to get started on

Suboxone by me and was doing well. Then he and his girl friend had a baby

boy who developed seizures at age of 3 days. Baby Cassious was diagnosed

with some dreadful teratoma-rhabdo-sarcoma (?TTRT) of the brain and have

been in Seattle at the Childrens Hospital getting full press tx since Nov.

Hence, he hasn't been able to make the follow-ups as " required. " I'm in

Seattle doing medical school admission interviews this week, so the pt and

I have our " office visit " in the surgical PICU at Childrens last night.

Some may fault me for being emeshed or having poor boundaries, but I

prefer to view it as treating others with compassion as I would hope would

be extended to me in the same circumstances.

March 9, 2011

Pt's kitchen table (sutured hand, no insurance), back of mini-van, grass mat on hut dirt floor in Haiti, clinic in animal barn in Guatemala, pick-up tailgate in Iraq..... whatever the situation requires, right?

Steve’s done web and phone visits while we were on vacation in Cooke City, MT (with dial-up internet!), from Maui, even from a cruise ship in the Carribbean.

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info

From: [mailto: ] On Behalf Of roxywible

Sent: Wednesday, March 09, 2011 12:44 AMTo:

Subject: Weirdest place for a medical visit.

I've tried the DMV and the YMCA. Oh, and grocery store.Almost did a pap under a tree outside the clinic when we had to evacuate after an earthquake.

Anyone got a better story?I think Stew Mones did something in a parking lot when apatient locked herself in the car with like some kind ofSWAT team assembled around the vehicle.Do share. I think this is what **really** separates us from the

big box clinics.http://www.idealmedicalcare.org/blog/forget-the-er-try-the-dmv/~ PamelaPamela Wible, MD

3575 St. #220 Eugene, OR 97405www.idealmedicalcare.org

March 10, 2011

Why didn't you get paid by the insurance co? How would they even know the

unusual circumstances?---Sharlene---