I’m not a standardized patient!!!!

[Guest guest]

Please excuse me. I’m in one of those cycles where no matter how long I lay in

bed, no matter how many pain killers and sleeping pills I take, MY BRAIN WON’T

SHUT OFF!

So here I am at another 3AM doing my musings and ramblings and it scares me cuz’

I think I’m on the trail to the truth.

I’ll admit it. Before it happened to me, I used to think the chronically ill

were that way because they wanted to be. They went from doctor to doctor because

they wanted the attention. Anything to keep from being productive. Little did I

know that this happens because Marcus Welby didn’t exist. Marcus Welby, M.D. was

mature, well read, attended every medical convention in every specialty

available, remembered every periodical or bulletin he ever read (how many real

doctors have time to read any more?), and had at least 15 script writers to do

medical research for him. Not to mention the fact that he had known, and

treated, each patient (since delivery) all their lives. He didn’t need a chart,

he knew. What took Lister, Pasteur, and Curie life-times to discover, he could

good-naturedly bumble through, very successfully, in 15 minutes.

My realization, light-bulb above the head, whatever you want to call it, came

about when I saw what was replacing Marcus Welby. Marcus Welby didn’t retire. He

didn’t die. He had his license taken away.

You know, by guys like Ansel Marks, M.D., J.D.

The kind of guy that stays in school long enough to get two doctorates; the guy

who always sits in front of class and says will this be on the test? The future

Cliff Notes editor. Is he now helping patients? Is he now helping other

doctors? Is he now screwing them both? I know he’s not making house calls, and

I’d hate to see his billing rates. If it can’t fit on a 3x5 card, refer to a

specialist.

Between Managed Care and Cliff Notes, survival of the fittest is gonna come down

to either standardized medicine, or standardized patient. If standardized care

doesn’t cure ya, it’s gonna kill ya. If it don’t kill ya, then standardized care

is all you need. So, the standardized patient breeds standardized patient

breeds…. Thus, standardized care is all you need. That, or forced referrals to

specialists (for license protection), which doctors used to get it trouble for,

called referral fees but really are kick-backs.

Do you realize under managed-care-organization/HMO (MCO/HMO) rules, it’s 15

minutes per patient? It takes us PWLD 1:15 just to recite symptomology changes

since the last visit, if we can remember the last visit. Not efficient for the

MCO/HMO, it affects to bottom line. In the restaurant industry it’s called table

turns; for stock brokers it’s called churns (one is legal, the other isn’t).

Even if you come in with your symptomology changes neatly typed (4 pages, 5

pages?) and pre-punched for the chart, it takes longer than 15 minutes to read.

It’s better you be dismissed, that is referred, to someone with a larger

per-patient visit-time budget. Since it's all in your head, best to talk to

somebody paid to listen.

Do you know why the castrated bull types (CBT) only take classic " bulls-eye

rash, no recent abx " as patients and/or clinical study victims? (Besides being a

no-brainer.) It’s not because they don’t believe in chronic Lyme. It’s not

because they don’t believe in long-term abx. It’s because of the standardized

medicine, standardized patient Borrelia Spin (BS) they’re being taught in school

now, by the MCO/HMO grants. Next time you want to get really sick to your

stomache, check out who the big-buck contributors (money, material, pharm.,

etc.) are to the medical schools and teaching hospitals.

It’s all about the " self resolving " nature of early Lyme. It fits right in with

the MCO/HMO office practices and time/pharmacy budgeting.

Self resolving is like the old saw about a cold.

Treat a cold and you’ll be better within a week.

Don’t treat a cold, and it will go away within seven days.

Early Lyme, if you leave it alone, don’t do anything, will usually disappear

(self-resolve). At least outwardly. We all know what happens inwardly. Sure

makes for pretty impressive " cure " ratios for the MCO/HMO CBT. Exhibit the

classic symptoms (otherwise I won’t see ya), give ya a sugar pill (and call it a

blind study, why blow the pharmacy budget on real abx), and in three weeks I’ve

got another " cure " to show the bonus manager. Right on schedule, right on

budget.

I’d hate to think that the C students are in control of my life. However, it’s

been my experience that the major difference between A, B, and C students is not

how much studying each does. The difference is not in how well each can take a

test. (Although knowing what papers the Prof. has authored helps sometimes.)

The real difference is in the ability to think; creatively and deductively. Not

daydream. Not creative excuses or buck passing. Not windy hypothesis. Not name

calling or media exploitation. Actual thinking. If A = B, and B = C, then by

gosh A = C.

It doesn’t have to be in the Cliff Notes. It doesn’t have to be in some

" official " guideline. It doesn’t always have to be 2 + 2. It can be 1 + 2 +1, or

1 + 3, or 1.5 + 2.5, or ….

Did ya ever notice, no matter how they reword it, most of the guidelines are by

the same person, and they really don’t say a darned thing. Full of " may " ,

" perhaps " , " sometimes " , etc. Ya never see " appropriate " or " absolute " applied to

those recommendations. The only time ya see an emotionally charged word is when

it is applied to " patient advocates. " Those other equivocal weasel-words only

disappear when modified with " and/or " , " knew, or should have known. " Nothing

definitive, unless we want to nail ya. Then we’ll use " inappropriate " , even

though appropriate has never been determined.

Stealing from one person is plagiarism, stealing from many people is research.

Please pray for me, I’m not a standardized patient. And I still can't sleep.

R. - Euless, Texas

A Tick Made Me Sick

A TIICS Is Keeping Me That Way

(TIICS = The Insurance Industry Captive Specialists)

http://www.angelfire.com/biz/romarkaraoke/james.html

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[Guest guest]

Hi RJ,

You are so right. Good brain at 3am

Velcros

Connie, MI