Take a Number

February 14th, 2013

Yesterday I went to the post office to mail something. I was 23d in line, so I thought about blogging and how long it has been (again). There were four windows open, so it seemed that the line would move. But then Window #4 went on her ten-minute break (she was still gone thirty minutes later). What’s that got to do with you, or me? Let me make the connection.

I’ve been busy since my last post, working almost every day until this month. Half the time I was posted at a rural clinic upstate, a “federally-qualified” facility with osteopathic students in attendance, run as efficiently as possible with dedicated doctors and mid-level practitioners. The level of traffic was at times unreasonable, but no one could be turned away. If the patient showed up an hour late, he or she could simply declare that he/she was a “walk-in”. Only the high no-show rate kept the doctors from staying until midnight. The clinic was open until 9 p.m. evenings and all day Saturday, even providing van service for patients from nearby towns (thank you, taxpayers!)

The last few months were spent mostly in the Valley, not far from my old base of operations at Valley Presbyterian. However, that clinic was run like the post office or the DMV. The owner, who also operated several other clinics, paid himself about $700,000 a year, having appointed himself CEO, CFO and COO and collecting three salaries, plus a bonus. Employee morale was dismal, partly because they had to bring their own equipment (e.g. pens, paper clips, etc.) but mostly because 80 people were crowded into a crumbling building meant for 20. Efficiency was unheard of. Every patient, no matter how trivial the complaint, had to undergo financial screening, insurance verification, and then eye tests, blood pressure and other vital signs. Each doctor had one medical assistant; it took 2-3 hours before patients could even arrive at the exam room. I was grateful when my six-month assignment was ended early. I then covered a private practice in the High Desert for two weeks and the contrast was striking. Patients are the same in most places; these days they are mainly on government programs, for which most are grateful but some have a sense of entitlement that is offensive, to put it mildly. But the surroundings were cheerful and clean, the employees sharp and friendly (and there were enough of them), and it was gratifying to help the local pediatrician get a well-earned rest.

The point of all this is that medicine is headed over a cliff and will probably never be the same. Obamacare having been validated by a quirky Supreme Court decision, millions more folks are to be added to the welfare rolls (Oh, they won’t call it that) but doctors cannot be created by government fiat, so there will be fewer of us taking care of more of you. California has already announced its response; more care will be given by less-qualified practitioners: mid-levels, optometrists (!), pharmacists (!). Despite all the political promises, health insurance costs will go up, emergency room visits will rise, appointments will be hard to come by and brief, practitioners will burn out more quickly and will make more mistakes working under greater pressure. So when you’re standing in line, bring a book. Might as well make it “War and Peace!”

Bubble, Bubble, Toil and Trouble…

July 4th, 2012

That’s Shakespeare, for you unfortunate products of the L.A. school system who probably think it’s from a Drano commercial.

Happy Birthday to our beloved U. S. of A. Two hundred thirty-six years and still standing, although more than a bit rocky lately. In continuing to travel the Golden State as an itinerant pediatrician, I’ve had time to observe first-hand many of the things ailing our once-great state. California has always been at the forefront of so many trends, good and bad. That has not changed, but it’s pretty much all bad lately. Thousands of acres of valuable farmland sit parched [...] Continue Reading…

First Flight

October 23rd, 2011

Forty years ago today I fulfilled a lifelong dream and flew for the first time. I had expected to be a passenger as my instructor, a redhead from Kentucky named Kearnes Branham, showed me the ropes, but it doesn’t work that way. After a pre-flight check, I rolled down Runway 16L at Van Nuys and off we went. The little Cherokee responded to my clumsy inputs most forgivingly. After 44 hours of such dual and later solo flights, I received my license 71 days later.

Soon after I took a similar plane on my first real cross-country flight to see [...] Continue Reading…

Pot Wars

October 19th, 2011

Are you sleeping better at night knowing that your U.S. Department of Justice is coming after California’s mushrooming (sorry!) pot clinics as announced last week? This is the same DOJ that won’t go after Black Panther voter intimidation thugs; that shipped thousands of guns to Mexican cartels resulting in the death of at least one Border Patrol agent, Brian Terry, and hundreds of deaths in Mexico as well; that is suing the state of Arizona for trying to enforce federal law and turning a blind eye to all the “sanctuary cities” in the nation including Los Angeles which are [...] Continue Reading…

Back From The Front…

September 4th, 2011

…Which is an awkward position, come to think of it. This go-around my work was in Fontana, where I spent the last four months (minus the week in New York) filling in for a pediatrician at a family clinic.
If you know not where Fontana is, you have lots of company. It is part of the Inland Empire, a name only a real-estate promoter could have come up with. Surrounded on all sides by freeways and bisected by old Route 66, it is hardly the jewel of anyone’s empire. Asked by my wife to describe it after my first week, [...] Continue Reading…

Latest From the Front

May 30th, 2011

There’s a war going on that affects every one of you. I speak of health care and its hostile takeover by one party in the most shameless perversion of democracy in our lifetime. Everything from earthquakes, tornadoes and tsunamis to Charlie Sheen and Lady Gaga has pushed this topic off the front pages, but there’s a lot going on.

I attended a tea-party conference a few weeks ago and heard several speakers give updates on the pushback efforts going on. The Supreme Court will rule shortly on the constitutionality of the requirement to buy health insurance. As with an overtime [...] Continue Reading…

A Nice Place to Visit?

May 30th, 2011

We’ve just returned from a 5-day business trip to New York City, place of my birth (sort of). I was born in Jamaica Hospital, which at the time was one 3-story building. Now it is a major medical center with its own Trump Tower. Growing up in Queens (which is like the Bronx but without the glitter) I hated Manhattan for its noise, commotion, traffic and general urban menace. Moreover, to get anywhere else you had to squeeze through its choke points, the bridges and tunnels which were always jammed. Of course “anywhere” included New Jersey (don’t ask). Now [...] Continue Reading…

Radiation Hype

April 3rd, 2011

Last month one of the largest natural disasters of our lifetime struck Japan in the form of a 9.0 earthquake followed by a tsunami comparable to the one that hit Thailand and Indonesia several years ago. Unfortunately a nuclear power plant was in the path of destruction. From Day One, it seems that almost all the news coverage overlooked the terrible human toll (perhaps 18,000 dead and half a million homeless) and focused on the nuclear plant and the radiation disaster supposedly unfolding. There is no explanation for this distorted reporting than the anti-nuclear bias of the ruling elite [...] Continue Reading…

Doctors Behaving Badly

February 26th, 2011

“My bad”, as the expression goes. It is exactly six months since I updated this blog. We three are well and had great holidays, as I hope you all did. Two seemingly unrelated news items involving doctors prompt me to shake off the cobwebs and express my opinions.

Perhaps you’ve heard about the doctor, Kermit Gosnell, who was finally arrested after decades running an abortion mill in Philadelphia where he kept a museum of baby parts after systematically butchering not just early fetuses but fully developed infants capable of surviving outside the womb. Those born alive were murdered by snipping [...] Continue Reading…

Chickens and Eggs

August 26th, 2010

The current outbreak of Salmonella food poisoning from contaminated eggs prompts me to share my observations about this fairly common topic, much of which harks back to my days as a CDC epidemiologist.

Salmonella has about 1500 strains, all but one (typhoid fever) native to birds and therefore transmitted via their eggs. The present situation is apparently linked to a large operation in Iowa owned by a fellow with a long record of public health violations. He once paid a $2 million fine but apparently still hasn’t cleaned up his act. The disease is generally mild except in the immunocompromised, [...] Continue Reading…