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On this last day of 2008 I wish every Doctor and professor of medicine would read this entry.I hope you have had the opportunity to see and hear "The Last Lecture" by Randy Pausch, if not go directly to the book store and buy it!Open to page 62-63 and there in lies the secret to life and to being not only the best person but the best physician that you can be. Medicine as life has too many rules , barriers and hurdles but Dr. Pausch put it very clearly on the page. His entry defines hope, the moment at hand ,our loved ones and what is most important. In reading these brief pages I feel like Confuscius has entered the room because he has clearly stated what being a good physician is all about. Present and future is all we have , lets move forward with grace and the eyes of  a 5 year old clear and wondering!

RING

One night late I received the worst of calls a patient post heart surgery had a cardiac arrest, as I flew out the door - no socks, half awake,and desperately worried about my patient I tried to wake up. I live 6 miles from the hospital and we have no residents just great nurses, who by the way in my world were Doctors with different initials after their name. You wonder if the Doctor speeds , oh yeah and red lights we are all color blind to those. I arrive in the darkness and do my best superman impersonation trying as hard as I might to undress and put on surgeons scrubs as my nurses bring the patient to the elevator. I take off my wedding ring and clothes and meet them there as the doors close .I open up my patient right there and start cardiac massage and proceed to the operating room where a team of  people as bleary eyed as I jump to their tasks, over the next 30 minutes we bring this person back to life.  As any surgeon knows if the kidneys are working so is the brain but thats another story! I thank my folks and go out to speak to a family who are dazed and scared and whose eyes hinge on your every word and tell them Dad is ok!  Talk about highs and lows I sit down to take a few minutes to rest only to realize I have lost my wedding ring, it doesn't seem very important next to a human life.My quick hunt is useless and as I come off the elevator a wonderful policeman looks at me and says is this ring yours Doc? I found it in the crack at the bottom of the elevator door! I thanked the lovely lady and as I headed home my thoughts came full circle so to speak, as I crawled into bed my wife asked if everything was fine for the person I went to help and there and than I realized what that ring represents, LIFE!  TIP OF THE DAY: Secret to any success , marry your best friend!

KIDS

Have you followed the cuts in city and state funding. I get it but the one thing we have to support is education. I believe in the kids it is our present and unending hope for the future. Without it we will be mired in the 14 th century of our generation. Whatever we do never give up as Jimmy V. once said, I am totally fed up with politicians and their solutions look at Illinois.Are you inspired by the auto makers leadership or the banks or for that matter !Our role models the professional athlete! These are the people our kids are seeing on the news, the internet, talk shows and the like. You want to know who gets it ? Bill Cosby, thats who, he understands we need leaders white, black whatever color for our kids. Try everyday,every way to influence our youth and help a child . The older I get the more I respect a great teacher not a great athlete !  TIP OF THE DAY:  Eat with your kids and you might just learn something good, I do every day!! Trust and love.

UGLY

Today is the day Ugly died, you might think this is about plastic surgery but it is not. Remember that old rug or warm blanket or the blankie you had as a kid with the satin edge , thats Ugly. Those times with the fire going , coffee smells in the air, sweet rolls in the kitchen , thats Ugly! The smell of cut grass, horses in the pasture, dew on the grass and an ol bathrobe thats Ugly! Well ole Yeller had nothing on Ugly an old eastern North Carolina dog who could bark with the best of them and scare that UPS guy right out of his truck. Ugly went to be with   Yeller this weekend and in passing after 20+ years brought tears to my eyes, is this not what Thanksgiving is all about a life well lived and appreciated. The Movie Doc     TIP OF THE DAY: Take time to view your world thru the eyes of a pet, bet you just smiled!

GOBBLE

GOBBLE  for hot coffee,cool mornings,fall days, redheads,kids, azaelas in April,friends on the first tee,Augusta-Pebble Beach-St.Andrews, Buckeyes,Tarheels, beach week , family, dogs, rye grass, beer on tap, Chicago in January, midwest, Chapel Hill anytime, Ohio Stadium in October,Diet Coke, parents Millersport, Rubinos pizza, deer in your yard,light houses,sons and daughters, HD TV, NFL sundays and satellite, nurses, charities, kitchen smells all day.  But mostly just thankful for life friends and family and love for others !  HAPPY TURKEY DAY!  TIP FOR THE DAY: Eat turkey year around ,it helps sleeping.

SWEET!!!!

You ever heard the words Be Sweet , well in the South it can be tea or a goodbye, Be Sweet Ya'll! Dot a nice lady who I have known for over 20 years always tells me to be sweet when she leaves me but I never took it to heart. But now in this part of my existence I try everyday to make someone else feel like sugar because of Dot! Somedays it maybe only my dog but I try as hard  as I can. Well today I left two young ladies at a nursing home who try each and everyday to make those folks existence something  special and to them I say "you be sweet " as a compliment to their work! TIP OF THE DAY:Enjoy Fall color because it is as fleeting as youth! 

Scramble

In golf there is an event called a scramble where you are usually playing for a charity with 4 friends and its a great afternoon. Basically you all come together as one, all four hit a tee shot than you take the best one and play again in the same format. The key is when you arrive at the putting green there will be 4 putts to make the 1 shot for birdie. Now is when the fun starts all four people look and listen and plan how they will play the shot but it as one . When you make the putt it is exhilarating and you feel satisfaction for both the player who made it and yourself. This is the feeling I want you personally and our country as a whole to strive for every day, believe me it is attainable when you help just one person you have "networked" your day to success. At this Turkey Day time of the year gobble a little louder for a friend or colleague.! The Movie Doc.    TIP OF THE DAY: Nap this weekend its good for the soul!

Zollinger National Healthcare Proposal

1.Catastrophic $ umbrella{30 ,000$}2.HSA.  Health savings accounts, that roll over with business matching funds3.Quality plans and best practices requirements4. Preventive plans starting early in schools and business{ will require generations] 5. Centers of excellence to minimize duplication of services ie. transplantation 6.Tort reform, this covers duplication of testing and the CYA practice of medicine 7.Immigration reform, state medicaid and tax base over stressed by "free" care/ERs 8.Solutions start at state level rather than federal 9.Deal with 3rd party payers and drug companies."If patient competes for best product at lowest price" costs will come down 10. Drug costs , compare to rest of world. R&D is not sole cost of USA, generics and substitutes.  11.Patient has to be educated CONSUMER. Would you give 20K and tell buyer to get you Chevy and he brings  a pink 18 wheeler would you accept this. Well thats health insurance! 12.Brain drain issue, young folks are not choosing medicine , when they do its driven by life style issues. 13. Industries where technical people are highest wage earners do not exist, except in medicine. Too many chiefs and not enough indians or just leaders that others will follow and listen to. 14. The future will include rationing and have a tiered system I believe, higher taxes. 15. This is most important ! The IT penetration is horrible, we need EMR, in many places there are still PAPER trails hard to believe in some ways your own house is farther ahead of the technological curve than your hospital and Doctors office.  This is a start.The Movie Doc     TIP OF THE DAY: Hard water is good for osteoporosis due to mineral content.

Blessing

 The baby of the family, last child to come along can be a generational blessing. Like a southern snow storm you never know when or what you will get but it can be big or small. Forrest's Mom had it right! The best thing I have found beyond keeping you younger is that every child is unique and while some parenting rules are good to follow most require a halftime readjustment to be successful. I am frequently amazed to see the little things that you have no idea where they came from like artistic ability and musical skills but most scarifying and I know thats not a word, is the pieces of yourself that are on display each and every day. It is for this reason that I offer this blessing this time of year and that is God bless you Mom and Dad how in heck did you put up with me all those years..............the answer is easy absolute LOVE ! Thanks.  The Movie Doc.            TIP FOR THE DAY: To properly wash your hands its time not soap, so sing Happy Birthday twice  while you wash and you will be spick an span!

Braindrain

 Several years ago likely about 5 I predicted a massive brain drain on American medicine . Well it seems now it is coming to pass, you see all the news about family practitioners leaving the field with 99% dissatisfaction. The next generation has specific lifestyle goals and lowered expectations for success that send them toward different career paths. I find it interesting that it is reported these folks are choosing specialties because of higher pay while in the specialties there are decreasing numbers of qualified or interested candidates. The point here is the workforce is changing wether we like it or not and the consumer better learn to be a better purchaser of healthcare if he wants to survive both financially and physically! I think over time the specialties will prosper in the larger referral centers and the era of small community hospitals will pass. Preventive programs will be key to employers and their survival in the future,these include nutritional, genetic,exercise and importantly mental health. I do believe third part payers will have to go away or evolve and as with all our expenses we will have to be prudent shoppers.  The Movie Doc       

Dad

This week I read an article in GolfWorld a good read if you like the sport. In it there is a well written article about the evening Davis Love III 's Father who perished along with three other gentlemen in a small plane crash in Jacksonville, Florida. For me it gave me pause to appreciate the value of family, community and the human spirit especially at this time of year. My point is this as the baby boomers start to take care of their parents final days and years it can be a frustrating time and a difficult right of passage. Remembering that for many of us that by the time you figure out how to manage these different situations they are gone! There is no text book , no right or wrong way to do things. Let me just say this ENJOY those days and minutes for they are fleeting . As time passes I remember my parents at some time everyday but I miss those small moments as they aged , be kind as you see your future in their eyes!  Movie Doc     TIP OF THE DAY: Hug your kids and animals it lowers blood pressure!

Phones

Have you noticed how phones have changed, you have a cell, no booths, voice mail is already outdated, land line sounds like a weapon, kids do not speak on them,chat rooms are now text, caller ID is do not answer and we shall see, text and I will respond, 911 is used as gps, coming are voice activated responses to text messages that are returned in text form ......... Whooo nelly isn't that speaking , which requires personal interaction!  I believe that the era of more and bigger is less and that those of us who understand service and personal touch will succeed again only larger with this new generation as they will crave those relationships.  To me the best IT in the future is YOU. TheMovieDoc.    TIP FOR THE DAY: 2 beers a day increases your HDL/ good cholesterol!

Pep Talk

You have heard of the pep talk on sports talk or Dr.Lou on ESPN, well that exists in medicine also. Believe it or not its a sales pitch that the author of "The Little Red Book" could promote, even better because you are selling life and your continued existence! I had a partner once who I told you have to speak to folks as if they are your own family and he said thats poppycock you cannot let that emotion be involved in your decision making process! The point is if you don't than you never will have the empathy to be a truly great physician, that does not mean you can't be a success, the world is littered with successful but non empathetic Docs! Optimism is key, I  always give the family that ray of hope , its our one connection with spirituality.  One day I had an old farmer who I had to present open heart surgery too and the cardiologist and staff said he did not get it and was not to bright. My Dads family were farmers so I went to talk to this gentleman, he had his overalls and Dekalb hat on and some Mail Pouch in his front pocket . I sat down on the bed in his room and said listen here Mr.Jones let me talk to you about some plumbing you need done . Well he said shoot Doc , so I proceeded to tell him how I was gonna use a Black and Decker saw and open him up , do some plumbing to bypass his vessels cause the bridges were out ,close him up with coat hanger wires and see him back in 6 weeks to set him loose! I said 1 or 2 times in 100 you end up with dirt on your head instead of standing on it. He looks at me says  go get em Doc I get it now and off we went and he did wonderfully.This entire pep talk took 5 minutes of my time, but you get the point . While my colleagues threw around big medical vocabulary all they had to do was be honest and straight forward. The best Doctors in the world for this honesty are pediatricians because kids can see right thru the BS !!! T.Movie Doc    Tip for Today . Eat Blueberries they help your brain.

Moozies

Hey for fun go to www.syntheticfur.com this is our movie site where we produce thrillers, documentaries, feature films . Starting tomorrow we start shooting film about a young lady in our area who taught us all a lesson in life, check her out at www.marchforthwithhope.com.   These are two great sites have fun!!!!!!! MDoc

The Specialist M.D.

Remember the next time someone says I have a good  Doctor I am fine. But in todays world he does not go to the hospitals in the USA. If you and your family want to negotiate the treacherous waters of our healthcare maze than you need to know a family "specialist"!  These are the folks who actually take care of sick people.If you go to the ER expect  a 4 to 6 hour ordeal and than if you are admitted you will be cared for by a hospitalist , who is an M.D. who can be in many cases the least trained physician and one who is on a career path to somewhere else.  After a brief stay you are likely to be discharged with  a few tests , a prescription and a phone number for follow up! Here is my TIP FOR THE DAY  get to know any medical specialist, that includes all surgeons of any type and all medical folks such as a cardiologist, neurologist, pulmonologist, nephrologist  or any GIST you know! These folks can expedite your testing , your admission, your treatment everything and can compress weeks into days and even hours. Also always remember as in business its the relationships and the people not the building or facility that renders the care! The Movie Doc

Las Vegas or Insurance

Hey how about a trip to Las Vegas! No need just pull up your health insurance plan and play the game. Its better than  Super Lotto, Power ball or even a good old slot machine! Think of all the options right in your own home grab a drink , easy use of the facilities, food at your finger tips, even a couch for a few ZZZZZ's. Here we go , hold on for fun all you card counters out there. First we have the 5000$ deductible game , here you get a low buy in and can play monthly but if you lose a hand and go to the hospital whooo doggy your on the line for usually 40 to 30% of your bill. That will amount to thousands of dollars on the upside believe me. So here the gamble is will I get sick or not, if your answer is yes than put down more for your monthly wager, if not the insurance casino operator will win. Hey here is even more gambling fun if you do win they will not pay you for months gee lets figure this one out its called interest$$$$$! Also bet you didn't  know that if you learn to play this game when you do lose YOU have the option to negotiate a settlement at a lower cost, the old one in the hand idea. The difference with the insurance game is you can break even but it takes study and perseverance two things they count on you not to have! Movie Doctor

Vitamin D and The Internship

People always wonder when you are an intern are you a real doctor and the answer is yes. This is the first year out of medical school where you work in a hospital and seldom see the light of day. Recently I heard of a young intern who was found to be Vitamin D deficient and immediate treatment was recommended.As you probably know exposure to sunlight is an important part of the metabolic pathway that involves personal well being and feelings of depression and the like. After many years of testing and research I have come to a startling discovery! I have now come up with an extensive treatment regimen for these interns and I am planning a national tour to promote my therapy. Rx: 2 weeks in Miami and a case of Budlight!

Honey and the Vet

Did you ever wonder where the use of honey for sores came from ? Well some say it was the Egyptians but I know thats a croc because  its the Vet! Took ole yellow dog into see the Vet for a tumor which he removed from her front elbow.  Well it healed poorly so he took a snow cone taped it to her leg covered the wound with honey and sugar and whooo doggy it healed right up! She of course had to wear one of those neck guards that make her look like the dog from space. Well guess what I tried it on humans and it worked great, but if you try my remedy remember people really put up a fight about that damn collar!

The Doorknob Holder

Hey how about the knob holder, you know the Doc who holds on to the door like he has a jet to catch! We have all been there , you are afraid to ask a question because he is a busy man and has places to go. Like your time is not important too. Let me give you a subtle tip my Father gave me 30 years ago , sit down and talk to the patient! Gosh Gomer what a brilliant idea. But believe it or not an idea which is seldom used. Next time you visit your physician see if he or she takes the time to sit, if they do you have an empathetic communicator, if not it is probably another visit with the pocket protector carrying variety of Doctor.Thirty seconds on your backside makes the person feel like you have been there for 10 minutes, try it you might just like to LISTEN! 

Networking

In business its all about who you know, 7 degrees of separation and what have you done for me lately. In medicine you lose site of the fact that everyday of your life you are helping people, a fact that any great business man or woman will tell you is their key to reaching the highest goals . Remember if you help others thru "networking" it will be returned to you  TEN fold in your own endeavors! For those of you in medicine get out of the forrest, by that I mean enjoy why you went into medicine in the first place and don't sweat the small stuff because the solution to our medical crisis sits with you at the grass roots level! WE ARE THE STRONGEST LINK as the beautiful Brit would say. Go out and help someone you will feel better for it I sure do .

Bad Day

You thought you had a bad day! There I was in the middle of a difficult case , sweat pouring off my brow , the room was tense with a bigol T! I turned to my senior scrub and said  I guess I will just have to shoot myself, she turned to me after all my swearing and slapped a sterile pistol in my waiting hand and said go ahead I am ready for a beer! At this point the tension was broken and the case flew to a conclusion. Point here be careful what you wish for and remember there is a lesson to be learned each and every day! Remember treat people with respect and the return is ten fold. Have a great day ,my nurse sure did!!!!!    Movie Doc

Questions for the Doc

Hey you need help navigating the healthcare system I will be here to help you !  The hows and why this an that of insurance , deductible , fighting back. Why you need a specialist as your Doctor and not just your family doc.!    How to save on medications equipment, and also how to make a thriller on the side . I am here for you. I will lay out my health care reform proposals this week. 1. catastrophic  coverage $ 30k, HSA that are tax free and last a lifetime, lower the pharmaceuticals costs thru competition, eliminate third party payers ie. insurance companies. For example when did you last buy a car and give 20k for a Chevy  and received a pink18 wheeler! Well thats what insurance gives you. Folks need to take charge and fight back .   Movie Doc