Comments for Blog of the Christian Science Committee on Publication for Oregon

Comment on A Softer Side of Health Care by Christian Science Committee on Publication for Oregon

Christian Science Committee on Publication for Oregon — Fri, 26 Apr 2013 00:24:56 +0000

Insightful observations, Dan. Thanks for sharing them. I’m sure Pamela will get something from reading them too. John

Comment on A Softer Side of Health Care by Dan Sager

Dan Sager — Thu, 25 Apr 2013 17:47:23 +0000

enjoyed the post John. There is something sad, too, about this. As Pamela Wible can’t be alone in her thoughts, as a doctor, it makes me think many thousands must be stuffing away their needs into some place that isn’t very healthy. Some of those ways of avoidance mirror the reaction of doctors to the dislike of some (many?) of their patients (more accurately, their patient’s behavior) who present to the doctor with pathologies of thinking and expectation. These patients are reflecting cultural pathologies in their own misdirected distress. I believe much of the money-making behavior of doctors is one of the avoidance strategies, but so also is a lot of the interest in science and “research” (mostly funded by fancy drug company benefits and meetings), computers (computerized medical records, and the like), instruments (what are called medical devices) and related areas of subspecialization, tests (like xray and many labs that have similarly small overall impact on real care needs) and using disease “scores” and other metrics to assess how a patient is “doing”, etc. It is a bit sad. This translates fairly seamlessly into an understanding of the medical marijuana, narcotic analgesic, and antidepressant epidemic that the medical health care system is now realizing. One day, what MBE understood and stood for will be widely rediscovered, but not until the public’s fascination with disease and medical science is exposed as a emperor without clothes. Dan

On Apr 24, 2013, at 12:07 PM, Blog of the Christian Science Committee

Comment on A Softer Side of Health Care by Christian Science Committee on Publication for Oregon

Christian Science Committee on Publication for Oregon — Thu, 25 Apr 2013 04:30:23 +0000

You are very welcome, Evelyn.

Comment on A Softer Side of Health Care by Evelyn Brookins

Evelyn Brookins — Thu, 25 Apr 2013 04:28:14 +0000

This is certainly enlightening information. Thank you for bringing these new concepts to our attention.

Comment on WHO HEALS THE HEALERS? by r58black

r58black — Thu, 11 Apr 2013 02:09:42 +0000

With regards to physician suicide, burnout and depression….the first step in dealing with the problem is to recognize there is a problem. The next step is to find the root of the problem, if discoverable. Even though the old concept of exogenous and endogenous depression has somehow magically fallen out of fashion nowadays…..it most likely is still quite applicable. It may, however, be of limited utility if an individual has essentially exogenous depression- i.e. depression due to circumstances external to the individual experiencing the depression- in a setting of a situation that the depressed individual has no real significant control over. In turn, that initiating event/condition may set off a series of internal events that essentially lead to endogenous depression….which….may even persists even after the conditions that initiated the exogenous depression are long gone much like a post traumatic depression syndrome (a.k.a. burnout). With regards to physicians, that profession in and of itself is noted to have up to five times the rate of depression, etc. when compared to the general population; however, of note that statistic was formulated based on physicians working in a socialistic medical system in the U.K. It has been my distinct observation that certain specialties have had a marked increase in dissatisfaction with their status especially over the last forty years. Many a retired previously happy family practitioner doc has confided to me as to why they quite early; most, if not all of these statements, distinctly correlate with the progressive invasion of third party control with the demand by that third party of increasing random access to the doctor’s time and with no reimbursement for the doctor’s time. It is disruptive of a busy schedule to say the least. After working under many settings, hospitals, large groups, solo practice, small practice, administrative medicine….I have found recurrent themes of rational, valid reasons for what are the conditions that have led to what I would term is exogenous depression that may/may not include physician suicide and/or physician burnout. These recurrent themes have been essentially an invasion into the doctor’s time, almost always on a non reimbursable basis as the disrupting individuals of the doctor’s time are often either paid by the hour to disrupt the doctor’s time or do not have to pay anything for disrupting the doctor’s time…..and I am not talking about emergency calls, etc. but even so, those events should be a reimbursable event and the affected doctor can chose to accept it as such or not. Patient’s and staff have not uncommonly contacted doctors in their so-called off time….which is really an invasion of personal time that one often shares with friends and/or family….the individuals that really ultimatley make life worth living for…..often for matters that are not really urgent/emergent….and if so, should not be handled over the phone anyway…as one should be calling 911 if emergent, etc. This flagrant disregard is most prominent with physicians that are salaried. A salaried physician has essentially agreed to be the employee of an employer on a 24/7 basis. So, with that unfettered, non reimbursed access one not uncommonly gets silly calls such as Ms. Jones in room 214 has constipation (even though there are standing orders in place to address such concerns) …or…one can even spend hours playing marriage counselor to a frustrated spouse of a patient….over the phone…non reimbursed. So, first and foremost is the distinctive disregard of the patient’s personal non reimbursable work time which when combined with a third party pay mentality, salaried (i.e. not paid by the hour) and all in a culture now steeped in entitlement….is the evil triad cluster flock that makes one finally realize that after all of these years of training, dedication, etc. that one has simply become a public serf. I know of many “great professionals” whose professional life is of utmost respect….but there personal life is marked by much tragedy….much more so than is commonly seen in households which treasure and protect their personal time. Second, is the fact that physicians often have become nothing more than a human shield in that they are often held liable for (not scientifically causative of) ….processes that are controlled by another individual…but the same individual controlling the process is not responsible for the process that they are controlling (i.e. a tyrant). Unfortunately, the misapplication of ERISA to health care by the thankfully now deceased President “I’m not a crook” tricky dick Nixon codified this tyranny into law. (However, even Dr. Martin Luther King wisely pointed out that “Everything Hitler did was legal”…..definitely immoral….but unfortunately legal in that jurisdiction). The civil court system, with regards to malpractice has little if any interest in seeking truth…i.e. scientific causality used to determine liability….and justice….i.e liability, if so then determined via scientific, not civil probability, ……….then judgement rendered is based on certified life care planning to determine the actual incurred cost of care, including counseling and/or chronic pain management, if applicable….as opposed to the open, ended subjective pain and suffering awards. (In early 2013, there was an actual award of 120 million dollars in a malpractice case in NYNY…incredible!). Add to all this the fact that physicians have different views on things as they have had more exposure to death and morbidity as compared to the general public. It is not an uncommon reason that people in the medical field often marry other people in the medical field as it is a unique subculture in and of itself. A provider’s anxious but appropriate response to a potential significant problem may not be equally appreciated by friends and/or family who are not of that distinctive subculture. Furthermore, as provider’s deal with morbidity and mortality….or for some just the fear of aging…..these are all matters than many in the general population would prefer “not to think of” until they have to. So, to a cheery inexperienced non medical person a casual conversation at a cafe can be a real downer for them. Even more so there is much envy in this society….which has become increasingly socialized as one hears the polite looter’s battle slogan of such things as “income equality” as though individuals who study long and hard, work hard, should somehow be paid equally to others whose demands of their profession are frankly far less than those of physicians; this legitimized tactic of envy is unfortunately even further accelerated by the mere fact that physicians are a voting minority. So, the crowd with the most votes wins….but not really…. ultimately. So, what’s a poor sod to do when one comes to the unavoidable realization of what one has allowed/tolerated what has been done to and/or become of….one’s profession? For starters, try saying “N-O”…practice it daily in front of a mirror if you have to. Avoid working under salaried conditions. You may have the allure of the promise of a “regular” income….but a reality check should honestly answer the questions…WHAT IS MY NET, AFTER TAX, NOT GROSS, TAKE HOME PAY AND HOW MANY HOURS DID I HAVE TO WORK TO GET THAT? I had an old professional friend in Canada….who as the progressive, socialistic taxation increased…..finally realized that by working five days a week…he was essentially a slave. He finally was able to pin down what I term is the “financial rape point”…i.e. the point at which out of every dollar one earns little is kept….and ultimately worked just two days a week. Rather than being a slave the remaining three days a week….he chose to pursue other events that he enjoyed with family and friends. Consider it. Do not be shamed by administrators or others. You should have no guilt for realizing that you actually have a right to your life. If you want to devote yourself 24/7 and that makes you happy…then go for it. But if it doesn’t that realization does not make you a bad person (even though you might be viewed as a disappointment to those who would knowingly/unknowingly prefer to enslave/indenture/loot from you. It simply means that you are not Mother Theresa (note that she had no family of her own) and that is quite OK not to be. The human shield exposure/demoralization upon realization that one is quite often simply a liability shield for a tyrant requires some additional, intelligent counter strategies to combat. Please note that some of these tyrants outwardly might appear and superficially act like very well mannered polite individuals……but their true nature will often be revealed when one has to work underneath them……they want control of a process…..but not responsibility for controlling that process….and worse…sometimes they want another individual to be responsible for the process the tyrant controls (a.k.a. patsy/fall guy). READ WHAT YOU SIGN INCLUDING THE FINE PRINT….IF STILL CONFUSING, AMBIGUOUS, CONTRADICTORY, NOT MEASURABLE AND/OR NOT ENFORCEABLE….THEN ASK FOR A REVISION TO MAKE IT NOT SO…..IF NOT SO REVISED AND IF THREATENED IN ANY MANNER OR FORM…SIGN WITH THE NOTATION “WITH DURESS” BY YOUR SIGNATURE OR WALK AWAY. Consider, if you can requiring that your patients and/or potential patients sign an arbitration agreement with you as requirement to continue to see you or to become a patient of yours. The point is to think clearly of your options…use them…respond creatively…..say no if need be….guard your personal time if you want to…..do not become a serf willingly unless you want to (and make sure your motivation is not from some unresolved childhood issue or being raised in a guilt laden culture synonymous with the concept of original sin, etc.). So, reclaim your destiny as much as you can. Clearly delineate control responsibility loops (which clearly mark the boundaries of accountability). If you have feelings of guilt/shame try taking some assertiveness training if you need to….unless you enjoy feeling that way (and I am not referring to a sense of guilt for processes that you truly control and are, therefore, responsible for). Even if a physician has primarily what would classically be called endogenous depression….it can only help his/her primary condition if the factors causing the secondary exogenous depression are modified, preferably in a manner base upon reason and accountability.

Comment on Health, More Than a Two-step? by Health Conscious Pennsylvania

Health Conscious Pennsylvania — Fri, 05 Apr 2013 09:08:23 +0000

[...] To read John’s article titled, “Health, More Than a Two-step”, click here. [...]

Comment on Health Apps, or an Inner Spiritual Sense? by Christian Science Committee on Publication for Oregon

Christian Science Committee on Publication for Oregon — Sun, 17 Mar 2013 00:17:19 +0000

Thanks, Dan! Great to hear from you!

Comment on Health Apps, or an Inner Spiritual Sense? by Dan Sager

Dan Sager — Sat, 16 Mar 2013 04:25:41 +0000

John, loved the blog. Thanks for what you do. Dan

On Mar 14, 2013, at 1:33 PM, Blog of the Christian Science Committee

Comment on Health Apps, or an Inner Spiritual Sense? by Jerry McIntire

Jerry McIntire — Thu, 14 Mar 2013 20:48:50 +0000

Bravo. Shows the common ground in our human search for practical answers through a higher power.

Comment on Compassion to What End? by Judy P

Judy P — Fri, 22 Feb 2013 22:54:22 +0000

Compassion, of all spiritual qualities, is the greatest gift that we can give to another being, and to ourselves. It’s amazing what can be accomplished towards the balance of good with a simple smile, a sincere look into someone’s eyes, a loving thought sent in their direction; or, yes, even a dollar here and there. Yet, yielding to and understanding God’s Commandment to love ALL mankind equally, unconditionally, as He does, seemingly is our most challenging life’s work. Jesus lead the Way by example. Mary Baker Eddy discovered the how-to by demonstration. Every good action — day by day, hour by hour, instant by instant — in this journey makes the world a more loving and lovable space.