Hopkins: The Best Show on TV

Whether you like medicine or not, Hopkins is arguably one of the best shows on broadcast television this summer.

Because of the nature of the show, a reality drama, the producers could only shoot 6 episodes. Just recently, a seventh episode was announced (they had that one in their back pocket the whole time) but that will most likely be the last one until Grey's Anatomy comes back this fall to fill the slot.

What makes this show so great and well liked by people of all ages and professions? It shows the experience of medicine from all angles - the patient angle, the physician's, the families of the physicians. It's just superbly real.

Hopkins, Thursday 9CT p.m. on ABC. Picture caption: Dr. Ann Czarnik, ER resident Johns Hopkins.

The Human Ant Farm

It's books like this, How the New Quality Movement is Transforming Medicine, that give me pause to enter the field of medicine.

New York Times contributor, Abigail Zuger, MD, reports on the book by Massachusetts health insurance advisor Charles Kenney. Right now, Zuger points out, health care is being examined with greater scrutiny than ever before. It's getting to the point where some - typically not doctors or nurses - advocate for a flat health care structure in which even patients and their families can call the shots on treatment.

The synopsis of Zuger's review of Kenney's book is that the problems of health care are great - but it's probably wishful thinking to transform the system by putting even more pressure on health care workers to perform impossible tasks to reach perfection. Although Kenney accuses physicians of treating humans like cars, Zuger argues that no one in the health care field treats anyone like a car. Things do happen in medicine that are not always pleasant, organized or easy to accept. Still, physicians and nurses are really doing all they can.

As a first-hand observer in a children's emergency room, I can attest to this fact. Doctors and nurses are still in health care to help and do the best they can. Our health care administration, the rules set by insurance companies and the lack of government support are really what's killing the system.

We Don't Need This Kind of Help

With health care in a tailspin, this is the type of story you just don't want to hear
A social worker from Chevy Chase, MD, has been found guilty of health care fraud.

61-year-old Melvin Shandler bilked close to $250,000 for services never rendered.

How many stories like Shandler's go unchecked?

My Kind of Town

Just got back from Chicago. Great weekend. The city is fantastic this time of year - I had no idea. The only other time I've hung out in Chi-town has been during the college school year when I went to Saint Mary's, OR during the marathon when it was freezing even then.

Check out the pictures

UK vs US Health Care Options

Riding to work today, I heard this alarming piece from NPR comparing the health care options for a patient with MS in England to a patient with MS in the U.S.

Here are the highlights. Although the UK patient waited a few weeks to see a specialist for her chronic illness, once she got into see the doctor, it was instant feedback from tests on therapy options, drugs, etc. Within months, the UK patient was on medicine and under physician supervision all paid for through the UK's National Health Service (NHS). The only expense is 30 pounds, out-of-pocket each month for physical therapy. This patient was even reimbursed 5,000 pounds for the minimal amount of time she did have to pay-out-of-pocket for some of her medication while the government waited to see the results of the drugs on a population of patients.

The US patient with MS, meanwhile, had to leave his job, lost his health insurance, has two children, a wife and a re-possessed home. He and his family now rent, filed bankruptcy and try to live off of his wife's new health insurance. This patient filed for Medicare two years ago - but it take two years to be approved in the US. He will not receive reimbursement until December 2009.

The US has the best health care system in the world? Not likely.

Texas 4000 - Riding for Cancer

My good friend Brooke is somewhere heading towards Vancouver on a 4000 mile bike ride up the west coast for cancer. The ride serves as symbol of courage and endurance, and the riders themselves raise tons of money for cancer research and cancer support. As an aside - I am leaning toward going into pediatric oncology, so cancer charities have a special place in my heart. A few years back, I coached one of the marathon teams in Austin for Team in Training with the Leukemia and Lymphoma Society.

Let's point out the straight facts. She's riding 4,000 miles in a summer (it works out to be approx. 80 mile road rides a day with a couple of days off here and there) to Alaska - the final destination. That is unreal! Add to that fact, she was diagnosed with mono just before the ride started. The diagnosis only deterred her some. It is clear, I am friends with a rock star.

Check out her blog about the ride and search around for other blogs from the riders involved in Texas 4000. It's a unique and wonderful charity. Donate online if you can.

Doctor Video Blog - Not a Showman, but Insightful

Doctors are busy people, so it's nice to see that the medical community as a whole has embraced social media, blogging, commenting on articles, etc.

Family practice physician, Robert Morrow, MD has a sort-of funny, but mostly spot-on video blog commentary about patient visits and the health insurance industry. Worth a watch.

Customizing Your Career

Stuck in a corporate job, but really love to paint?

Feel you are better working with people, but you are also a finance genius?

Love medicine, but also love to write? Wait! That's me!

Check out NY Times blogger Marci Alboher whose blog for the Times, Shifting Careers, points out some great resources on how to create the job that is you.

I've mentioned before an author hero of mine, Perri Klass, who is a mother, pediatrician and journalist. Pretty much defines my goals in life.

I'm gonna check out some of the books Alboher suggests, including her own, that provide insight on careers and how to go about defining the one that makes you the happiest.

Health Insurance Is Really Making Me Sick

This is just one of the many stories on the state of the health care industry in the United States. From yesterday on MSNBC.

How is it that men in suits that sit at desks make decisions about who gets coverage, how much it costs and who is at risk.

According to the report, the health insurance industry is about to launch a campaign to make itself look good. Kind of like when Phillip Morris ran advertisements about how you could quit smoking...it's all such a farse. They don't really care. They want you to buy their cigarettes and most smart people know it.

"Campaign for an American Solution" (I recommend scrolling to the MD comments after the article) will launch a listening tour in Columbus, OH that records that small percent of Americans who are satisfied with their insurance coverage.

Richard Kirsch, president for Health Care for America Now, a non-profit joining forces with a ton of other groups - see here - to combat the health insurance industry. Kirsch told MSNBC, "the health insurance industry is free to reject who they want and charges unfairly based on risk. If you’re older you get charged more. If you’re a woman you get charged more.”

Loved this very true statement from another activist:

Brian Rothenberg, the Executive Director of Progress Ohio, railed against the lack of progress in health care reform despite the fact that “it’s been 16 years since the health care debate first came on the national scene.” He said that many people are “one bad boss, one difficult decision at work away from being unemployed and having no health insurance.”

I've Been in Texas Too Long

Austin - A New-Found Appreciation

Once I was able to solidify that I would be staying in Austin for school, it's almost like moving here for the first time all over again.

Some of my personal favorite spots to check out if you live here, or if you just come for a visit - Part 1:

Stay Cool with the city's spring-fed watering holes and lakes:

Barton Springs - A crisp 68 degrees Fahrenheit. Kind of reminds you of the movie Cocoon.
Deep Eddy - Oldest swimming pool in the state of Texas. A crisp 72 degrees Fahrenheit. Better for doing real laps because the pool is in the shape of a square and has an area for lap swimming.
Pace Bend Park on Lake Travis - this year, the water is so-so. But, come on a good summer with lots of rain, and this is what you can find at Pace Bend:













Grab a cool drink:

Crown and Anchor - A UT hangout year-round. You won't find a lot of youngsters at this bar. It caters more to graduate students and professionals. Dogs welcome, "Arf!"
Shoal Creek Saloon - Owned and operated by Louisiana folk, this long-standing Austin pub serves up cold beers, wine, liquor and cajun cooking. Saints fans, look no further. Scream "Who 'dat" like you mean it!
Uncle Billy's Beer and BBQ - Austin's home-brew destination. Drink Billy's beer and eat fairly decent bbq while sitting under the oak trees of Barton Springs Road. For those new to town, you won't have the pleasure of sitting outside at Billy's next to the traditional RV park (where even Matthew McConaughey kept his Airstream trailer.) The owner of another local spot - Austin Java (also located on Barton Springs) bought the park, forced the residents out and is now in the process of building even, more, yes, more, condos for Austin.
The Longbranch Inn - Old favorite. Just started serving liquor 3 years ago. Before that, patrons bought their own bottles of liqour at the store next to the bar and were served setups. The bar itself is an ornate, carved wooden structure taken from the original bar at the Driskill Hotel.

Hot sips:

Emerald City Press Coffee - New and so cool. Drive up to the open front for coffee, treats and the paper.
Quack's - Also known as the 43rd Street Bakery, Quack's has been around longer than I could research. But, because Austin is a young city, that might mean it's been around since 1979, or something. It caters to the graduate and undergraduate set for studying and lounging, but you'll see Hyde Parkers of all walks at Quack's. It's definitely a scene of the intellectual, hip looking and eclectic. "Keep Austin Weird!"
Jo's - Now serving coffee, food and beer at the original South Congress location and now in the new 2nd Street district. Coffee is great, and the food (mostly at the 2nd Street location) is amazing!

Healthy sips:

Daily Juice - With all these chain smoothie places, it's so refreshing to find a local joint that serves up truly fresh and tasty smoothies, elixirs and juices. Drinking a Daily Juice concoction will make you feel healthy, hippie and holistic. I recommend the Subliminator with Almond Butter.
Wheatsville Grocery - one of the original food co-ops in the U.S., grab a smoothie at Wheatsville back at the Deli.

Part 2 of my Austin series will include:

• Hear some live music
• Eat well
• Dress well
• Do something for your body
• Do something for your home
• Where the dogs are
  

New England Journal of Medicine on Non-Traditional Medical Students

Thought provoking article on non-trads and their importance to the future of medicine in the NEJM

Here's a Scary Thought: Doctor's Are Only Human

When I think of doctors, three types of bed-side manner come to mind.

1) Nice
2) Cold
3) Indifferent

Of course, there are subsets of these personalities, but these three comprise the make-up of most of our experiences with doctors.

Everyone loves the nice, warm, jovial doctor. Who wouldn't? Pleasant people rock. In any profession, the pleasant employee can get a lot accomplished by placating colleagues across various groups. And, when the pleasant employee has a bad day, which is just life, for the most part, it is completely acceptable. "Ah...Joe must be having a bad day," you might say, and then leave it at that.

Are doctors really any different? They are humans after all.

I'm starting to believe the answer is no. At least based on what I hear from my friends who tell me their stories of visits, or even calls to their doctors. "They were so indifferent when I told them I hadn't slept all night because of my headache," a friend once told me. And then he continued on to say, "doctors are so bad sometimes....but you won't be like that."

I've always felt super comfortable around doctors. Heck, one was my grandfather, so I saw from a very young age his human side. He got angry, he got sick, he laughed, he got cranky. In fact, he even slept from time-to-time, and in a real, human bed. I never saw him bleed, but I am 99 percent certain he was a human. I don't think a robot could tan like that.

There are some bad doctors out there, but most of them are just, well...human. They have bad days too. They get upset stomachs and headaches, and funny-enough, they even get grossed out sometimes by what you come into their offices to show them growing in your ear.

Then there are the exceptionally nice doctors, and to me, those are the doctors truly destined for the profession. I witnessed, recently, a doctor who had one of the best bed-side manners this side of a cupcake factory. The patients just melted in her presence and really worked hard on improving their lives for their next visit. She confessed to me later that she loves her job, but really never liked the sciences.

Then you have the science genius, who got all As in high school and college and didn't have the first clue on what to do with such a genius brain, so took the next best logical step, and went to med school. Twenty years later, Dr. Smarty Pants can become the emotionless doctor or the downright unpleasant doctor. Remember, he/she too started out life human, watched Different Strokes and played Connect Four just like you and me. So, like many humans, Dr. Smarty Pants can get depressed about the choices he/she made about becoming a doctor, or maybe it's the spouse they married or the town they live in. Just like other humans, life can wear them down.

Now, imagine being that human with the responsibility of other peoples lives in your hands, a broken health care system and a stomach ache from the pizza you ate the night before. Maybe it would be better if you weren't human.

It's the Little Things....

I have an addiction. It's pretty pathetic that it's gotten so out of hand lately, but admitting to it is always the first step.

I am obsessed with Hulu.com. It's like everything I ever dreamed the Internet could be. I can watch movies, TV shows, funny excerpts of my favorite comedies, all on a robust player that doesn't stop to buffer and plays short commercials without me having to use my fingers to hit, "Click to Continue." I can keep my arms snug and warm in bed and not move a muscle while hulu just plays away.

And, then, just when I think it couldn't get any better, I discovered the following is now available through Hulu...Buck Rogers

Somebody pinch me! Of course, you can also find reruns of St. Elsewhere.

What a country!

Chilaxin'

It's funny to think that just three weeks ago, my life was all up in knots. Oregon vs. UT, how am I going to make this work, will I be able to stay at my job if I stay??? Now, it all seems like a fond memory. It even gives me the warm fuzzies to think back on this entire spring.

The last three weeks have been some of the most enjoyable I've had in many years. First, there was the weekend in Oldenburg, TX - outside of Burton (not that it helps to know that) - where 24 hours passed like an entire week. I learned how to shoot a 12-gauge shotgun; fished; saw the symphony and watched the cows eat grass.

Then, all last week, I spent in Charleston, SC with my entire immediate family. It was a very special reunion - as we don't get to do that very often. My nephew and nieces are now old enough to be more engaging and talk to me and be silly. My parents were having so much fun with all the activity in their house. We had a fireworks display that was most likely illegal and definitely dangerous.

And, for the first time in several years, I attended a family reunion without feeling left out. I am the last one in my family to get married or have kids, and that has always bothered me until now.

Which brings me to the ultimate point of my post. Post 30 years of age, I have really slowed down on my expectations of life and learned to focus on what is reality and what makes me happy outside of anything society or people who care about me might think.

All throughout my 20s, I was eager. Eager to date, eager to get serious, eager to get engaged, eager to make good money, eager to get a better job. I was never quite satisfied, and I never really considered if the relationships I were in, or the jobs I had, really made me happy. I was too concerned with checking off the boxes. It's no surprise to me that I dated men who were not the best for me, but I stuck it out anyway. Why wouldn't you, when your biggest goal is to get married and have kids. You would do anything to reach your biggest goal, wouldn't you?

Well, it took until now to have this realization: If you're not right with yourself first, there is no way you can be right for someone else. And, because I was so eager to get so much done by the time I turned 30, I forgot to reflect on whether I enjoyed the journey.

Now, as a 30-something-year-old, I am no longer in a hurry. Just at the age everyone says you'll have an early-life crisis or feel the pressures to get hitched and have kids, I have finally decided that I enjoy chillin'. Just easin' down the road of life, and loving every step of the way.