Things that Make You Go '"ARRRRRRRRRRGH"

I struggle with stupidity. When confronted with asinine policies, procedures or responses grace goes out the window and I become an impatient, short-tempered jerk. I tell myself that I will do better the next time, but each time the next time comes I find myself struggling all over again.

One of my greatest frustrations is the number of useless forms that have become a part of my life. I somehow missed the memo, but last week must have been National Stupid Form Week.

CVS Pharmacy interrupted my day demanding to know the diagnosis for a patient being prescribed narcotics. While they say they are trying to stop fraudulent prescriptions, my prescriptions are sent through a secure electronic system that is double password protected. One of the passwords changes every 30 seconds, so fraud is impossible. This did not matter to the pharmacist, who had a form to complete.

A perfectly healthy patient came in with Federal Family Medical Leave Act forms from her employer. These forms are to be completed when patients have a serious illness that requires an extended absence from work. She had missed three days with a stomach flu so the forms did not apply. This did not matter to the Human Resources person who apparently could not take any action or make any decision unless there were forms attached.

A Plastic Surgeon’s office sent over forms for “pre-operative clearance” on a perfectly healthy 40 year old man who was getting his nose fixed. The medical literature is replete with studies and guidelines stating that such clearances are worthless and should not be performed. This does not matter to surgical schedulers. They need a form.

A medical supply company sent over forms for new CPAP supplies for a patient with sleep apnea. They needed me to write out an order for new supplies (they are replaced annually) and to submit an authorization to the insurance stating that they were needed. For the insurance I need to include the diagnosis and supporting documentation. Sleep apnea is a chronic disease that never goes away, the diagnosis never changes. The patient has had the disease for years and all of the documentation has been previously sent. This does not matter, as to dispense the supplies someone needs to complete a form.

My problem is that I resist. I try to point out to the person requesting the information that the form is useless and unnecessary. This does not compute. Their request is not a result of reason or necessity. It is a matter of policy. Trying to change a policy is futile. I would have more luck arguing with my dog about eating food dropped on the floor.

I have realized that if I try to change these policies, as foolish as they are, I will end up frustrated, angry and responding in a very non-Christian fashion. Since arguing is pointless and wastes so much of my time I have decided I have only one option left.

I have my nurse do it.

- Bart

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The Visible Hand of Invisible God

He lost his wife in January after 32 years of marriage. He was at her side for all of those years as she battled an incurable and progressive lung disease. For the last three months of her life being at her side required him being in the hospital. It was a devastating loss.

While his grief remained, after several months had passed he decided to explore the dating world. He invited someone to his home to watch a movie and have dinner. He wondered how to act, how to behave, how a man his age should relate to a woman. He found encouragement in an unexpected place.

He had also been searching for a new doctor and had come across my name in the physician directory. While researching me and my practice he came across my blog. One of the recent posts was on the series I wrote about adultery based on the chapter from my book. He clicked on the link to my sermon on the topic and watched it online. The words I spoke reminded him of the standards of morality set forth in scripture and of God’s plan for intimacy.

A month later he came to my office for the first time and shared with me the impact that the blog and the sermon had on him. The words he spoke had a profound impact on me. When I uploaded the posts on adultery and the sermon I did so never knowing if they would ever be read or watched, if they would have any impact on anyone at all. It just seemed the right thing to do.

He reminded me of the truth that God is always working, even when we cannot see it. So often in life we can feel as if our best efforts result in nothing happening or nothing changing. It is easy to be discouraged and feel as if we have no value. He reminded me that it is God who makes things happen, that God can take our small acts of faithfulness and use them to accomplish his purposes. A kind word to a stranger, an encouragement in a Facebook post, or a brief prayer for someone in need can each make a difference in someone’s life. We may never see it, but it is happening every day.

- Bart

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8 Tips for Success With Your New Doctor

Health insurance often changes with the new year and many patients find themselves searching for a new doctor. Here are some tips for making your first visit a success.

1- Come in for a reason. While it may seem courteous to want to meet your new doctor before you are ill or in need, these “getting to know you visits” aren’t always popular with doctors. Insurance companies require a diagnosis to bill and “establishing care” doesn’t count. If you want to become known by your doctor, schedule a visit for an annual wellness visit.

2- Don't come with too many reasons. There can be a lot of paperwork during the first viait and a lot of data to be entered. If you have more than 2 issues to address, ask for a longer appointment or be willing to come back for an additional visit.

3- Write out your health history in advance. Ask if the office has forms. Take the time to gather important data such as immunization history and dates of important screening tests such as colon cancer screens and mammograms. It really helps.

4- Bring a complete list of medications you are taking or better yet, bring the bottles themselves.

5- Know your insurance coverage. There are a lot of changes each year and it is impossible for office staff to keep up. They may have hundreds of different insurance plans to deal with, you have one.  Know what you need to pay each visit and be prepared to pay it when you arrive.

6- If you doctor offers the ability to communicate online, take advantage of it. I love it when patients who were unclear about my instructions gave me the chance to clarify later. 

7- Find out about office policies for someday visits and after hours calls. If your health plan requires you to use certain hospital facilities or urgent care centers it pays to know this in advance.

8- If you are unhappy, say something! If you have an unpleasant experience, let the doctor know before deciding to switch providers. Some of my greatest improvements were patient suggested. If you receive exceptional service share that too. Even doctors need an occasional “good job!”

- Bart

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Leaving the Church

People leave churches. It just happens. In some circumstances it is due to a loss of faith but many times it is because something changed in the church. When a  place that once felt safe and once felt like “home” can sometimes become unfamiliar and uncomfortable. We have seen some of our friends reach this conclusion lately about churches they attend and move on to other congregations. It is sad. It is also increasingly common.

I don’t judge my friends in their decision because it is a decision I have struggled with at different times over the years. We never plan to leave a church, but it happens. In conversations with my friends and through personal experience I have learned some of the reasons that good people, godly people, move on.

1-      Bait and Switch. No one does this on purpose but the term describes how people feel when they think a church or a pastor is one way but then turns out to be another. We have experienced this a number of times. A pastor starts off as a solid bible teacher but then decides that they are not enough “new people” coming to the church. The pastor changes his approach to attract unchurched people. This can be expressed in many different. In milder forms it is songs, music styles and dress codes that change. When more drastic  sermons can get watered down and harsher biblical truth is avoided. Mature believers end up feeling left out or even ostracized. When this happens they often move on to a place where pleasing the world is not the primary goal.

2-      Doctrinal shifts. God never changes, but people do. There is a natural tendency to want to appeal to the culture around us. Doctrines that are unacceptable to the world get re-evaluated and revisited. Over time they can be rejected. I have seen this with issues such as same-sex marriage and women in the pulpit. Faced with the choice of setting aside firmly held beliefs and staying or moving on, many choose the latter.

3-      Seeing behind the curtain. Pastors are human and are fallible. Some faults are more dangerous than others. For a while I led the Children’s Ministry at a local church. As my time in leadership increased I saw that the pastor was not the man or the friend I thought he was. I attempted to speak with the pastor as a peer and was put “in my place.” Realizing that the man was not truly accountable, we decided that “our place” was in another church.

4-      The Glass Ceiling. Churches, especially large ones, are bureaucracies. As such they often rely on structure and hierarchy to maintain a sense of organizational order. Lay people with leadership gifts can easily find themselves at odds with leadership. Churches are much more comfortable with dedicated followers than they are with gifted leaders. When lay leaders realize there is no place for them and no opportunity to use their gifts, they move on.

5-      Lack of relationship. Churches are filled with people and people often only have room in their lives for a few meaningful relationships. This can make it hard to connect. When people are isolated it is easy to look for another place to fit in.

These are just a few of the reasons Godly people leave. I share them not to be critical, but to remind church leaders and church members that not everyone who moves on is “wrong”. Sometimes their reasons are valid and just. When people start leaving churches leaders need to take a close look at themselves.

I write also for those who do not feel at home in their current church, to remind them that as long as churches are filled with people, they will have problems. We need to remember that only God is perfect and that He, not the church, needs to be the center of our faith. If you decide to move on, consider taking the time to let someone know, as kindly as possible, of your reasons. If the leaders do not know they cannot grow.

-          Bart

The Absurdity of Christmas

The Christmas story doesn’t make sense. At all. This heretical thought that came to my mind as I watched our church’s Christmas program. The orchestra played the familiar carols beautifully, the choir was excellent, the soloists sang well and the tenor quartet performed their numbers wonderful harmony. Between the musical numbers my favorite pastor shared the story of Christmas simply, eloquently and with appropriate emotion. He spoke of the angel appearing to Mary, of the fear and wonder that must have gripped her as she was told that she, a virgin, was to give birth to the Messiah. He shared with us the Christian teaching that God became man in the person of Jesus, that from embryo to fetus to newborn baby to young child God existed in human flesh.

As he spoke I thought of how absurd this all sounded.

Seriously? Do we actually believe this? It makes no sense at all. It is difficult at times to believe there is a God at all, to believe that the all powerful creator of the universe would enter the human race via the womb of a virgin seems akin to believing in unicorns and pixie dust. The story sounds like a fantasy tale, the ridiculous creation of an unintelligent mind under the influence of an illegal substance.

And yet there we all were, over 2000 of us in this church alone, singing and clapping and celebrating this tale as undeniable truth. To these worshippers Christmas is not a fable or a myth, it is a timeless truth to be remembered and commemorated. The joyous celebration of which I was apart was and is not unique, nor is it novel or new. Similar celebrations have been held around the globe for hundreds of years. The natural question is, "How could so many believe so intensely in an event that seems so implausible?"

There are many reasons. The obvious reason is the person the baby in question grew up to be. His life, his teachings, his death and his resurrection are the evidence that supports the miraculous tale. Miraculous birth is more reasonable in the context of a miraculous life. The knowledge that this birth was foretold adds to its believability.  A review of the Hebrew scriptures written hundreds of years before the event leads to the discovery that this remarkable birth was not just anticipated, but predicted.

The Christmas story does not make sense. It defies human reasoning and is contrary to our understanding. Man's disbelief does not change the fact that it happened, just as the gospel writers described it. In a stable in a small town outside of Jerusalem, the Divine appeared in human flesh. Timeless God entered time, becoming the one man who would die for the sins of all mankind. It is miraculous, incredible and absurd, but it is true. Believe it or not.

-          Bart