Prayer as Medical Treatment

Her head had been in near constant pain for over 3 weeks. She had endured migraines for years but they had been rare and relatively brief. The pain was not making it difficult to sleep and function, work was out of the question.

This was her 4th visit in the office in a 2 week period. I had prescribed pain medications (which made her vomit), medicines to abort migraines (which had minimal benefit that did not endure) and had even stayed late one day to administer a steroid shot (which was a long shot at best). When I walked in the room the tears in her eyes and the strain on her face told the story. She was emotionally done, the end of the rope had been reached. She wanted help.

Unfortunately I did not have much to offer. All of the options for immediate relief had been exhausted. The next step would be to start daily medications to prevent headache, but these medications can take several weeks to be effective. I ordered a CT scan of her brain, which although medically needless was emotionally necessary to calm her fears and wrote the prescription for the daily medications.

Out of options, as I was bringing the visit to a close I asked, “Are you religious at all? Do you practice any faith?”

“Not really,” she said, “I went to Catholic school though. Why do you ask?”

“Nothing else has worked, so I was going to offer to say a prayer for you,” I replied.

“I’m not religious,” she said, “but I would welcome you saying a prayer right now. I will take whatever help I can get.”

I walked across the room and put one arm around her shoulders and said a simple prayer, “Dear God, Amber is hurting right now. She is frustrated and exhausted. Give her hope, give her peace, and giver her relief from pain. Amen.”

I had been taught In medical school I had been taught to never inject faith into an office visit and to never allow my faith to intrude into my care. Her acceptance of the hug and the prayer proved my former teachers wrong. Faith, expressed as love and concern for a person in need, always has a place.

Bart

House Calls of Death

He was serious alcoholic. His disease was so severe, his addiction so powerful, that 21 stints in rehab had failed. His marriage had fallen apart, his children had been taken in by his parents, he was unemployed, lonely and miserable. He was 41 years old and in his mind his battle against alcohol had been permanently lost. He gave up any hope of recovery and went to his primary care doctor looking for a special kind of help. On July 14 of this year his doctor gave him the “help” he requested. His doctor killed him.

The patient, Mark Langedijk, lived in Holland, the country with the world’s most liberal euthanasia laws. Physician administered death is common there, in 2015 more than 5500 Dutch citizens had their lives ended at the hands of a doctor. That calculates to about one of every 2000 Dutch adults. In Holland, having your life ended by a physician is not a rare event. 

The law, as originally introduced 16 years ago, was purported to be about allowing patients with terminal diseases to choose the timing and means of their own passing, a way for patients doomed with incurable and progressive illnesses to control their destiny and avoid needless suffering.  That is not the current reality. The scope of conditions for which physicians are allowed to give lethal injections has widened considerably. A young woman in her 20’s struggling with post-traumatic stress disorder from child sexual abuse was recently determined to have mental suffering severe enough to justify ending her life. A physician injected her with heart stopping medications.

An increasing number of states in the US have passed laws for physician assisted suicide, which makes the Dutch experience all the more sobering. All of these state laws were advanced with the same arguments and promises given in support of the laws in Holland.  Opponents of these laws who feared widespread and inappropriate use of euthanasia were accused of lacking compassion for the suffering of others. Proponents of these laws consistently argued against “slippery-slope” arguments, saying that controls and limits were included in the laws to make sure they would not be abused.

The reality is that slippery slope arguments are always valid. When society moves in a direction it typically continues in the direction. The debate is not about whether we will move towards greater use of euthanasia, that will happen. The only question is the steepness of the slope and the speed of our descent. When a society crosses the line and says that some lives can be terminated they have embraced a system in which society has the right to determine which lives are worth living and which are not. The stories from Holland remind us that once that line has been crossed,  that over time more and more lives will be determined unlivable and more lives will be ended by physicians.

If there is no course correction, Americans will one day wake up in a world where death doctors are performing house calls, a thought which should be sobering to us all.

Bart

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reference- The Daily Mail November 30, 2016

How to, and Not to, Apply for a Job

We needed a new receptionist. Receptionists are the first voice patients hear on the phone and the first face they see when they come into the office. They can be the difference between a positive or negative impression of not only the practice but of the doctor on a personal level. A bad hire can lead to damage that takes months to overcome. With these reasons in mind I began the search process with a sense of dread. I did not want to make a mistake. Again.

I decided to attack the problem on two fronts. I called a local temp agency with whom I had worked in the past and also put an ad on Craig’s List. The resultant flood of resumes and applications revealed a lot of how, and how not to, apply for a job. Here are some of the lessons learned.

1-Career Objective statements on resumes are often stupid and can kill an applicant’s prospects.

I do not know who teaches medical assistants how to compile a resume but someone has been telling people to say really stupid things at the top of their resumes. Here are some of the opening goal statements-

“Obtain a Administrative position where utilizing extensive skills and knowledge will help people.”

“My objective is to one day rise up in a company and expand my knowledge, strengths and interests in the different things I do in life, also to learn and grow from my mistakes which I consider stepping stones in life for a better future.”

2-Many applicants seem to be seeking a job other than the one for which they are applying.

I received resumes from applicants stating they wanted to “improve sales” or “work in a hospital” setting as well as  others that did not make any mention of the position for which they were applying. In a competitive market applicants should take the time to edit their resume so it appears they are applying specifically for the job in question.

3-Grammar and spelling matter

One applicant was very interested in a "postion" with my company. She didn’t get it. She didn't get the position either.

4-Many applicants don’t understand they need to do what the boss wants.

In order to make the process more efficient I decided to conduct all of my initial interviews via Skype or FaceTime. There are times when I can tell someone is not a good fit within just a few minutes. It seems unfair to both of us to make someone drive to my office for what may be a brief interview. FaceTime seems to be a great way to conduct a brief initial screen and respect other's time. I called one applicant and asked if we could schedule a brief initial interview on FaceTime. She replied, “I would rather not do that.” The result was that she did not get interviewed at all.

5-A little homework goes a long way.

In our area our office is the top rated practice on Yelp. I have an office website and Facebook page as well as this personal website/blog. Less than half of the applicants I interviewed had taken the time to read about me or my practice and as a result were unable to give specific reasons why they wanted to work for me. They came across as interested in any job, not for this specific job. As I was looking for someone who believed in our vision and philosophy of care these people placed themselves at a significant disadvantage.

6-Your past is not a secret.

One applicant sent over by the agency gave a good interview and we were ready to hire her. Then her background check revealed she had multiple felony counts pending for stealing prescription pads and writing fraudulent prescriptions. Another applicant had judgments against her for breach of contract. In an internet era a person's background is only a few clicks away.

7- Do it right and you may get more than you expect.

The person we hired had none of the above problems. Her career objective on her resume was “To obtain a position in a company where my experience and skills can be utilized to better improve patient satisfaction.” As our primary focus is quality care and service, this statement showed she shared our values. Her resume emphasized her experience in medical offices in a clear and concise manner.

When I called and asked if she was available for a FaceTime interview her reply was perfect. She told me she thought that was a great idea and that she would be available that afternoon. When I “called” her, she was dressed nicely, had appropriate hair and makeup, and was ready with a smile and pleasant demeanor. She had done her homework and knew who we were and what our values were. She had read our reviews on Yelp and told me she liked our emphasis on customer service.

Finally, her social media presence showed someone who was mature and committed to family. Everything about her was positive and appealing. When all of this was combined with the talents she revealed when she came in for a working interview it is not surprising that I hired her right away at a salary above what she requested.

She comported herself like a winner and won the job. She made me feel like a winner as well.

Bart

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Fighting to be Thankful

I woke up Thanksgiving morning feeling more stressed than thankful. While not unaware of the blessings that fill my life, these blessings have recently taken a back seat to stress. Turnover in the office, conflict in some relationships, a recurrence of chronic pain issues and even a sick dog have weighed heavily on my mind. My morning began with a tinge of sadness and I found myself reflecting on more negatives than positives.

A tweet helped change my mind.

The tweet was from Don Willett, Texas Supreme Court Justice. It featured the picture in this post with the comment, “This Thanksgiving, remember with gratitude America’s peerless military, far from home & close to danger.” I did what as Justice Willet suggested, and took time to remember the blessings secured and preserved by the millions of men and women who have served.

I remembered that I live in a free nation, with a free economy in which I am blessed not only to have a job, but to own my own business. I go to work when I choose, leave when I choose, pay my employees what I choose to pay them and am free to do what I believe is in my patients’ best interests.

I am free to worship. Each Sunday morning, I wake up with the ability to not only go to church, but to choose which church to go to. The pastors are free to preach whatever they want without fear of recrimination or arrest. I am free to give to the church of my choice and the money I give is not taxed by the government.

I am free to vote. I may not always like the choices I find in the ballot booth but I am free to vote, or not vote, for whomever I want. The candidates are chosen by the people, not by the government.

I am free to speak out. I can criticize the government, I can march against perceived oppression, and can stand on a street corner with a sign supporting or denouncing any cause or position I choose.

I have all of these rights and hundreds more because someone else fought for them. My ability to sit with my family to eat Thanksgiving dinner today exists because of others who have sacrificed time with their families in order to preserve my freedoms, which is a lot to be thankful for.

Bart

A Silly Game, Enduring Values

It was a stupid, simplistic table game. As we were too young to know we should have been bored to tears by its lack of sophistication we played it over and over. The game was called “'Tis so” and it was based on the Old Testament book of Proverbs. Its purpose was to teach proverbs to young kids. It worked.

The game consisted of small 1.5 inch by 0.5 inch pieces of cardboard that each had a portion of a proverb written on one side. Proverbs were divided into three sections with the words for a particular proverb all written with the same color font. The goal was to collect the three parts of a proverb and then lay them out in front of you in a fashion similar to the card game “Go Fish.” The player who had the most proverbs in front of them won the game. Pretty simple concept but it had a profound impact on me.

It was through this game that I learned a proverb that has shaped my life-

A good name is to be chosen rather than great riches, and favor is better than silver and gold. Proverbs 22:1

I was only 10 years old but I understood what the verse meant. There is nothing in life more important than your character. It was clear to me that if I was ever forced to choose between doing the right thing and making money that the right thing should always win out. Good men never count the cost before doing the right thing. From that time on I set my sights on the lofty goal of being a good man. Although I ended up pursuing a well paying job wealth was irrelevant compared to integrity. What mattered the most was who I was inside, not the stuff I possessed.

I have worked hard to instill this value in my children. When my son was in 4th grade we went to his parent/teacher conference. When we sat down with the teacher she briefly mentioned some behavioral issues our son had displayed, that he had been mean to a special needs child. She quickly told us that the issue had been dealt with and then tried to move on to a discussion of his stellar academic performance.

To her surprise and chagrin we had no interest in discussing his classroom performance. “I know he is smart,” I said, “I am more concerned about his character.” I told her I would rather my son be a trash collector with character than a dishonest President of the United States. I backed up my beliefs when we went home.

We learned that he and another student had been picking on another child while they all played on the school's new and very popular playground equipment. We told him that he was banned from that equipment for the rest of the school year, a total of 8 months. “Every time you see the other kids having fun on that playground I want you to remember why you can’t" I said,  “We are Barretts, we don’t pick on the weak, we defend them.” We said nothing about his academic success. Both my son and his teacher learned that day that in our eyes character was more important than worldly success.

It seems that the values found in Proverbs 22:1 are increasingly on the decline in our nation. We just completed an election cycle led by individuals who seem to believe that character is irrelevant. All that mattered was winning by any means possible. This seems to be the  new American way, which means we have lost out way as a nation. People cheat in business, on exams and in their marriages. There was once a time when a handshake sealed an agreement, we now live in an era where promises are made to be broken. 

I cannot change America but I may still be able to make a difference. It is my hope and prayer that I will be a honorable and trustworthy man and as a result encourage those around me to do the same. I may not end up rich, but perhaps I can leave this world with something of greater value. A good name.

Bart