السبت، 8 يونيو 2013

June 8, 1971

J. I. Rodale (1898-1971)

On this day in history... a man died (big surprise, huh?).

Like the late James Ferrozzo, it wasn't so much that he died, but how he left us. In death, as in life, style and timing are everything.

Jerome Rodale was an early proponent of healthier eating, and his legacy continues today. He was one of the first to support sustainable agriculture, and believed crops should be grown without pesticides. His publishing empire lives on today, with the magazine Prevention, which he founded, and more recent additions such as Men's Health, Women's Health, and Runner's World.

On this day in 1971 he appeared on the then-popular television talk show, The Dick Cavett Show. It aired late-night, but was taped earlier each day in front of a live studio audience.

Mr. Rodale (age 72) was the first guest interviewed, and happily went over his beliefs in living a healthier lifestyle. He promoted the benefits of organic farming, and expressed his optimism over its effects on himself. Things he said during the show included:


"I'm in such good health that I fell down a long flight of stairs yesterday and I laughed all the way."

"I've decided to live to be 100."

"I never felt better in my life!"

"I'm going to live to be 100, unless I'm run down by some sugar-crazed taxi driver."


After the interview, Mr. Rodale sat back in his chair as Dick Cavett brought the next guest onstage (New York Post writer Pete Hamill). As Cavett and Hamill chatted, Rodale made a loud snoring noise, and appeared to doze off in his chair. The audience thought he was pretending to be bored, and laughed.

According to witnesses, Cavett asked "Are we boring you, Mr. Rodale?" (Cavett to this day denies making that remark). Hamill looked at Rodale, then turned to Cavett and said "This looks bad."

Two production interns ran onstage and began doing CPR (unsuccessfully) on the healthy-lifestyle advocate as Cavett took the microphone and asked "Is there a doctor in the audience?"

Cavett, in a 2007 interview with the New York Times, said "I thought, 'Good God, I'm in charge here. What do I do?' Next thing I knew I was holding his wrist, thinking, I don't know anything about what a wrist is supposed to feel like."

Mr. Rodale was later found to have suffered a heart attack. The episode was never aired, with the network choosing to show a re-run in its scheduled place.

الخميس، 6 يونيو 2013

To err is human

Dear American public,

I apologize.

I accidentally cost you $470 last month, and so I owe each of you a $0.000000076.

I actually feel quite bad about this, but more in terms of the money lost and the inconvenience to the patient.

What happened, you ask? Well, I meant to order a lumbar spine CT scan. But due to a busy day and multitasking, accidentally wrote an order for a cervical spine CT. No one questioned it, and so it got done. I didn't realize the error until the report showed up on my desk. I apologized to the patient, and ordered the correct study.

The whole thing is overall harmless. The patient is elderly, and a few additional units of radiation are inconsequential. The 1 week delay in getting the proper test didn't have an adverse impact on his condition.

But still, I feel bad. I'm certainly not out to rip anyone off, especially other taxpayers.

This is, as far as I know, only the second error I've made in ordering the wrong imaging study in the last 10 years. I assume I have the same error rate as other docs for this sort of thing, and the total for mine is around $1100. Given that there are roughly 900,000 practitioners in the U.S., that comes out to $990 million dollars wasted every 10 years. That's enough to pay 20,000 school teachers for a year, or buy the Air Force eight F-35 fighters. Even by government standards it's still a decent chunk of change.

I don't have an easy answer for this. Should I be responsible? If a doc orders the wrong test, should he have to eat that cost? I guess that makes some sense, but someone is going to argue at some point that a test shouldn't be ordered. What happens if I did order a correct test, but then an insurance company claims it wasn't necessary - so should I pay for it?

Or what if the patient (after getting a test bill, of course) claims that I shouldn't have ordered a test, and wants me to pay for it? I've had that happen (I refused) and have learned it's common. I know another doctor who was threatened with a malpractice lawsuit to get her to pay for a study (she stood her ground, and they backed down).

So, I guess the only easy answer is to leave it as it is, and accept the fallible nature of humans. If ordering the wrong CT scan (at no harm to the patient) is the worst mistake I ever make in this business, I'll take it.

الأربعاء، 5 يونيو 2013

Doctors behaving badly

I'm with a patient, when Mary knocks on my office door.

Dr. Grumpy: "What's up?"

Mary: "Sorry, it's Dr. Promissory. He says he needs to speak to you urgently."

Dr. Grumpy: "Okay." (picks up phone) "This is Dr. Grumpy."

Dr. Promissory: "Hi, sorry to interrupt you."

Dr. Grumpy: "What's going on?"

Dr. Promissory: "My wife recently started her own business as a mortgage agent, and I was wondering if you'd considered refinancing your home?"

الثلاثاء، 4 يونيو 2013

Mary's desk, June 3, 2013

Guy walks in, stands at counter.

Mary: "Can I help you, sir?"

Counter Guy: "Yeah, um, is this Dr. Grumpy's office?"

Mary: "Yes, sir. Do you have an appointment?"

Counter Guy: "No, I'm looking for another office. Thanks."

(leaves)

الاثنين، 3 يونيو 2013

Maaaaaaaaaarrrrrrrrrrrrryyyyyyyyyyyyyyy!

Dr. Grumpy: "Can you smile for me?"

Mr. Poligrip smiles a little.

Dr. Grumpy: "Smile wider. Can you show me your teeth?"

Mr. Poligrip takes out his teeth and holds them up.