Category Archives: healing

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The pending healthcare bill

I’ve just seen an article from the American Academy of Family Physicians that more and more solo and small practices are closing.

Call your Congressperson, because the thing that is most likely to close my small clinic and clinics near you is the latest healthcare bill passing.

That is, to be even more specific, the thing that will most likely close MY one doctor clinic is THAT I WON’T BE ABLE TO AFFORD HEALTH INSURANCE.

Really? Oh, yes.

I was sick for ten months, June of 2014 until April of 2015. I managed to hire a physician’s assistant by November of 2014 and I returned to work April of 2015. I was only allowed to work half time initially, for a year. Actually, quarter time. Because the latest article on primary care has average salaries. What interests me is that every doctor they interviewed who is earning the “average” is working 60-70 hours a week.

So when I returned to work I was allowed to work half days. That is, four hours a day. So, 20 hours a week. One third to one quarter time.

Also I was paying for my own insurance and I had a $5000.00 deductible. Which I had to pay in both 2014 and 2015. I also had to spend retirement money and savings to keep the clinic open. Negative earnings and using up savings in 2014 and 2015. I worked 20 hours a week for a year. And guess what? My income for 2015 qualified me for Obamacare in 2016.

No deductible. By April of 2016 I am released to “full time”. But I have learned my lesson. My sister died in 2012 and my father in 2013 and these deaths were the trigger for me getting sick. I can’t retire yet. I have burned through savings for three years. I choose to work 40 hours a week.

This means that I stop seeing patients by 2:00 pm. I still do an eight hour day because there is at least three hours of phone calls, insurance prior authorizations, lab results, x-ray results, specialist letters — like yesterday. The specialist says the patient should have an MRI. But the patient is a veteran. So the specialist says I should order it. That means filling out the paperwork for the VA authorization, mailing the order to the patient, calling the patient to remind them that triwest will throw my order away unless the patient calls to get the test authorized. Yep. And the specialist gets paid 3-4 times what I make. How nice.

I also choose longer visits. The local hospital kicked me out of their clinics because I protested about a daily patient quota. I was not diplomatic. And I don’t care, because two years later they decided I was right and lowered it. And I like my private clinic better.

BUT if Congress passes this healthcare bill and I return to over $1000.00 per month health insurance for me and a 19 year old daughter, and with a $5000.00 deductible…. I don’t know. I think I will run a Go Fund Me and ask President Trump and my Congresspeople to donate to pay my health insurance and keep me open.

And by the way: I think Congress should have the same health care as their constituents. Give the ones over 65 medicare and the ones under 65 medicaid. Let them experience what older Americans and disabled and poor experience. And don’t let them bypass it with cash, either.

Call Congress. Stop the bill. Thank you.

 

I am a board certified board eligible family doctor for over 30 years, who has chosen to do rural medicine the entire time. I am small and ordinary…. like this song sparrow.

For the Daily Prompt: meddle.

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prayers for children

This is my daughter, five years ago, at Lake Matinenda in Ontario. I cried when I read about the baby thrown from the London fire.

Prayers for the children in the London fire and their parents and grandparents. Prayers for the refugee’s children, that they are not lost and drowned. Prayers for the Congresspeople shot yesterday and their families and friends.

Prayers for all the children in the world.

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tour group

I took this photograph sitting on the steps of the Renwick Gallery, finishing a cup of tea before I went in. I was back visiting my son and old friends in the Baltimore-Washington corridor.

They should rename it the Baltimore-Washington superhighway.

And is it a revelation that you see things like this in Washington, DC? It’s a pretty weird place.

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damage

This is not about one patient. It is about many. I have permission from the person I gave a copy to: one of many.

what do you say
to the person
with the terrible childhood
with addiction and chaos
and suicide attempts and hospitals
and that was the parents
that they ran away from

and then numbed themselves
in addiction for years
multidrug and chaos
and now stable
working their 12 steps

and grieving
their lost years
and their behavior
unforgiven, it takes time
to build trust after
thirty years of damage

and grieving
the next generation
following the same
path and feeling helpless
to stop them
and guilt for their
contribution

it is not a matter
of a pill
of a diagnosis

the simplicity of stopping
of getting clean
joy and pride
yes

and then the hard work
of grieving
begins

 

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I took the photograph at the Renwick Gallery.

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small mother

I was already a mother when I became a mother. Long before I had my son. I just didn’t know it.

I became a mother at three. My mother had tuberculosis when I was born. Luckily she coughed blood a month before, otherwise I would not be here. I was born in a tuberculosis sanatorium, the first baby there in 25 years. My mother said that the staff was hugely excited about a baby. She was drugged to the gills while reading about the French Revolution and hallucinated Marie-Antonette’s head on a pole and the guillotine. She joked that she could never read about the French Revolution again. I was born, she kissed me, and I was swept away so that I would not get tuberculosis.

I was with my father and father’s family and then with my maternal grandparents. I came home to my parents at nine months. Adults kept handing me to other adults. I concluded that they were loving but stupid and couldn’t be trusted for a moment.

My sister was born five days before I turned three. My mother said that I met guests at the door and said, “Come see my baby.” Mine, because these adults don’t understand the needs of a baby, and I want her to feel loved and safe. No one will give my baby away!

Later my mother would tell a story about my sister worrying about Kindergarten. My mother could not reassure her. Neither could my father. I spoke up: “All you learn is colors, numbers and ABC and you already know those. I taught you.” My mother claimed that my sister was instantly reassured. I don’t remember: these are my mother’s stories and she is gone. But I have collected mother daughter pictures and small statues, just a few, all my life. And I wanted to have children. I liked surgery and obstetrics, but I chose family medicine, because I want to have children and to see them and be a mother too.

Health and joy and safety and comfort to all mothers and fathers and children everywhere.

 

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xerotic

The letter X in Blogging from A to Z.

X for xerotic, which means x-rated erotic…

No, just kidding. Xerotic means very very dry skin or dry eyes and it’s a medical term. We do have xerosis as a medical term. As we get older our skin gets drier. One of my dermatologist friends says that we lose our bubble wrap: the layer of fat padding the skin thins until our hands bruise with normal daily activity.

Have you felt xerotic? This has been a long week in clinic and I am feeling tired and sad for some of my patients. My spring of ideas for healing is dry at the moment and I need to rest. I am going on a beach walk today. I need healing too, to be at an oasis, to be nurtured and cared for. Maybe xerotic is not used that way but it could be.

Two more letters and one more day.

I took the photograph on a hike at Joshua Tree in 2009.