The Other End of the Stethoscope

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Contents

Foreword..............................................................................ixIntroduction..........................................................................3Recruiting the Best and the Brightest.................................................11Indoctrination of Medical Students....................................................12Internship, Residency, and Fellowship.................................................21What Makes a Great Physician?.........................................................24Medicine vs. Family...................................................................25Oath for Doctors of Medicine..........................................................27A Lack of Practical Experience........................................................29The Three A's of a Good Physician.....................................................30A Typical Day in the Life of a Doctor.................................................32Thirty-Six-Hour Days, One-Hundred-Hour Weeks..........................................44Dealing with Insurance Companies and Managed Care.....................................46The Good, the Bad, and the Ugly—Patients and Physicians.........................48Remembering "The Good Old Days".......................................................55Chapter 3: The Business of Medicine Humble Beginnings.................................57The Costs of Private Practice.........................................................61Pharmaceutical Companies and Health Care Costs........................................62Insurance Companies' Costs and Control over Health Care...............................73Managed Care or Middleman.............................................................77Lawyers and Health Care Costs.........................................................89Rising Overhead Costs.................................................................89Decreasing Reimbursement Rates........................................................93Increasing Unpaid Time................................................................100Malpractice Claims Are on the Rise....................................................105Examples of Successful Malpractice Lawsuits...........................................108Consequences of Malpractice Litigation................................................114Defensive Medicine....................................................................124Doctors Make Poor Patients............................................................135A Little Knowledge Can be Dangerous...................................................135Doctors Have More Complications.......................................................137Being a Patient Makes a Better Doctor.................................................145Preserving Humanity in Medicine.......................................................149Art vs. Science in Medicine...........................................................150The Doctor-Patient Relationship—Adversaries or Allies?..........................151Getting Control over the Middlemen....................................................156Would a Single-Payer System Be So Bad?................................................157A National Malpractice/Complications Fund.............................................158Physicians and Patients: Heal Your Health Care System.................................162Afterword.............................................................................167Bibliography..........................................................................169Index.................................................................................177

Chapter One

A career in medicine used to be viewed as one of the highest callings anyone could have—it was seen as a noble profession associated with respect, appreciation, and trust. Being a physician was regarded as one of the best things a person could do with his or her life. Medical schools were able to recruit the best and brightest students from college, and acceptance to medical school was extremely competitive. Aspiring physicians were some of the most intelligent and idealistic people, filled with enthusiasm about the opportunity to heal others and to learn everything they could about the human body, illness, and treatments. Is the medical field still a noble profession?

I grew up in the sixties and seventies, a rebellious era for most young people. My father died of lung cancer when I was sixteen, and his death shut me down emotionally for a long time. Because I was such a bad student and always in trouble, I dropped out of public high school and went to a free school called Skunk Hollow High School. Needless to say, I was not voted most likely to succeed, nor was I the class valedictorian or a cheerleader. In fact, no one would have pegged me as a future neurologist, yet from these nontraditional roots, I stumbled into this noble career. Skunk Hollow High School was a place filled with hippies, musicians, artists, and philosophers. There were no grades, no scheduled classes, and no attendance taken—basically no rules. At a time when I was rebelling against everything remotely authoritarian and struggling to define myself as a young teen, I finally found myself in a place where there was nothing to rebel against. I have many great memories associated with this school, but the greatest lesson I learned in this midst of true academic freedom was that unless you got up and did something with your life, nothing happened. If I wanted to learn something, I had to find the teacher or resource and make it happen. If I wanted to be good at something, I had to learn the discipline of practicing, studying, and hard work. This has been a cornerstone of my philosophy of life, and I admit I often have difficulty understanding those that wait their whole lives for something to happen or for someone else to make decisions for their futures. I became interested in herbs and nutrition, perhaps as a reaction to the failure of traditional medicine to heal my father's cancer. It was my first inkling of something that would consume my life. Perhaps it was a way to take control of an event over which I had no control.

After high school graduation, I moved out to California in my little white VW van, piano in the back, boyfriend in the front, and all the world ahead of me, undiscovered. I played the French horn to the cows at rest stops along the way. I enrolled in the local college to take a few courses that interested me while I worked days as a file clerk in a court reporting office. Anatomy and physiology, psychology, microbiology, and Edible Wild Plants comprised my first year's schedule. By the end of the year, I was hooked on learning about the human body. I became more and more aware of how little I really knew. I then took a course in deep tissue massage that incorporated principles of healing, movement, and energy analysis—alternatives to traditional medicine—which were highly controversial. I experienced the joy of touching others, experiencing their energy, and making a difference in how they felt. I was learning to develop my perception of others, looking for blockages in their energy fields or auras, and to channel my own energy to heal others.

As my knowledge of health and illness grew, I...