I had one of those episodes in the office that sums up the entitlementiasis that seems so epidemic these days. I had grandma who was 42 and on disability for "fibromyalgia" and daughter who was 22 and on disability for "bipolar" who were requesting that I fill out forms for grandaugher to have full disability for her now resolved skin infection. Both had knowledge of the whole disabilty process that would make most attorneys jealous. I gave them my usual answer, that is , I said "I am not a disabilty doctor and I really dont think you would like me to fill out those forms."
Right after they left I had another patient who is on full disabilty. He is not impaired in anyway that I could determine, in fact I had seen him climb out of his jacked up moster 4X4 truck with a 4 wheeler in the back. Turns out he was on full disability for his back. I wonder if he got it after loading his ATV in the back of the truck.
I dont understand diability, the disabled patients all drive themselves to their appointments, why cant they get jobs as drivers? I guess I haven't caught entitlementiasis yet, it must be all that alcohol had cleanser that we use.
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"Hereditary ENTITLEMENTIASIS!" Very funny...LOL!!
And so Throckmorton...what is the icd-9 code for this entitlementiasis you speak of? ;)
It's generational. What was intended to give some help to get a leg up and productive again has turned into an out of control government paycheck that rewards people for being poor, sick, etc. I'm talking about welfare actually.
Yet my own mother is in a subsidized building and has MDCD. She did work hard her entire life. She has never abused the system. Totally different situation then what these people do.
I don't understand disability either.
I know of a patient who was on disability for his legs. It had something to do with circulation.
Yet..he walked around (with a cane) and drove "everywhere" and actually opened a limousine service. He did quite well.
Ha! He even took my girlfriend and me down to a Bruce Springsteen Concert(fun) and waited the whole time of course. I thought with circulation problems you are not supposed to sit long but he did.
I think maybe you should start sending said patients home with some hand sanitizer. ;)
I don't ever want to be in the disability position. If you have your health..you DO have everything.
The system is so flawed.
Good morning Throckmorton!
I still love saying that. :)
What do doctors like?
Do they want the patient to say "whatever you want doc?"
I guess you can't speak for others but what about you? Did you like hearing that? On the one hand...it must feel great to have your patients vote of confidence... but if it is a serious surgery...like what you were just presented with, no clear cut answer...could go either way...and the buck stops with you... the operating surgeon... maybe you don't want all the decision making responsibilities.
As surgeons, it seems from what I have read in blogs and dare i say TV..that you have to jump in and decide and stand by your decision. I guess because surgery is so precise..it'd not for the faint of heart.
Ha! I just thought of something and hope I don't offend you since I don't know your political persuasion, but it ties in with your kind of posts.... If McCain and Obama were residents...picking a specialty, then based on the last debate (last weekend) McCain could be the surgeon and perhaps Obama a psychiatrist. :) McCain was swift, to the point and decisive, whereas Obama was pensive and evasive. I don't know what kind of med doc would suit him and is why I went with the head.
back to decision making.
If a case is complicated...is it just better to say"whatever you want doc."?
If it is open heart..the pt doesn't have a choice.
S/P MVA..multi-trauma ..with a liver lac etc...the pt doesn't have a choice.
If my doctor knows I need this surgery and has no doubts about it..I wish he could somehow make me understand... but if he has ANY doubts..or serious concerns...if there is ANY chance he might be able to do something else, anything else..I would be game because of course who in their right mind wants a major surgery if they have another alternative?
Maybe I need to by a book.."How to decide" or something..or maybe... I should toss a coin.
I know what I am in for with open abd surgery because I had 2 c-sections. the operating doc said he was using the old vertical c-section incision. The difference is this will be a 3-4 hr surgery, more complicated, more risks and chance of complications and now I am older with risk factors I didn't have when younger.
And as you said..it's the patient that pays the price. But maybe I have it magnified worse than it is. The operating surgeon was so confident about it, but also indicated risks...like clots in pelvic surgeries.
I think the things I worry about..I have to realize you guys do these things as naturally as breathing.. it IS your job.
Reading Surgeon's blog has helped and scared me. I like one comment Sid made where he said something like... (not verbatim)the patient is never more looked after then in the OR because they are attached monitors and everyone there is focused on them, ready to take action. But he wrote a funny piece about operating on St Nick and it was all slippery and more difficult because of the fat inside.
I assume post-op will be more of a bitch -sorry than back then.
My doctor is concerned about the per-operative time. I KNOW.. the sooner you are up and around the better. That 1st time is a killer...but you get through it. I think the gas pain is worse than the incision. Coughing post anesthesia is tough but ya gotta do it. I know with this one... no food for at least 3 days (I don't know about liquids-that will bother me if I can't drink)and in the hospital for a week. Oh and I would be stented again.
Now if it goes well...then I am done with this issue..once and for all and don't have to look back and can move forward. people tell me.."just do the surgery. why don't you do the surgery?" What they don't understand is it is not a routine surgery. If I did not know of my doctor's concern and why...I would've lined up like a lemming for the OR in June 06. Ignorance is bliss. I really would have said.."Okay..when?" But I do know. But I am glad to be informed and should be.
I know you probably don't want to answer my question, so I'll consider them rhetorical... but IF you can say anything that would shed some light on how to look at this... I would be most grateful.
I am still hoping and praying I can avoid all this but admittedly am beginning to wonder. I just can't see the forest for the trees right now. I was actually hoping to get a year more and continue working on getting healthier... therefore stronger and more stamina and so be in a better position to endure and recuperate from surgery should I need it.
And whatever I do...i guess I need to avoid surgery in the teaching hospital between may and July. ?? :)
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