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Sunday, July 6, 2014

Almost time.

It's been almost a year since we moved to Arkansas, and it's been a rather remarkable year. Now, the decision was not an easy one. We loved living in Edmond, the work in OKC was generally satisfying, and the people I worked with were wonderful. But it came down to deciding between my staying around (and getting paid less), or leaving. And where, you might ask? Well, I've got 4 of my 6 grandkids right here in NW Arkansas, and there was need of another hospitalist (actually more like three more). So, for me there was really no decision to be made. And our house sold (for the asking price) the day we put it on the market. It seems the way was set for us to move...

And with moving, you tend to see things in a new perspective.

Some of you may have noticed that the practice of medicine (or to use the current terminology, the delivery of health care) has taken on new and not altogether friendly dimensions of late. And here I am, getting close to retirement, and not liking this change one bit. When I went to medical school and did my residency - it was the exciting, demanding, and patient-centered pursuit of excellent medical care that I was taught. We finished residency (or fellowship) with a purpose, and we were ready to take on the challenges of providing the best medicine for our patients.

But what we were not prepared for was the influx of the "third party" into our lives. What may have started innocently enough, became a great iron wedge between us and our patients. And it is a very demanding, oppressive and demeaning thing that we have to deal with. And where is the patient in all this?

And have you looked at medical records lately? If you can filter through the pages and pages of computer-generated trash that is the bulk of the medical record to try to find out what the patient actually complained of, and which led to him/her being admitted to your facility...

Not to mention what becomes of the physical exam, which now is a series of boxes that someone has checked off, and it contains the electronic signature of the recording "physician." And that ER record... what an incredible piece of garbage is that? Do I sound bitter? Well, I am. And what does this all have to do with us moving to Arkansas? I'm getting to that.

Right here in NW Arkansas, our three hospitals are owned and managed by a very large, slow-moving, unyielding and unforgiving entity called Community Health Systems. And everything that needs to be done locally has to "go through corporate." And this corporate giant has decided that, thanks to the previously mentioned "third parties," we must now tow the line and get on board with "computerized health records." The go-live date is sometime later this month. And mind you, this is the same entity that cannot manage to keep what computers it has on hand running, or if they do, they make certain that they have to update their system in such a way that 1: you have lost some access to needed data, and 2: it will take another three or four weeks to get it back to running the way it was supposed to, and 3: you've now got to change your passwords again!

I just think that I am getting a bit too old for all this.

And that brings me around to what I originally was talking about is this blurb. You see, my wife and I have decided to go on another Alaska cruise. And what does that mean? It means that we are going (all by ourselves) in a little over three weeks to the home of whale-watching, salmon bakes, fabulous opportunities to hike in the cool woods, to shop in the quaint stores, and to watch the majestic glaciers - all the while getting it photographically recorded for my other blog (

Maybe, just maybe, when we come back, I'll have a better perspective on "the delivery of health care." Or  maybe I'll just write the rest of my sequel...

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