PookieMD's Blog: Where Physicians Learn About the Business of Medicine

I am reading the fascinating book, The Healing of America,by T.R. Reid.  I will review it more detail later but was very much intrigued by a mention of Dr. Ernst Wynder.  Dr.  Wynder is my new hero.

In the May 27, 1950, Journal of the American Medical Association, Dr. Wynder published his findings that smoking causes cancer.  Dr. Wynder studied 604 non-smokers, “moderate” smokers and “heavy smokers” based on patient interviews.  He examined, retrospectively, 20 years of smoking behavior.  He found statistical correlation between cigarette use and lung cancer.  Dr. Wynder also developed a machine that would smoke cigarettes.  He then painted the residual tar on to mice, and with in one year, 44% of the mice developed cancers.  Tragically, Dr.Wynder’s mentor and co-investigator, Dr. Evarts Graham, a heavy smoker, died of lung cancer.

This single study probably has done more for American public health than any MRI, transplant surgery, or medication created during this same time.  Yes, we hear all about the famous surgeons and scientists (think DeBakey, Watson and Crick, Jarvik)  but truly, Dr. Wynder is an unsung hero, and has had immense influence on America’s health.

“It should be the function of medicine to help people die young as late in life as possible.”–Dr. Ernst Wynder

Who is your medical hero?

I love Thanksgiving, because it is a holiday with all the right things.  It has family, food, football and some time off to boot. It’s not horribly commercialized, and no one gets all upset about gifts and decorations.  What’s not to like?

So, here is what I am thankful for this year:

1. I have a job that allows me to work more when I need it.
2. My family (and me!) is healthy.
3. I have a home to live in, surrounded by nice neighbors and great friends.
4. I have a great kid, and a loving husband.
5. My furnace works.
6. I have a big back yard with a hammock and rose bushes.
7. The docs I work with are amazingly kind and real.
8. My subaru has 200,000+ miles and keeps on going!
9. I have food to eat.
10. On Thursday, I will break bread with family and friends, and thank God for the freedom I enjoy every day.

Please remember to say a blessing for all those young men and women in our armed forces that serve so that we may enjoy all the riches this country has to offer!  And while you are at it, say one for the police, fire department, and of course, all the doctors and nurses that are working while we are eating.

God Bless you all! Happy Thanksgiving!

The following cases are true, but the names have been changed to protect the innocent.  You may recognize your practice here, and if so, shame, shame, shame!

Case 1: The Absentee Owner. At this practice, the physician owner  (in solo practice) never reviews the books.  The book keeper goes in once per year and balances the books.  The physician never looks at anyreports to see where his money comes from or where it goes.  “I have plenty of money, so I don’t really care,” he says.

Case 2: Irreconcilable Differences. At this practice nothing is ever reconciled.  There are over two years worth of bank statements, credit card statements and random receipts that have never been entered in to the books.  The physician owner, again in solo practice, wonders if a  book keeper and/or a practice manager would be helpful.  Time will tell if the practice keeps it’s doors open!

Case 3: The IRS is on line 1. Here, mail is allowed to pile up, unopened, with the philosphy of “if I don’t open it, it can’t hurt me!”  Several of the envelopes contained inquiries into way ward payroll payments, from friendly IRS agents.

Case 4: No review of systems.  Here, there is absolutely no review of systems, actually no system at all!  Bills, payments, notices, and other random paperwork are placed in piles, with out any way to manage them.  There are no formalized ways of doing things,and so things just don’t get done, leading to financial meltdown.

If this is you and your practice–get help!  Stage an intervention! You work too hard to become another case in the PookieMD casebook of mismanaged practices.

• @foxggf I use EPIC a lot, and they wanted a physician to help the other physicians. I'm not super, I'm just a user! #
• @SteveBar2 Thanks for the info! in reply to SteveBar2 #

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• Digging out of the snow here in Colorado. I get a break next week, as I will be the "super user" for a hospital bringing up the EPIC EMR. #

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• Recertified my ACLS today. Glad it's over! Learned about a cool, new "fail proof" intubation devic–the King Airway. Anyone use it? #

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• Next week I review Crush It!, but don't wait–go buy the book! #
• Finished my portion of the NIH grant application. Keep your fingers x'd! #

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• Interviewing for a new assistant. Want someone extremely detail oriented and reliable. #

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• Learning to use linkedin. Trying to figure out how to import it to wordpress. Anyone know how? #

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• Help! Need tips on how YOU manage when there's just too darn much to do! #
• One of our doctors has her panties in a twist about using an emr at a client's clinic. Sometimes, I think docs are a bunch of whiney kids! #

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