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I came across this advertisement on Facebook . . .

RunOver45
Seriously?  Are we supposed to think that runner is over 45?  I’m wondering if she’s even over 25!

And by the way, I am over 45, and I can run faster than a nine minute mile (especially if I am following her!)

I guess I should get the rate I deserve on life insurance!

And if you are over 45, you should probably ask your doctor if your heart is healthy enough to have running.

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The past week I had the opportunity to go running on Hilton Head Island, in the Sea Pines area mainly.  The weather was fantastic, although perhaps a bit more humid than one would choose for running.  After the winter we had in central PA, I will not complain about heat or humidity!

This was a typical view while running:

HiltonHead

The Sea Pines Resort area had an elaborate maze of biking/running trails that wound along the roadway system and golf courses.

Trails

This made running really enjoyable until . . . .

STOP

Thou shalt not pass! (DO NOT collect $200)

ARE YOU KIDDING ME?  A STOP sign for pedestrians?

STOPcloseup

Well!  Isn’t that special?!  Let’s give the benefit of the doubt and the right of way to the two ton death machine instead of the helpless pedestrian or biker.  Who came up with this idea?

As if that wasn’t bad enough, there were still thoughtful drivers who would come to a stop to allow bikes, runners and walkers to pass.  The problem was, the cars behind said Good Samaritan weren’t always ready to stop–they weren’t expecting it, especially if they were local and used to this cockamamie hierarchy of right-of-way privileges.  Worse yet, one lane of traffic would stop, which they didn’t have to, but the other lane wouldn’t.  This was problematic when a small child on a bike started forward  because the nearest lane stopped, not realizing the other lane wasn’t stopping.  I saw this happen numerous times.

I have to be honest.  I ran many of these STOP signs.  Literally.  Forgive me Father, for I have sinned.  A Hilton Head cop finally pulled me over.

I tried to explain.  “I slowed down officer.”

He wasn’t impressed.  “You were supposed to STOP.”

“But I slowed down, ” I protested.

He then pulled out his nightstick and started beating me.

As I’m writhing in pain, he asks, “So!  Do you want me to slow down, or do you want me to STOP?”

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Today, I participated in the Beaver Stadium Run sponsored by the Paterno family, with proceeds benefiting Special Olympics of Pennsylvania.  I was able to raise $1,450 to benefit Special Olympians.  Last year they raised over $400,000 but I do not know the total for this year.  As a result of my fundraising efforts, I was invited to a reception with Sue Paterno, Jay Paterno, Franco Harris, and Pat Chambers, who is Penn State’s basketball coach.  I know!  I didn’t even know we had a basketball team!  James Franklin wasn’t at the reception but he and his family were there for the race.

I'm in there somewhere!

I’m in there somewhere!  Maybe.  It’s last year’s photo.  I was there.

Anyway, after the Blue-White Game, a free football scrimmage that marks the end of Spring practice,  and the private reception they had accommodations at a hotel in State College for runners that wanted to stay overnight before the race.  I only live about 40-45 minutes away depending on how many cops are alongside the road, but the reception ran till 8:30, and the race was the following morning at 11:00.  I could save gas by not driving back and forth.  It seemed like a win-win situation for me and the environment to stay in the hotel.

Until one o’clock in the morning.

That’s when the smoke alarm in my room started to chirp every minute or so.  After listening to this for a few minutes, and quietly hoping it would just STOP, I got up and removed the battery.  Hey!  It’s not like I’m in an airplane bathroom here.  And it’s not because I wanted to smoke.  I just wanted to sleep!  I have a race to run the next day!

Finally, I called the front desk.  They came relatively quickly, although my room is physically as far away from the front desk as you can get.  They gave me a map to help me find where to park.  I had to stop and ask directions.  I was afraid I might need a passport, but fortunately, I did not cross any foreign borders on the way to my room.

They replaced the battery and . . . . silence.  They apologized profusely, and excused themselves.  I turned out the lights and tried to return to my racing dreams of crossing the finish line first to be congratulated by the entire Penn State cheerleading team . . . but I digress.

Within two minutes, the chirping resumes.  WTF?!

I again call to the front desk, but there is no answer.  I guess the two who made the Lewis and Clark journey to my room haven’t returned yet with Sacajawea.  So I listened to the bird chirping and wondered if it was a finch or a blue jay?  After finally contacting the front desk duo again, I waited for their arrival and let them in.

They played with the battery some more.  He thinks perhaps he put it in wrong.  (That’s what she said.)  She just seemed distressed or perhaps she knew the entire hotel was at risk because there was no one at the front desk right now.  She suggested cutting the electric wires to the unit–which makes you wonder why it needs any battery after all except as a backup for power outages and this seems like something that could wait until say, 10:00 the next day.  He asked her if she wanted to electrocute him.  She does not answer (but smiles.)  I was sensing some tension between these two.  Or I might just be TIRED!  He pushed a button to test the unit.  Long, loud chirp.  Okay, I am fully awake now!

Finally, the chirping stops and the two apologetically removed themselves from my room again.

Sleep at last!

I have set my phone alarm to go off at 8am.  I’m only 10 minutes from the race location, but I’m pretty sure I am gong to need to eat something, but I can’t run right after I eat something, so I figure three hours is a good compromise.

Unfortunately, the previous occupant of this fine hotel (“we’ve had no fire in 117,497 days!”) room set the alarm for 6 am.  And it dutifully awoke me at 6 am.

I should have just gone back home!

Humor aside, I don’t think it affected my performance.  Maybe the two beers I drank at the reception did.  Or the two creme filled donuts I had on Friday.  Or the double quarter-pounder with cheese and fries before the Blue White Game.

Whatever,  I did not win.  There were no cheerleaders.  It was only a dream.

But I did place 64th out of 1900 runners, and fifth in my age group (old farts.)  I beat my time from last year (22:43:82) with a new personal record of 20:59:01!

But I have to admit I was humbled a bit.  As we lined up before the race, they attempted to group people by how fast they run.  I moved to a point just ahead of the sign that read 7:00 to 8:00 pace (my official pace was 7:00!)  NAILED IT!  I stood near a young woman (and quite frankly, they all look young to me anymore except for my cataract patients.)  I find it helpful to have something to focus on while running.  She was wearing very short, very skin tight gray shorts, and a tank top.  She was very focused.  She would be the rabbit to my greyhound.

However, as the race started, she was more like a turbo charged super ninja rabbit on steroids, and was out of my sight before we reached the one mile mark.  I never saw her again.  I ate her dust.

Worse yet, the person in my age group that beat me out for third place and a possible medal (by 12 SECONDS) blew by me about 3/4 of a mile before the stadium.  I know this because my first thought when he went by me was, “that guy is old.”  He was.  Gray hair (not tight gray shorts) and everything.  He had on a gray T-shirt with words on the back.  “Ask your doctor if getting off your ass is right for you.”

This is what losers see.

This is what losers see.

The shirt distracted me.  Not the same way the gray pants did.  I had to think about this–it had words and humor and everything.  The shorts only had a Nike Swoosh.  (And that’s what they did.  Swoosh!)  Meanwhile, he’s sprinting ahead of me like I’m standing still.  I’m doing 8.57 miles per hour in a 7 mile per hour zone!  He only beat me by twelve seconds, but I never recovered from that shirt.

It had to be that shirt!

Although it might have been the smoke alarm keeping me up all night.

Or the donuts and beer.

Whatever.

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Like most runners, I like me a banana now and then.  I usually eat one every day.  It’s a nice quick snack between patients or surgeries that is actually good for me.

Now in all those years of carrying my banana to work with me, I have never had a serious banana incident.  Oh, I may have dropped it on the ground once or twice, but I don’t eat the outside anyway, so it’s not necessarily a problem.

Other people must have banana issues I am not aware of.

Fortunately, we have science.  Technology meets healthy snack in a new way:  THE BANANA BUNKER.

bunker

It seems Groupon marketed this product on their website with some hilarious reactions.  The basic problem here is that the protective banana bunker resembles something else . . .

Among the comments and Groupon’s responses:

Bunkercomments

Laugh if you will, but  they sold out.

So we must wonder now, is that a banana bunker in your pocket, or are you just happy to see us?

Don’t forget to sponsor me in the Beaver Stadium Run to benefit Special Olympics!  Thank you!

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Get it?  😕  Colon.  Oscopy.

I was really hoping to find some humor in this procedure.  This was my first colonoscopy.  Welcome to being 50!  It is like a right of passage.  I have read many stories over the years about this procedure.  Most of the horror surrounds “the prep,” which is a nice way of saying that Satan is coming down your colon with a supersoaker from hell.  And while that was mostly true, it was not as bad as I was expecting.

Granted, having to stay within 30 feet of the toilet for most of the night was not pleasant.  The time actually spent on the toilet was not pleasant.  I did get to play a lot of games on my iPad, so it wasn’t a total loss.

Here I sit and dream of glory, alone inside the lavatory.  (An obscure reference–leave me a comment if you know the source.)

Personally, I thought that drinking “the prep,” a concoction called Suprep that comes in two 6 ounce bottles of cherry flavored hell, was actually worse than getting rid of it.  I’m not a big fan of cherry to begin with, and that is probably a good thing.  My dad underwent a colonoscopy a number of years ago.  He mixed his prep at that time with Squirt, a citrus soda.  From that day on until the day he died, he could not bring himself to drink Squirt again.  And that name is kind of ironic, doncha think?

So if taking this prep turns me from cherry flavored anything, it is certainly not the end of the world.

It looks so innocent!

It looks so innocent!

And it was god awful.

Yeah, there was cherry.  With bitter undertones and a hint of maybe seltzer–or mineral water.  I think I detected some acetone or benzene, if my senses have not failed me from biochemistry.  The bouquet was nonexistent–it didn’t even smell like cherries.  And it was crystal clear, so you could almost convince yourself you were drinking water or vodka, until it actually touched a single taste bud on your tongue.

You see, you had to dilute this wonderful prep into 16 ounces of clear but vile crap that you must choke down before you have to run to the bathroom.  Twenty minutes.  That’s all it took.  And I had to down two more 16 ounce cups of water afterwards, or it would have sucked the water out of my brain.  I would have ended up a pile of dust floating in the toilet.  The beast had to be fed water.

So after choking down the cherry shit, alternating forced gulps with some coffee or white grape juice (you can’t drink anything with red or purple dye!) to try and save my taste buds, I then had to down 32 ounces of water over the next hour.  I’m not sure I drink that much water in a single day!  I drink–coffee, tea, soft drinks, wine, beer.  But only occasionally do I ever drink plain old water.

The first bottle came out explosively but without any accidents I am happy to report.  I did get baby wipes as recommended since toilet paper could be “irritating.”  By the time I was ready for bed, I was no longer living on the seat.

Unfortunately, bottle two had to be taken seven hours before my scheduled time, with another 32 ounces of water in the hour after that.  Then, no more liquids until after the procedure.  With a 9:00 appointment, I had to get up at 2:00 am to force another cherry jubilee down my esophagus, and through my intestines.

I was hoping that being half asleep, I wouldn’t mind the cherry crap so much.  I was wrong.  It was worse.  I have never drank gasoline, but if you throw some cherries in it, I imagine this is how it would taste.

Boom!  I’m back in the bathroom.  Cholera without the actual disease.

In the morning, I looked longingly at half a cup of coffee left over from the previous night’s escapades.  I carefully took a mouthful, swished it around my mouth to tantalize my taste buds and maybe absorb some through my mouth’s mucosa, before spitting it out in the sink.  I watched as the coffee went down the drain.  I was devastated.  But I didn’t drink anything!  I did not swallow!  (That’s what she said!)

So I arrive at 8:45, and I am back in the holding area with all my clothes off except for my socks, a hospital gown and a sheet to keep the young women from laughing at me, or at least, not laughing at that.  At 11:00 o’clock, they finally come to take me for the procedure.  Waiting that long was more irritating than the toilet paper.  And I’m a doctor!  There had better have been an exploding colon somewhere to delay me getting my damned coffee.

Anyway, I’m all ready to take notes about the actual procedure for this blog, to bring the colonoscopy experience alive for my readers my reader  the person who stumbled here by accident.  They ask me to lay on my left side.  And  . . .

Then I woke up.

Propofol

What a disappointment!  This is the closest thing to a sexual encounter I’ve had in years and I missed it!

And in case you care, my colon is just fine, thank you very much.  Not even a polyp.  Come back in 10 years.

And I finally got my coffee.

Seriously . . .March is Colorectal Cancer Awareness Month.  And if you are over 50, don’t be like dead-from-colon-cancer Rob Lowe–get DirecTV and a colonoscopy today.

ColorectalMarch

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I should host my own cable show . . . Ice Road Runners (Ice Road Truckers)  . . . or maybe Man vs. Nature (Man vs. Food or Man vs. Wild.)

The need to run in the cold weather is the summation of three primary vector forces coming together as one.  First, I love to run.  Second, I hate the dreadmill or running indoors.  And third, I live in central Pennsylvania, not far from the home of Punxsutawney Phil.

I foresee more winter . . .and snow FOREVER!

I foresee more winter . . .and snow FOREVER!

One might also argue that a little bit of obsessive-compulsive personality disorder or run-of-the-mill insanity plays a role here, but I’m not sure why people think those things about me.

Running in the winter presents a number of new challenges that our running brethren in Florida, Arizona and Texas do not need to worry about.

Perhaps first and foremost is the issue of traction.  Running shoes meeting ice do not generally end in good results.  There is no way to throw it into four wheel drive when you are only ever running on two wheels.  And while the snow may look soft and fluffy, the ground beneath it is HARD.  I have tried several traction devices over the years, one from North Face that you slip on–but they kept coming off!) and I tried screwing sheet metal screws into the bottom of an old pair of running shoes . . .

screwshoes

The problem with the latter, is that under most running conditions, I am not always on snow or ice.  The removable cleats are better for running where you might go from road, to trail, to sidewalk and back to road at irregular intervals, with varying levels of ice, snow or no precipitation.  Also, I always felt like I could feel the ends of the screws coming up at my feet–it might have been in my head, but I just didn’t like it.

My favorite to date is Kahtoola NANOspikes, which are removable, but seem to stay on my shoes better than the other product.  I recommend these for the runner who must traverse icy conditions.  I think I could jog laps on a skating rink with these on!

Four-wheel drive for your feet!

Four-wheel drive for your feet!

But in addition to traction, there is another issue of equal or greater importance . . . the temperature.  It’s cold in winter.  When I got up this morning, it was -2 degrees F.  The wind was howling with chills estimated at -15 to -22 deg F .  It was actually about 5 degrees at noon when I headed out, but the wind chill was still subzero.

The key to dressing in winter is LAYERS.  I start with a Nike DriFit tank, followed by a Nike DriFit long sleeve.  These are wicking shirts that allow moisture to wick away from your skin.  The only thing worse than being cold is being cold AND WET.  And even at zero degrees, if you are running, you will SWEAT.  In fact, you will generate enough heat that you should dress as if the ambient temperature is about 20 degrees warmer than it really is.  You should feel cold when you start, because you will warm-up as your muscles generate heat.

I next add an UnderArmour cold gear shirt which is heavier than the first two layers, but also wicking.  And on top, I use either a Nike jacket or the pullover (a Pittsburgh Penguin pullover made by Antigua) you see in the following series . . .

Layers!  Not just for cake anymore!

Layers! Not just for cake anymore!

Fortunately for you, there was no room for the final image in this running game of strip poker which I seemed to keep losing.  At 5 degrees with subzero wind chills, I also wore three pair of gloves, a UA balaclava and a warm running hat also made by UA.  There are different styles of balaclavas and this type can be pulled up over one’s mouth, but I am a mouth breather when I run, and I find it gets too wet and icy if I cover my mouth.  Some people opt for a ski mask with eye holes, but it makes me feel like I am a bank robber running away from the scene of a crime if I wear something like that!

Layering also gives one the option of removing layers if the temperature rises or you simply overestimated how cold it would be.  I actually felt warm at times (sun was out, and when the wind wasn’t blowing in my face!)   My left eyelid froze to my cornea, but I microwaved some artificial tears when I got home and melted that baby off in no time!  Please do not try this at home–I am a trained eye professional!  (Ok, my cornea wasn’t really frozen–I made all that up, and please do not put hot drops in your eyes and never microwave your eyedrops!)

I do not wear any special socks, and in fact, I prefer thin wicking socks.  I wore my regular socks and my feet were not cold, but that is me.  If you suffer with cold feet, there are thermal socks you can invest in.

There is a certain satisfaction in overcoming the elements, like a mountain climber beating Everest or a rock climber successfully ascending (insert a challenging rock climbing mountain here.)  I would much rather be running in Phoenix at 120 dry degrees, but that was not an option this morning.

And my nose will thaw out by spring.  Which should come sometime in the next six months.  I hope.

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Has your eye doctor asked you to disrobe and bend over for a prostate exam?  You might want to think about getting a new eye doctor if your answer was yes, but that scenario might not be as absurd as you think.

The United States government, in all its infinite wisdom and good intentions, is changing the way your doctor takes care of you.  Now this is a government that can’t adequately fund or run the Social Security System, Medicare or Medicaid, but they know what is best for your health.  They can’t run the Post Office without a loss, but they know the best way to deliver your health care, and starting in the near future, in addition to no mail you likely won’t be able to get health care on a Saturday.

After all, what would a doctor know about delivering health care?  They went to medical school instead of business school!  They weren’t elected to protect your rights!

Enter Electronic Health/Medical Records (EHR or EMR).  Physicians are “mandated” to computerize medical records.

According to Michelle Malkin:

Buried in the trillion-dollar stimulus law of 2009 was an electronic medical records “incentive” program. Like most of President Obama’s health care rules, this top-down electronic record-sharing scheme is a big fat bust.   Oversight is lax. Cronyism is rife. The job-killing and privacy-undermining consequences have only just begun.   The program was originally sold as a cost-saving measure. In theory, modernizing record-collection is a good idea, and many private health care providers have already made the change. But as with many government “incentive” programs, the EMR bribe is a tax-subsidized, one-size-fits-all mandate. This one pressures health care professionals and hospitals across the country into radically federalizing their patient data and opening up medical information to untold abuse. Penalties kick in for any provider that hasn’t switched over by 2014.

Like so many federal programs, the EHR incentive is advertised as an optional program.  I don’t have to convert to medical records if I don’t want to.  But, oh, by the way, if I don’t convert by 2014, Medicare is going to penalize me.  The federal government has a long history of such extortion–think of the 55 mph highway speed limits that were enforced in the 70’s and 80’s.  States could legalize higher limits, but then they would lose federal funding.  You don’t have to participate . . . but we know you will!

I don’t have to participate in Medicare, but here is the reality:  80-90% of my ophthalmology practice is Medicare.  If I don’t participate, my waiting room will be empty.  The vast majority of Medicare covered patients can’t afford to pay for services out of their own pockets, so they will go to physicians that do accept the coverage. I can’t blame them–I would too.  So I participate because I have to–not because I want to.

And such is the case with EHR.  I can’t afford to collect less from Medicare.  Seriously.  The reimbursement for a cataract surgery today is 1/3 what it was when I started in practice in 1994 and about 1/4 of what it was in 1986 (I now perform THREE surgeries to get paid the same as I used to get paid for ONE!)

Think about that for a moment.  If you are a farmer, you must now plant and harvest three fields to make the same profit you used to get for farming one field.  If you are a salesperson, you must now sell three times as much to keep your salary the same.   Or keep it even more simple–if you are paid an hourly wage, you must now work three hours to take home the same pay you used to work one hour for.  That sounds fair, doesn’t it?  And that is without taking into account inflation and the fact that a 1986 dollar is worth more than a 2013 dollar, not to mention the fact that cataract surgery today is safer and more predictable than it was in 1986.  When you factor in inflation, it is criminal what the federal government has forced upon physicians.  And now there is the 2% sequestration loss on top of all that.

The worst part of the whole thing is that I spent 12 years of my life (four years of college, four years of medical school and four years of residency) and well over a $100,000 for my education, and I am only trained to be an ophthalmologist.  It’s not like I can take my training and skills set and join another company.  I’m not qualified to do anything else, except consulting in some capacity or teaching ophthalmology.  Judging by the page views on this blog, I couldn’t make a living doing this!

So the government dragged me into EHR kicking and screaming, but I have not yet seen one cent of any “incentive” that was promised.  Why?  It’s not because we aren’t using EHR–all of my new patients and 90% of my old patients are now computerized.  It was a long, arduous and frustrating process.  It was expensive.  Anyone in our office that needs access to a chart–from technicians, schedulers, phone operators and insurance filers–must now have a computer and each computer has to have a rather expensive software license.  And every time we submit to get our incentive, there is a new reason why we failed to meet the criteria. No soup for me!

And if the computers go down–I can not access a new patient’s information.  It’s backed-up somewhere, but I can’t get to it until IT figures out what the Hades is wrong with the software or server.

The whole process of computerization and data collection sounds nice on the surface.  This site outlines the process like this:

EHRoverview

Improved communication, quality measures, patient access and efficiency are all wonderful buzz words that make it sound like a fairy tale come true.  But it’s the details of the process that are horrendous. It’s the “meaningful use” of that technology that is problematic.  The fine print for meeting these criteria include 15 CORE objectives for physicians, apparently regardless of specialty (“one size fits all”):

1.  Computerized provider order entry (CPOE)
2.  E-Prescribing (eRx)
3.  Report ambulatory clinical quality measures to CMS/States
4.  Implement one clinical decision support rule
5.  Provide patients with an electronic copy of their health information, upon request
6.  Provide clinical summaries for patients for each office visit
7.  Drug-drug and drug-allergy interaction checks
8.  Record demographics
9.  Maintain an up-to-date problem list of current and active diagnoses
10.  Maintain active medication list
11.  Maintain active medication allergy list
12.  Record and chart changes in vital signs
13.  Record smoking status for patients 13 years or older
14.  Capability to exchange key clinical information among providers of care and patient-authorized entities electronically
15.  Protect electronic health information

If you are a non-physician and you look at this list, you are probably thinking to yourself that physicians should probably be doing these things anyway–and in fact, good physicians have been doing most of these things on paper for years.

Who wouldn’t want an electronic prescription as opposed to a scribbled, illegible one from the doctor?  Or an office note that is typed and legible rather than scrawled by a dyslexic platypus?   Have you ever used a computer?  Have you ever mis-typed a text message or email?  Clicked the wrong icon?  Have you ever tried to submit an on-line form that was refused because you missed one of the starred items or entered something incorrectly?  Have you ever sent a text or email that someone didn’t get?

In the short period of time we have been adhering to the eRx mandate, we have had multiple calls from pharmacies where patient’s are waiting to pick up their eye drops but no prescription was received.  Our computer says it was sent.  I know you probably find that impossible to believe because computers are perfect and people are not, but how many essential prescriptions do you think might be lost and the patient not realize they didn’t pick up all the meds they were supposed to?  Or what if the doctor clicked the wrong medication in the drop down menu by accident and didn’t pick up the mistake because he was trying to save encounter time so he could ask you about smoking (see below)?

It’s not as though folks couldn’t forge or change their prescriptions before to get controlled drugs.  They did.  But how long do you think it will take hackers to figure out ways to illegally transmit prescriptions for controlled substances, if they haven’t already?  (Actually, I think controlled substances still need a paper Rx, but as an eye doctor, I haven’t written for a controlled substance in 21 years, so don’t quote me on that.)

We are on the Titanic chugging along here folks, and this is only the TIP of the iceberg.  Medicare is telling us to move ahead full speed!

Number 12 mandates that we “record and chart changes in vital signs.”  Sounds like a good idea, doesn’t it?  Why didn’t a doctor think of that?!

Here is what your hard-working government–and I swear they employ people to stay awake all night thinking up ways to screw all of us–is doing for you:

Record and chart vital signs: height, weight, blood pressure, calculate and display

BMI, plot and display growth charts for children 2-20 years, including BMI

So you show up for your eye appointment.  Your doctor’s assistant asks you to step on the scale.  They calculate your BMI (body mass index) and determine that you are overweight.  Wait a minute, you came here for glasses, didn’t you?   Or a cataract?

Your podiatrist now is asking you about smoking.  And they are handing you materials about smoking cessation.  All you had was an in-grown toenail.  WTF?

How long will it be before I have to put my patient, who is getting glasses, into a paper gown and ask them to turn their head and cough?

Or better yet, “I’m sorry Mrs. Jones, but before I can take out your cataract, Medicare requires I document a rectal exam!”

Don’t laugh!  They are changing these rules as we speak.  And I’ll give you a hint–they only make it worse.  The Academy of Ophthalmology fought the Centers for Medicare Services (CMS) for relief from having to buy scales and waste clinical time discussing your weight instead of your eyes, but I am still being forced to ask my patients about smoking.  And while that does have a modicum of relevance for macular degeneration patients who are at higher risk for the wet type as smokers, for the vast majority of patient encounters, it is just one more thing we must document for no other reason than to make Mr. Obama and his merry band of legislators happy.

We are treating the computers (and legislators)–not our patients.

Seriously, if you are a smoker, you probably know already from the media and lawsuits that smoking is bad for you.  Your general medical doctor, lung specialist or cardiologist should discuss that with you.  But if you are being checked for cataract or getting contact lenses, is that really necessary?  How many people are really going to stop smoking because their eye doctor or foot doctor or proctologist told them to do so?

But wait!  There’s a pamphlet for that!

Vital signs should be appropriate to the specialty–blood pressure and pulse for the cardiologist, respiratory rate for the pulmonologist, vision and eye pressure for the ophthalmologist, etc.  But the government system won’t allow for individuality or common sense.  There are universal protocols for everything, from infection control to marking a surgical patient, regardless of what the infection or surgery may be.

And it only continues to get worse.

So maybe you don’t care if your eye doctor is making less money as you sit in the over crowded waiting room (because I now have to see three times as many patients to maintain my income AND pay for this new computer system I don’t want.)

But if you have to disrobe and bend over, you might just start to care.

I just hope it isn’t Obamacare.

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