Dr. Linda's Life Lessons http://lindalee.posterous.com medical blog posterous.com Sun, 31 Oct 2010 15:06:13 -0700 Beautiful Hair for a Beautiful Cause http://lindalee.posterous.com/beautiful-hair-for-a-beautiful-cause http://lindalee.posterous.com/beautiful-hair-for-a-beautiful-cause For many years now, people have admired my daughter's long , black, flowing beautiful hair. Recently, she decided to do something that I hope people will admire her even more!  She decided to get 10" cut and donate it to a very worthy cause Pantene's Beautiful Hair for a Beautiful Cause .
http://www.pantene.com/en-us/beautiful-lengths-cause/default.aspx

This wonderful cause takes 10" ponytails and makes them into a  real hair wig for cancer patients who subsequently lose their hair after chemotherapy treaments. A real-hair wig allows a woman to look in the mirror and at least see a familiar face while she fights to regain a sense of normalcy in her life. The wigs are distributed free through the American Cancer Society wig banks.

What a wonderful worthwhile reason  to grow your hair long. Not just for looks, but for the  love that can be shown to someone in need.

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]]> http://files.posterous.com/user_profile_pics/114244/DCP_2700.JPG http://posterous.com/users/1bh0cq0OUqR Dr Linda M. Lee Dr. Linda Dr Linda M. Lee Thu, 20 May 2010 11:54:25 -0700 Remembering Romeo ( my medical school cadaver) http://lindalee.posterous.com/remembering-romeo-my-medical-school-cadaver http://lindalee.posterous.com/remembering-romeo-my-medical-school-cadaver Recently I read a blog/letter written by a medical student about the special bond she developed with her anatomy cadaver. http://www.kevinmd.com/blog/2010/05/medical-student-writes-gross-anatomy-cadaver.html

It reminded me of my cadaver in medical school.  It is true, after working on your cadaver zillions of hours, learning every organ, every nerve, tendon and muscle...you definitely have a special bond.  We called him Romeo- because he had an unusually HUGE heart.
Most likely he had some sort of dilated cardiomyopathy. By the time your group finishes dissecting your whole cadaver ( at the end of a few months)...the body is no longer distinguishable as a body ( since it has been completely dissected). We really learned to honor and respect these people who donated their bodies to the medical schools, so that up and coming doctors could learn and be trained to help future generations to come.  At the end of the course, there was a memorial service held for these people to honor them.
I will never forget  him....Romeo- who had such a big heart both physically and spiritually - to have the heart to give of himself after he died.

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]]> http://files.posterous.com/user_profile_pics/114244/DCP_2700.JPG http://posterous.com/users/1bh0cq0OUqR Dr Linda M. Lee Dr. Linda Dr Linda M. Lee Wed, 05 May 2010 15:15:27 -0700 Ride at Your Own Risk! http://lindalee.posterous.com/ride-at-your-own-risk http://lindalee.posterous.com/ride-at-your-own-risk Recently, I read an article about a possible danger to your health if you ride on those crazy fast roller-coasters  that are at many amusement parks nowadays.

This article reminded me of the time when I was doing a rotation with an Ear Nose and Throat Doctor while in medical school.  A girl came in after she had been scuba diving earlier that day at a local lake ( she was training to learn how to scuba dive). She apparantly did not decompress correctly when coming up from the deep and she blew out her ear drum ( ear barotrauma). My ENT attending was quick to point out to me that this is a common injury to scuba divers.

The next day , my husband and I were leaving for our honeymoon in Jamaica.  Needless to say, I decided not to try scuba diving after seeing this particular case! To this day,  I still have yet to get up enough courage to try it!  I guess  now I should think twice about riding those super speed roller-coasters too!  Aww...I am no fun anymore!

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]]> http://files.posterous.com/user_profile_pics/114244/DCP_2700.JPG http://posterous.com/users/1bh0cq0OUqR Dr Linda M. Lee Dr. Linda Dr Linda M. Lee Wed, 17 Mar 2010 18:26:00 -0700 GLOW IN THE DARK STOOL! http://lindalee.posterous.com/glow-in-the-dark-stool http://lindalee.posterous.com/glow-in-the-dark-stool
Recently I read an article on the causes of green fluorescent colored stool in a baby.Reading this article makes me laugh because it is 
the  type of article that would only appeal to a physician or possibly young parents of newborns! http://ow.ly/1nzsT
Some of the possible causes listed are ,ingestion of large amounts of green veggies, decreased colonic transit times or possibly food dyes-specifically blue dye #1. You can find such dyes in popsicles or fruit loops!

This article immediately reminded me of a humorous "on-call " story that happened to me many, many years ago.

One evening while I was on call for the large physician group that I used to  work for, I was awoken by my pager at 2 AM

I groggily answered the call...and it went somewhat like this...

Me:  " Hello, this is doctor Lee, what is your medical emergency?"
Patient:  "Ummm....hello doctor,  MY BABY JUST HAD A GREEN POOP!  Is this colic?

Bewildered why someone would call me in the middle of the night with such a question, I asked her some more things to assess  what was going on.

Me: " Is your baby in distress? in pain, crying, having diarrhea?"
Patient:  " ummm...no my baby is sound asleep. She had a green poop earlier today...and I was just wondering, so I decided to call the doctor on call"

Sigh...unfortunately, patients often think that when a doctor is on call that you are sitting by the phone all night waiting to answer calls and questions- like an answering service.

I really don't remember what I told her after that. I am sure I tried to educate this patient on proper use of the on-call physician.  It is for urgent, emergent problems, not routine calls.  But, I guess a better answer could have been  " Don't worry mam , it's Blue dye #1"
360
  

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]]> http://files.posterous.com/user_profile_pics/114244/DCP_2700.JPG http://posterous.com/users/1bh0cq0OUqR Dr Linda M. Lee Dr. Linda Dr Linda M. Lee Sat, 20 Feb 2010 10:44:57 -0800 Me and My Shadow http://lindalee.posterous.com/me-and-my-shadow-13 http://lindalee.posterous.com/me-and-my-shadow-13
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Job shadowing is a common occurrence in the medical field. I believe it is valuable for a student to shadow another physician to see what life is like on the job before they decide to go into the medical field.  I personally love to have students shadow me in my solo family practice. I enjoy mentoring and teaching students.  I believe it is especially important to be a good mentor in today's medical environment where primary care is not respected, not seen as exciting or valuable. In an article called "Primary Care Disrespect Starts Early in Medical School"  it is discouraging to read  the glaring truth "...generalist-specialist salary disparity, combined with the paperwork and high professional dissatisfaction rate, are major reasons why future doctors are avoiding primary care medicine."  http://www.kevinmd.com/blog/2009/11/primary-care-disrespect-starts .  Having a student shadow me in my small solo office, however,is a time for for my ideals as a family physician to shine!  I love to show the uniqueness of my small solo practice: a blending of "hi-tech with high touch" personal care. I love showing  how it allows me to make an impact in patient's lives and their health, the deep doctor/patient relationships that I can forge and  my enthusiasm for  preventative medicine and following chronic illness.  I love seeing the reaction on the student's face when they see that it is indeed possible to break away from the hamster wheel, the assembly line type of practice where they are forced to see a patient at a clip of every 15 minutes and are expected to take care of all their medical needs. I love being able to show a student that there is not just one path to take if you decide to become a family physician . You don't have to take the road to professional dissatisfaction. There is another path.You just have to dream big enough and have the courage to pursue it ! It is indeed possible.

I am often asked if I would advise my own children to follow in my footsteps and pursue a career in medicine, more specifically Family Medicine. In the past, these have been hypothetical questions, but now that I have a daughter who is in college and she has decided to head down the pre-medical path, suddenly, the hypothetical has become reality.
Over the winter break, my daughter had the chance to do some shadowing. She had two great opportunities to experience Family Medicine at its finest.  The first was shadowing a family doctor here in the inner city of Rochester, who reaches out to the under-served Hispanic population. My daughter's interests is in medical missions and serving the under-served, in addition, she speaks Spanish. So, of course  this was right up her alley!  The second opportunity hit even dearer to her heart (well, maybe to my heart) - because it was shadowing me...her mom.
  There is a clinic in the city of Rochester called UR Well. It is a clinic for the uninsured , run completely by the medical students at the University of Rochester Medical School.  I volunteer to precept and teach the medical students while they see and care for these patients. One particular evening, I brought my daughter along so she could interact with the medical students and also see me in action.  I think it was a great example of how family physicians can contribute to their communities and truly make a difference in people's lives.  I have come to realize the importance of my role as a family physician in mentoring and being a positive influence to  these young, up and coming  doctors -  and especially to  my own daughter...my true shadow.

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]]> http://files.posterous.com/user_profile_pics/114244/DCP_2700.JPG http://posterous.com/users/1bh0cq0OUqR Dr Linda M. Lee Dr. Linda Dr Linda M. Lee Tue, 16 Feb 2010 12:08:00 -0800 No News Is Bad News http://lindalee.posterous.com/no-news-is-bad-news-1 http://lindalee.posterous.com/no-news-is-bad-news-1

Recently I read an article about the timeliness of patients getting the results of their laboratory tests http://www.kevinmd.com/blog/2010/02/notify-patients-abnormal-test-results.html .  This is a constant struggle in doctor's offices. We order tests/labs on a patient, give them a lab slip or test requistion and send the patient on their way with expectations that they will follow through.  How do we know if the patient even went to have the test done? . What if the lab sends the results to the wrong office or doesn't send the results ( which happens quite often).  

Many doctor's tell their patients that " no news is good news".  In other words, if you don't hear from me, then all your results were normal and you don't have to worry.  I find this as a lazy and irresponsible way to handle the communication between physician and patient.  I feel it is the patient's responsibility to know and understand what is going on with their health.  This means, getting the tests done, and then following up with the physician to understand the test results.   I always tell my patient when I give them a lab requistion that they should hear from me- even if their labs all come back normal.  If they don't hear back from me by a week  after getting the tests done, then they should contact me and inquire. Very often, the lab sent the lab results to the wrong office or address and I have no way of knowing this.
It is my patient's responsibility to take charge of their health and to have good communication with their doctor.   Yes, this is a case where " No News is Bad News".

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]]> http://files.posterous.com/user_profile_pics/114244/DCP_2700.JPG http://posterous.com/users/1bh0cq0OUqR Dr Linda M. Lee Dr. Linda Dr Linda M. Lee Mon, 24 Aug 2009 18:45:00 -0700 Spread your wings and fly http://lindalee.posterous.com/spread-your-wings-and-fly http://lindalee.posterous.com/spread-your-wings-and-fly

BP716 Rainbow and Bird by listentoreason.
We went to Cornell University to drop our daughter off . It was a bittersweet time for our family. How can one have such joy and sorrow in  one's heart all at the same time? Coming to a close is her childhood- a new chapter of adulthood is beginning .  As we said a teary good-bye, driving off in the car - I couldn't help but think back on her years of growing up and our parenting and family life.  Did we prepare her  well enough for the road before her?   Will she be able to withstand the pressures of the future? Will her faith in God grow ever stronger even when confronted with  adversity , possible heartache and failures?    I thought of a baby bird leaving the nest. Yes,  she is ready...we have done our best as her parents.  God has prepared her for this point in her life. We entrust her to His loving care.  She will always be my child, my baby girl.  But the time has come and she is ready......Spread your wings....and fly!

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]]> http://files.posterous.com/user_profile_pics/114244/DCP_2700.JPG http://posterous.com/users/1bh0cq0OUqR Dr Linda M. Lee Dr. Linda Dr Linda M. Lee Fri, 14 Aug 2009 18:05:00 -0700 re-blog of my posting : I Love my Job http://lindalee.posterous.com/re-blog-of-my-posting-i-love-my-job http://lindalee.posterous.com/re-blog-of-my-posting-i-love-my-job

I am reposting this so I can autopost this to my WellSpring Family Medicine  Fan page on Facebook.

   Even in light of reading something like this :  Medical students want to become primary care doctors, until reality hits http://bit.ly/8p3dq   

June 06, 2009

I STILL  LOVE MY JOB!

I get asked by many people if I like being a doctor, do I like my job, would I recommend this profession to their kids, if I had to do it over- would I do it again? 
 
I have pondered these questions this past year, especially in light of my oldest daughter who is interested in going the medial school route. Do I think it is best for her to go through all that you need to do to become a physician? It is a very long road, lots and lots of studying, long hours, no sleep, a zillion exams to take and pass, 
life and death situations,just to name a few.  But, when I think back on all my years of preparation- I really feel it was so worth it! 
The richness of the lives you interact with is amazing! God has taught me so much through the people that I have met, their life stories, their struggles. I am deeply privileged to have the opportunity to know and understand my patient's struggles and dreams and to try and help them in their journey of life. 
 
This is exactly why I have decided to blog about my experiences. I have learned so much through my patients and I don't want to forget them. Yes, if you ask me about my experiences in being a doctor ....I will emphatically tell you that I LOVE MY JOB! I am so blessed that God has brought me this far and I can't wait to see what is in store for me in the future!

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]]> http://files.posterous.com/user_profile_pics/114244/DCP_2700.JPG http://posterous.com/users/1bh0cq0OUqR Dr Linda M. Lee Dr. Linda Dr Linda M. Lee Wed, 12 Aug 2009 20:17:00 -0700 When Sucking Your Thumb Can Save Your Life http://lindalee.posterous.com/when-sucking-your-thumb-can-save-your-life http://lindalee.posterous.com/when-sucking-your-thumb-can-save-your-life

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Recently I was reading an article in the NY Times about Women at Risk:

Women at Risk: Considering Bob Herbert's Column // medical blog

Life in the United States is mind-bogglingly violent. But we should take particular notice of the staggering amounts of violence brought down on the nation’s women and girls each and every day for no other reason than who they are. They are attacked because they are female.

A girl or woman somewhere in the U.S. is sexually assaulted every couple of minutes or so. The number of seriously battered wives and girlfriends is far beyond the ability of any agency to count.

Bob Herbert, via nytimes.com


As  a family physician I can attest to  the violence against woman both physically and mentally . The words "they are attacked because they are female" is especially haunting and disheartening to me.  The one issue that this article did not address is the fact that the  "attacks"  start even from conception, in the "safety" of the womb.

I recently read an article entitled "The Daughter Deficit: what happens where parents have a fervent preference for male offspringhttp://bit.ly/2NRg0N

This article cuts to the core of my heart  for several reasons
1. I am of Asian decent and have witnessed the subtle bias towards boys and having sons in my culture
2.  I am the mother of three beautiful daughters
3. I believe in the sanctity of life from the womb.

Reading these articles reminded me of a patient encounter that I had when I was in my residency.  An Asian couple came to my clinic for an office visit. The wife was around 3-4 months pregnant and they had come in to see me after they had just had an ultrasound .  The purpose of the visit was to find out the sex of the baby. After I told them happily that they were going to have a baby girl, they quickly shot a glance at one another and told me "We want to terminate the pregnancy".  I was taken off guard but even more shocked when they told me their reasons.
"We already have two girls at home and we want a son. We have too many girls".  My eyes welled with tears as I thought of the fate of this poor, helpless baby who had no voice, no rights- who was about to be "attacked just because she was female".

I pulled the ultrasound image from the chart- and my heart quickened. The image was of the perfect outline of the precious little baby girl sucking her thumb.  The timing of the ultrasound image was perfect!

I proudly showed them the image- and the look and emotion on their faces changed. "That is our baby?" they inquired.  " We didn't think it had that much form- and she is sucking her thumb already?"

I explained to them that their baby was completely formed with a beating heart. And yes, she sucks her thumb and she can feel pain.  As they left the office, I said a little prayer for them and the fate of the little baby girl.

Fortunately, there was a happy ending to this whole encounter. The couple, after they saw the  precious ultrasound image, decided to keep the baby.  I helped deliver the baby six months later and they added a third healthy beautiful girl to their family.
This patient encounter had a deep impact on me. By the grace of God it was the power of a captured image , a baby sucking her thumb. It was this image that saved her life!

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]]> http://files.posterous.com/user_profile_pics/114244/DCP_2700.JPG http://posterous.com/users/1bh0cq0OUqR Dr Linda M. Lee Dr. Linda Dr Linda M. Lee Sat, 18 Jul 2009 07:16:00 -0700 Failure to Thrive? http://lindalee.posterous.com/failure-to-thrive http://lindalee.posterous.com/failure-to-thrive
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So many milestone events have happened these past few weeks. My oldest daughter graduated from high school, gave an amazing Senior Recital ( violin), turned 18 yesterday, and soon will be headed off to Cornell University. My middle daughter pretty much planned and put together their Youth Group's Senior Banquet ( to honor the Seniors)- planning the activities and slide show. The event was held at our house last night. Around 40 teenagers descended on the Lee Residence! My youngest daughter gave a little speech to honor her oldest sister which really touched my heart. I have often lamented at the quick passage of time. I sometimes wish time would just stop or slow down, and my children could stay little and cute. However, after experiencing the events of these past weeks, I am in awe of how much my 3 little girls have grown and matured in their character and faith! It is a blessing and I am so thankful!
I draw the analogy to my practice as a doctor. When I see my little kiddo- patients for their Physicals, we as doctors always measure their height and weight and chart it in a growth chart. A healthy child will be growing proportionally and tracking upward on the chart. If a child's height and weight fall off the growth chart- it is called Failure to Thrive, and this alerts me to be concerned and look for reasons why they have stopped growing.
We look to see that they meet developmental milestones such as rolling over, crawling, walking and talking.
I am thankful that I see no evidence of "Failure to Thrive" in my family and instead of looking to the future with sadness because of the passage of time-
I embrace the future ahead with anticipation and excitement to see how my three precious girls will continue to Thrive in the Grace of our God!


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]]> http://files.posterous.com/user_profile_pics/114244/DCP_2700.JPG http://posterous.com/users/1bh0cq0OUqR Dr Linda M. Lee Dr. Linda Dr Linda M. Lee Sat, 11 Jul 2009 12:19:00 -0700 Hazardous to your Health? http://lindalee.posterous.com/hazardous-to-your-health http://lindalee.posterous.com/hazardous-to-your-health
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Chinese and Asians in general are notorious for eating all kinds of food. For example, we eat intestines ( tripe), pigs feet, chicken feet etc. My caucasian friends are often appalled when we eat a whole fish with it's head on. The fish eyes are even considered a delicacy to some! We never let any part go to waste! I really love steamed lobster! Recently we were visiting my in-laws and having a nice lobster dinner. In the lobster is this green mushy stuff, which no one would eat except my mother in law. Everyone proceded to hand over the body of their lobsters to her, so she could eat it. None of us really knew what the green stuff is. But, according to my mother in law , it is suppose to be very nutritious and good for you!

Later when I arrived home... I googled this green stuff in lobster and found this!

http://kennebecjournal.mainetoday.com/view/columns/5255760.html

I sent the link to my mother in law... I don't think she will be eating it anymore!
I suppose it used to be good for you...until our oceans became polluted with all kinds of toxins! Now it is hazardous to your health.

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]]> http://files.posterous.com/user_profile_pics/114244/DCP_2700.JPG http://posterous.com/users/1bh0cq0OUqR Dr Linda M. Lee Dr. Linda Dr Linda M. Lee Wed, 08 Jul 2009 17:19:18 -0700 The Doctor Will Text You Now http://lindalee.posterous.com/the-doctor-will-text-you-now http://lindalee.posterous.com/the-doctor-will-text-you-now
http://online.wsj.com/wsjgate?subURI=%2Farticle%2FSB1000142405297020387240457... The above link is an interesting article about the use of email , virtual office visits or "e-visits". I have just started using this in my practice. Only my patients can do a virtual office visit for only very simple non emergent problems that don't necessarily require them to come into the office for a face to face visit. I find using the computer for the visit is much better than doing things over the phone. It is well documented in an email ,whereas a phone conversation is often not documented. I often, just copy and paste the email into the patient's chart. The use of texting is also an interesting concept. I have a deaf patient who usually calls me and we communicate through a relay service. There is a "middle man" who tells me what he is saying. Recently, I told my patient to go ahead and text me instead of going through the relay service. It was great! We got to the root of the problem much quicker! I continue to try and be creative with the use of technology in my practice - to make my practice more effecient and effective and to better my patient /doctor communication and relationships. Well, for those of you who think I am some tech savvy kind of person... Today, my 16 year old daughter made a comment about my office. She said " mom, how can you do all that you do with computers and technology in your practice- and still not know how to turn on our television at home?" ( It's because it takes 2-3 different remotes to work our tv!)

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]]> http://files.posterous.com/user_profile_pics/114244/DCP_2700.JPG http://posterous.com/users/1bh0cq0OUqR Dr Linda M. Lee Dr. Linda Dr Linda M. Lee Fri, 19 Jun 2009 08:22:00 -0700 Medicine in the Age of Twitter http://lindalee.posterous.com/medicine-in-the-age-of-twitter http://lindalee.posterous.com/medicine-in-the-age-of-twitter
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Recently , I read an article called Medicine in the Age of Twitter.
http://www.nytimes.com/2009/06/11/health/11chen.html?_r=2&hpw
It is a topic that I am very interested in ( the use of socia media- email, facebook, twitter, ipods, youtube) in conjunction with my practice.

How can I use the recent technology to make my practice more efficient, practical, and helpful to my patients?

Already I think my practice is quite hi-tech. I use Electronic Medical Records, electronic billing, my patients can schedule on line, they can do something called a virtual office visit (if they cannot physically come into the office), I email patients , email them their test results and lab results.
I now have a blackberry so that while I am out and about running errands or running my kids back and forth from their activities, I get an alert if a patient made and appointment online- and I can then go back to the office to see them. I can look up medical information on my blackberry , send electronic prescriptions to the pharmacy ....the possibilities are endless!

Is twitter useful in my practice? I could send out tweets /updates about swine flu , useful medical information or bulletins etc....
The possibilities are mind boggling!

Please comment or give me feedback on this post! I'd appreciate your insight into this topic!

Oh yes- and credits go to Boaz Tang for the "Apple-Ipod " photograph!  Click on the flickr link and check out his 365 project!

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]]> http://files.posterous.com/user_profile_pics/114244/DCP_2700.JPG http://posterous.com/users/1bh0cq0OUqR Dr Linda M. Lee Dr. Linda Dr Linda M. Lee Fri, 12 Jun 2009 11:31:00 -0700 Inspiration to Take the Plunge! http://lindalee.posterous.com/inspiration-to-take-the-plunge-0 http://lindalee.posterous.com/inspiration-to-take-the-plunge-0

This is the article that inspired me to take the plunge- to start my own solo practice!

http://www.aafp.org/fpm/20020200/29goin.html

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]]> http://files.posterous.com/user_profile_pics/114244/DCP_2700.JPG http://posterous.com/users/1bh0cq0OUqR Dr Linda M. Lee Dr. Linda Dr Linda M. Lee Wed, 10 Jun 2009 13:08:00 -0700 A Common Cold? http://lindalee.posterous.com/a-common-cold http://lindalee.posterous.com/a-common-cold

This next story illustrates the importance of knowing your patient well and continuity of care-which unfortunately is sorely missed in today's healthcare system.  Some of the most common complaints from patients about their doctor's office is that their doctor doesn't have time to listen to them, or that they often do not get to see their own doctor when they come in for a visit.  They usually end up seeing another doctor or a nurse practitioner who do not  know them. 


Beatrice( not her real name)  paid a visit to Afterhours care over the weekend because she had developed a cough and some mild shortness of breath.
At afterhours they diagnosed her with a viral upper respiratory infection ( the common cold) and sent her home  with some cough medicine and saying she should get better in a few days.
First thing Monday morning Beatrice came into my office. "Dr. Lee, I went to afterhours over the weekend with a cough and was told I have a cold. I am still coughing and still  short of breath.  I think I have bronchitis and need an antibiotic". I asked all the usual questions, including " are you, or were you having any chest pain?"  Beatrice adamently denied having any chestpain." They told me I have a cold, so I was going to wait a little longer to come in to see you- but  doc, I just think I need an antibiotic"

I know Beatrice very well, she is a patient who has diabetes, high blood pressure, high cholesterol and furthermore doesn't like to stay on the medications that she is suppose to be on. These are all facts that the Afterhours doctor was not privy to.

I examined her, and really couldn't find much wrong on exam. Her lungs were clear, throat not infected, no sinus congestion.
The symptoms of mild shortness of breath bothered me and my gut told me to look into it further.
I did an EKG ( electrocardiogram) and  found there were some subtle changes....nothing dramatic but it was  slightly different from last years EKG. 
" I think we should have you see a cardiologist to be sure your heart is okay", I told Beatrice.

I called a cardiologist and advocated for Beatrice to be seen as soon as possible.  They gave her an appointment for the next morning.

The following day, I got a call from the cardiologist office telling me they were sending Beatrice to the Hospital to be admitted because the test that they did in the office showed that she had had a large heart attack ( probably about a week ago) and that she was in heart failure- which was causing her shortness of breath.

Within 24 hours of me seeing Beatrice in my office for a " common cold" - she was now  on the operating table undergoing Quadruple Bypass surgery !

I am very thankful that Beatrice decided to come and see me that Monday morning.  I am thankful that I have a practice where I can take the time to listen to my patients carefully, know their past history well and to be able to have the time to advocate for them to see the right specialist at the right time.  In my past office that I have worked at- where I saw 30 patients a day at 10-15 minutes slots, I know I would have been tempted to just give the patient what they wanted ( an antibiotic) and sent them on there way.

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]]> http://files.posterous.com/user_profile_pics/114244/DCP_2700.JPG http://posterous.com/users/1bh0cq0OUqR Dr Linda M. Lee Dr. Linda Dr Linda M. Lee Mon, 08 Jun 2009 13:35:00 -0700 A Listening Ear http://lindalee.posterous.com/posterous-re-i-love-my-job http://lindalee.posterous.com/posterous-re-i-love-my-job

I stole this from another solo doctor's blog! This physician is a good friend of mine. He is another solo/ideal medical practice doctor who practices in California.  His practice is very similar to my practice.   I think he says it so well! So...why rewrite?

If All Doctors Had More Time To Listen 

From today's New York Times:
LILI SACKS, a primary care doctor in Seattle, says she began thinking differently about her work on the day she realized she was beginning each appointment with the words, “Sorry I’m late.”

Scheduled to see as many as 25 patients a day at a large clinic, she lacked the time for thorough examinations and discussions. Because of this, she said, primary care doctors are often forced to order tests and send patients to specialists.

“Could I have helped some people without specialists and tests? Absolutely,” said Dr. Sacks. “Would it have saved the patient and the insurance company both money? Absolutely. Is the system set up for the best care and cost efficiency? Absolutely not.”

Dr. Sacks said she worried that seeing so many patients would lead to errors. Last year, she moved to a clinic that focuses on longer patient appointments, 30 to 60 minutes. This translates to 10 to 12 patients a day. Patients also communicate directly with her by phone or e-mail.


I am reading a book right now called The Tipping Point by Malcolm Gladwell which talks about what factors are involved in causing trends to change, whether that trend is an epidemic, fashion, crime. In it he describes a study that is relevant to today's practice of medicine.

Two Princeton psychologists, John Darley and Daniel Batson, did a study where they asked theology students to prepare a talk on a Biblical theme and then walk to another building to give the talk. They were not told that along the way they would pass by a man slumped over in an alley with his eyes closed and groaning. They wanted to see what factors would increase the likelihood that the theology students would stop to help the man, and in effect emulate the parable of the"Good Samaritan".

What determined whether these otherwise caring and conscientious students would stop and help was not their desire to help others, how recently they were reminded of the Good Samaritan parable or even whether they were about to give a talk about the Good Samaritan. What made the difference was how much time they had. If they were told that they were running late, only 10 percent stopped to help. If they were told that they had a few minutes to spare, 63 percent of the students stopped to help.

From The Tipping Point:

What this study is suggesting, in other words, is that the convictions of your heart and the actual contents of your thoughts are less important, in the end, in guiding your actions than the immediate context of your behavior. The words, "Oh, you're late" had the effect of making someone who was ordinarily compassionate into someone who was indifferent to suffering -- of turning someone, in that particular moment, into a different person.

So I don't blame doctors who are harried and rushed to see 20+ patients a day if they are less thorough or even less caring. The current dysfunctional healthcare system will harden even the kindest hearts.

But more and more doctors are choosing a different path, the same one that I chose 5 years ago. One that allows for more time to listen, to think, and to do what we have been trained to do. For a directory of where to find like-minded doctors, go to the IMP Map.

If all doctors (or even just primary care doctors) had more time to listen, then we would have better healthcare. The question is, will the new healthcare reform that is shaping up in Washington give us that time?

|| akifox 11:31 PM

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]]> http://files.posterous.com/user_profile_pics/114244/DCP_2700.JPG http://posterous.com/users/1bh0cq0OUqR Dr Linda M. Lee Dr. Linda Dr Linda M. Lee Sat, 06 Jun 2009 05:51:00 -0700 I LOVE MY JOB! http://lindalee.posterous.com/i-love-my-job-7 http://lindalee.posterous.com/i-love-my-job-7

I get asked by many people if I like being a doctor, do I like my job, would I recommend this profession to their kids, if I had to do it over- would I do it again?
 
I have pondered these questions this past year, especially in light of my oldest daughter who is interested in going the medial school route. Do I think it is best for her to go through all that you need to do to become a physician? It is a very long road, lots and lots of studying, long hours, no sleep, a zillion exams to take and pass,
life and death situations,just to name a few.  But, when I think back on all my years of preparation- I really feel it was so worth it!
The richness of the lives you interact with is amazing! God has taught me so much through the people that I have met, their life stories, their struggles. I am deeply privileged to have the opportunity to know and understand my patient's struggles and dreams and to try and help them in their journey of life.
 
This is exactly why I have decided to blog about my experiences. I have learned so much through my patients and I don't want to forget them. Yes, if you ask me about my experiences in being a doctor ....I will emphatically tell you that I LOVE MY JOB! I am so blessed that God has brought me this far and I can't wait to see what is in store for me in the future!

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]]> http://files.posterous.com/user_profile_pics/114244/DCP_2700.JPG http://posterous.com/users/1bh0cq0OUqR Dr Linda M. Lee Dr. Linda Dr Linda M. Lee Fri, 05 Jun 2009 20:00:34 -0700 WellSpring Family Medicine http://lindalee.posterous.com/wellspring-family-medicine http://lindalee.posterous.com/wellspring-family-medicine
via drlindalee.com

I am thinking of trying to do a medical story blog. Blogging about my unique experiences in my solo practice Wellspring Family Medicine.
I guess you can first check out my website and find out about my practice.

www.drlindalee.com

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]]> http://files.posterous.com/user_profile_pics/114244/DCP_2700.JPG http://posterous.com/users/1bh0cq0OUqR Dr Linda M. Lee Dr. Linda Dr Linda M. Lee Fri, 05 Jun 2009 12:47:00 -0700 Love Hate Relationship with Technology http://lindalee.posterous.com/posterous-re-posterous-re-my-first-blog-post-4 http://lindalee.posterous.com/posterous-re-posterous-re-my-first-blog-post-4

   Today when I came into the office, I accidently hit a wrong button on my computer and I couldn't view anything on my computer !  My first patient Fred ( not his real name) was in the waiting room already!  I was all flustered because I am literally crippled if I cannot use my computer!  How was I suppose to look at his chart!  He was coming in to go over his blood work.  I sheepishly went out to the waiting room to get Fred and he said " What's wrong Dr. Lee, you look worried".  I told him my dilemma...and he chuckled and said. Let me help you with this. He quickly went to work, unplugging wires, control alt-delete, hard reboot, reconnecting various wires.  Fred quickly noticed my uneasy look as he worked away " oh..don't worry Dr. Lee, I do this all the time. In fact, I teach a course at RIT on how to take apart and put back together a computer.  It is very similar to what you doctors do...take apart people...and hopefully put them back together!"


So, he looked at my situation, diagnosed the problem, re-hooked in some wires, rebooted...and Walla...problem solved!  I was definately fortunate that my first patient of the day was one of those computer geniuses!

I don't know who got more out of this doctor visit- me or him? I almost paid him a copay instead of the other way around! :)

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]]> http://files.posterous.com/user_profile_pics/114244/DCP_2700.JPG http://posterous.com/users/1bh0cq0OUqR Dr Linda M. Lee Dr. Linda Dr Linda M. Lee