Why Doctors are Always Running Late

I came across this interesting article this past week. If you are tired of having to wait for your doctor, this is a worthwhile read. If you are too busy to read this, then you can save this for the next time you have an appointment. The basic gist is that doctors are always late because it is pretty much impossible to do everything a doctor needs to do in the fifteen minute time slots that is given to us in our healthcare system today. I wrote about this in my book:

I wanted … to be able to see past the physical and meet the deeper needs of my patients, which was another reason family medicine appealed to me. Looking back, that was a great attitude when I had two hours as a medical student to see a patient. I could talk about all sorts of things.

But now in fifteen minute slots I am expected to address patient concerns, manage chronic conditions, keep updated an ever increasing list of health maintenance tasks, perform a physical exam, educate patients on the care plan and medications, and do all of this with active listening and empathy, partnering with patients to motivate them to take charge of their health—sometimes doing all this through a translator phone.

It was estimated in 2003 that a physician would need seven-plus hours per day to complete all the recommended preventative service for a typical patient panel, and another ten-plus hours per day to provide quality long-term care.11 With ever-improving technology we can do a lot of things quicker and more efficiently, but that just means more things are squeezed into the time that’s freed up. No wonder studies have shown physicians have higher rates of burnout compared to non-medical professionals, with the highest burnout among adult primary care providers.12

Worth the Cost? pg. 50-51

11 Yarnell KS, et al., “Primary Care: Is There Enough Time for Prevention,” American Journal of Public Health, 2003 April; 93 (4): 635-41.
12 Shanafelt TD, et al., “Burnout and Satisfaction With Work-Life Balance Among US Physicians Relative to the General US Population,” Archives of Internal Medicine, 2012 Aug 20:1-9.

The sad thing is that we will probably have less and less primary care doctors like the one described in the article, one that actually cares more about the person and less about meeting quotas and checking off preventative service tasks. True, some doctors are slow. But many simply just care about each patient they see. Next time you have to wait, maybe that’s a good thing.



Finding God’s Will for Your Life!

I spoke at a retreat this past weekend for the young adult group of a nearby church. It was neat seeing a different manifestion of God through the unique interactions within that group so I definitely appreciate the opportunity to be part of that weekend. I spoke on living in God’s will for our lives, and it was a good time exploring together our callings.

Figuring out God’s will for our lives isn’t so easy, is it? Even just a couple years ago I wouldn’t have imagined I would be in seminary, preaching, and dabbling in book writing. As Christians we want to live for God. It’d be nice if He made it nice and clear what we should be doing. But perhaps it’s not so clear so that we can become adults spiritually and choose for ourselves to follow after Him, just as parents shouldn’t be planning out the entirety of their children’s lives.

I’m reading Gordon Smith’s Courage and Calling: Embracing Your God-given Potential, and it’s been pretty helpful. He offers three ways to think about our calling (loc 26):

1. God’s general call to follow Christ: God desires no one to perish, but everyone to come to repetance through relationship with His Son Jesus (2 Peter 3:9). This is a calling that we have to respond to first and foremost before trying to make sense of anything else about our lives. Our Christian doing comes out of our being, out of our identity as children of God. If we miss this, then we’ll be trying to find our identity elsewhere, which will turn any good endeavor into an idol that we worship instead of God.

2. God’s specific will for you: Generally speaking, God’s will for us can probably be summed up as “Love God, love your neighbor, grow in Christ-likeness, and advance the Gospel message.” But how that plays out looks different for each person since we are all created and gifted uniquely to carry out God’s kingdom purposes. When we are living this out, then we are living out fully what it means to be a follower of Jesus. Figuring this out is tough, and it involves a good grasp of Scripture, a personal relationship with God, and the input of the faith community. But sometimes, actually carrying it out once you know it is even tougher.

3. God’s immediate will for you: As we wait to finally “grow up” and do God’s will, it’s easy to neglect what we’ve been called to right now. Whatever stage of life we are in there are associated responsibilities that we are to be faithful to. If we are students, then we are called to deligence in our studies. If we have a job, even if it’s an in-between job, we are called to excellence in our work. If we have a family, then we are called to be involved in our kids’ lives and tend to our marriages.

While God doesn’t make clear to us the specific career we should choose, He makes quite clear how we ought to live on a daily basis. Many commands in the Bible have to do with everyday living, how we are to treat one another, and because of what Jesus has done on the cross, everything we do takes on eternal significance. Why? Because everything we do will either bear witness to the Gospel, or malign it, either make it attractive to non-believers, or push people further away from God.

As we are figuring out our future path, let us not neglect what God has entrusted to us now, and that includes a daily growing in Christ-likeness. Some people like Abraham and Paul were clearly called for a certain task. If that’s you, you better obey. But many were simply serving faithfully and God quietly redirected their steps. Like David who was just tending sheep when a prophet came along (1 Samuel 16). Or Timothy just serving at church, catching the eye of Paul (Acts 16). Sometimes through obedience in the small things God will bring clarity to the big things, so let’s pay extra attention now to what we know we should be doing.

How have you gone about figuring out God’s will for your life?


Get Your Flu Shots!

It’s that time again….Halloween stores, pumpkin patches, no more hot summer days (except in Southern California)… and flu shots! It’s a mad flurry of activity in the clinic with nurses trying to get every patient flu shots on top of all the other orders they have. If you haven’t gotten your flu shot yet, go and get one!

Here are some common misconceptions about the flu:

1. It’s no big deal.

Part of the reason people don’t get so worked up about it is because the flu vaccine works, and more people don’t get it. But sadly, tens of thousands of people still die each year from flu-related complications. Most of these deaths are in adults over 65 years. The very wee are at risk as well.


2. I’m a strappin’ young lad, the flu won’t affect me.

Maybe. But the world does not revolve around you my friend. Chances are you live with young kids or older folks, or you have friends with asthma, diabetes, or other chronic diseases that can be made worse if they get sick.  While the flu might just inconvience you for a time, you can easily pass it to someone who won’t be so fortunate.

3. The flu shot gives me the flu.

Most flu vaccines do not contain live flu virus so the flu shot does not give people the flu. You might feel sore, maybe a little off, but that’s just the body’s immune system mounting a response to the flu shot. And trust me, that’s nothing compared to what you will feel like if you actually got the flu, so it’s a small price to pay.


4. I’ll just get the flu shot when everyone starts getting sick.

It’ll be too late. It takes about 2 weeks for the body to make the antibodies to protect you from the flu.

5. Flu shot is unnatural, God doesn’t want me to use that stuff.

I think this will be a post on its own, but I will just briefly say that people who believe solely in healing prayer and will not accept medical intervention are misguided in their beliefs. While I commend their faith, a God who heals and a God who gifts people with the intellect and ability to bring about healing are not exclusive. We don’t wait in faith for food to appear, we work to produce it or make money to buy it with the gifts that God has given us (although there are times we can pray for God’s provision, again not exclusive).

Sin is a corruption not of just the spiritual, but the physical as well, and I believe God has given us the gift of medicine to combat the consequences of sin and give us a glimpse of the kingdom to come where there will be no more sickness and death. Yes there have been abuses in medical advancement, but that’s the case for every other good thing God has given us.

So with that, I hope you will all make an appointment with your doctor or go to your nearest pharmacy and get your flu shot (unless there’s a reason you can’t)! Here’s to a flu-free flu season.


Medical Injustice

If you didn’t know, the new health insurance market opened last week as a means to increase access to care amongst the uninsured. If you would like a brief overview of Obamacare, read this previous post. Hopefully the computer glitches will be smoothed out soon and people can be enrolled into health insurance plans.

All politics aside, I am happy as a primary care provider working with the underserved that more people will have access to basic care. Early detection and regular care can potentially prevent the chronic diseases that burden the healthcare system today, e.g., diabetes, heart disease, stroke.

But unfortunately, the scope of the new healthcare reform will not be as vast as previously thought. This was a pretty sad article to read from CNN talking about the gaps in coverage under the new plan. The Affordable Care Act (AKA Obamacare) had the provision that each state has the choice of expanding the programs that would help provide coverage for the poor.

Sadly, half the states have opted out of the program, and hence the uninsured living in those states will not receive any aid in purchasing health insurance. The article estimates there are some seven million working people who make too much to qualify for existing state aid programs, but not enough to receive subsidies under obamacare to purchase insurance.

Millions of people unable to get care that they need. Sad as that is, numbers are just statistics. Maybe a story will be more helpful. Here’s an excerpt from my book:

I was working in the ER one time and this guy came in for abdominal pain. I did the standard history, getting all the gory details. Then I went to do an exam. Heart sounds were good, no murmurs. Lungs, pretty clear. Abdomen feels okay … wait, I feel a mass? Is this stool in his intestines? So I follow it and it’s no stool. It goes down into his pants and there I find that his scrotum is the size of a grapefruit. I hope he didn’t see me go bug-eyed.

I asked him how long he’s had this and he told me four months. Four months? Are you kidding me? I asked him why he didn’t come in earlier. He simply shrugged. I found out later he had a cancer of his testicle and it had spread all the way into his belly.

We might find that story incredulous. Why did he wait that long to come in? You would think if your scrotum was the size of a tennis ball that would raise some red flags…

To give my patient credit, he was uninsured and didn’t have access to regular medical care. If I was faced with a decision to fork up money to see a doctor or put food on the table, I wouldn’t go to the doctor either. That breaks my heart. This is just one small example of the injustices that exist in our medical system…

Worth the Cost?: Becoming a Doctor Without Forfeiting Your Soul

One charge God had against the the Israel nation was that they failed to care for the poor and needy in the land. I can’t imagine God being happy with the state of healthcare, even with the new changes. I’m still wrestling with how the church (and the individual Christian) is to respond to this need, but I do my best using medicine to carry out God’s heart for the poor. If you have thoughts, feel free to share!

“Is not this the kind of fasting I have chosen: to loose the chains of injustice and untie the cords of the yoke, to set the oppressed free and break every yoke?

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