Today is a special day for me, a commemoration (I love that word) of sorts; it marks a third of a century that I've been in practice.
Today is a special day for me, a commemoration (I love that word) of sorts; it marks a third of a century that I’ve been in practice. I still remember my first day. It was Friday, December 3, 1976. I had just joined a four-man general practice group after one of the doctors had recently left with renal failure. And that weekend I was to take my first call for the group. My first patient was an 80-something-year-old guy who was still working for a local newspaper, folding papers every morning for delivery.
He came in complaining of his heart “just flopping around,” but no chest pain or shortness of breath. I took his pulse and it was bouncing all over the place. I asked what medication he was taking and he said, “a little white pill.” But he hadn’t seen a doctor in a very long time, and claimed to have been taking the pill for 25 years. I didn’t get an EKG, nor digoxin level, but gathered my recently attained medical education into one corner of my brain, and determined that he was most likely a bit dig toxic. Don’t forget, back then there were a lot fewer little white pills than there are now.
I told him to stop his medication and come back Monday morning for a recheck. He did and his heart rate was regular and he was feeling fine. I thought this job was going to be a snap. Then over the years along came HMOs, PPOs, ICDs, CPTs, CTs, MRIs, BC/BS, UHC, HIPAA, and EHRs. Then things got even worse; estrogens were found to be bad for you and chocolate good... well, maybe that’s not so bad!