In-Network Doctors – Quantity over Quality

Posted on May 16, 2012 | 1 Comment

Last Friday, I went for an annual Ophthalmology “check-up.”  Since my Eyes are not my primary medical concern and I’m broke from all my other medical problems, I decided to “work my health insurance plan” to find a doctor and, in the process, take my own advice.  Mind you, while Crohn’s Disease and my Gut are to me what Kryptonite is to Superman (if you have never heard of “Crohn’s Disease Man” you just aren’t reading enough comic books), my Eyes are nevertheless of vital importance to me.  Moreover, the auto-immune aspects of Crohn’s Disease have been known to affect the Eye so it wasn’t like I was going to see a Podiatrist or a Psychic and could thus roll the dice.  In that regard, I apologize to all the Psychics out there for comparing you to Podiatrists.

Tolerating “Quantity over Quality” from In-Network Doctors

More seriously, I have learned to merely “tolerate” my Insurance IN-Network Doctors based on my present experience with an Endocrinologist who has more satellite offices than he does office staff such that it takes 3 weeks to get a Prior Authorization for an MRI of my Pituitary Gland.  I am STUNNED he calls himself a Doctor and not a Medical Businessman.  I haven’t terminated our relationship yet because I’ve had a hard time finding another endocrinologist in my insurance plan who can see me within six (6) weeks and, anyway, at this point in our relationship he is merely accumulating test results and my Bookie could basically do that.  However, I will change endocrinologists when interpreting said test results becomes of paramount concern and a long-term treatment strategy must be devised.

Since I am seemingly caught in this weekly vortex of needing to be treated by one medical specialty doctor after another, I don’t have the energy to take the appropriate consumer “stand” with each disappointing health care transaction I encounter.  However, despite my medically dominated day-to-day life and the numerous disabling medical issues I must contend with, there was something so outrageous about my recent encounter with this Eye Doctor that I had to “fight back” if only to show this doctor that the BS he is pulling with other patients can’t be pulled with me (and shouldn’t be pulled with the other patients).

Do you “take,” or “participate in,” my Health Insurance Plan?

You see, I had to find an eye doctor who would not only evaluate my vision but also assess the various eye ailments I’ve experienced because of my chronic illness.  In that regard, a trusted family member of mine recommended this particular eye doctor because he was very kind to her and had solved her then-pressing medical problem so I checked to see if he was in my health insurance plan.  I was pleasantly surprised to see that he was IN FACT, an “In-Network” Physician Provider.  I point out this distinction because patients get fooled all the time when they call a doctor and ask them if they, for example, “take Green Cross of Boston Health Insurance” and the $12 an hour receptionist says, “Sure, the doctor ‘participates’ in practically all health insurance plans” or “the doctor ‘accepts’ all health insurance plans.”

You may not realize it at the time but “magic words” are exchanged between patient and medical receptionist during such a conversation and medical practices have been profiting off of the resulting misunderstanding with the same ease of off-shore oil drilling companies obtaining licenses to drill for oil under President Bush’s administration.  The medical receptionist technically said nothing wrong because saying the doctor “participates” or “accepts” all health insurance plans when asked if the medical practice “takes” a certain health insurance plan is like pulling into a gas station asking if they “take” the local town Entertainment Discount Card and expecting a great bargain if they do.  The gas station guy would say they do “accept” the Entertainment Discount Card but the rub is the extent to which he “participates” in, or “accepts,” the local Entertainment Discount Card plan.

The Financial Ramifications of Healthcare “semantics”

For instance, the gas station guy might smile and take the Entertainment Discount Card Coupon but after you fill up your gas tank for $49.00 he will come back to the driver-side window and tell you the total is $44.00.  “But I thought you ‘accepted’ the gas coupon from the Entertainment Discount Card?” you ask.  Still smiling as if he’s a regular Saturday night dinner guest at your house, he says, “I do, and I deducted $5.00 off your total, so all you owe me for filling up your car with gas is $44.00.”  That’s exactly what happens in healthcare when the words “participate” and “accept” are misunderstood.  Moreover, medical practices exert zero effort to correct patients from relying upon these magic words.  But we patients have no-one but ourselves to blame because the only phrase of any financial significance is “In-Network Provider” because then the most you can pay for an Office Visit is your “Insurance Co-Pay.”  With my current insurance policy, that is $30.00 for an “Office Visit” and $50.00 to see a “Specialty Doctor;” however, I have yet to see an Office Visit which they classify as anything but an office visit with a “Specialty Doctor.”

Having been burned many times before by the aforementioned health insurance “take/participate/accept” semantic BS, I was legitimately impressed that my Health Insurance Plan had this particular Ophthalmologist in its Provider Network of Doctors given the rave reviews he had received from someone whose opinion I respected.   Since my Co-Pay is $50.00 to see In-Network Specialty Doctors, I was going to get a full Eye Exam and Overall Consultation for no more than $50.00.  Looking back on it, I should have realized that when something sounds too good to be true, it invariably always is.  There are a few exceptions to this age-old axiom but you usually wind up marrying them and I have yet to be so lucky to meet the woman of my dreams. In any event, when I walked into this new Ophthalmologist’s office last Friday what I encountered SO DISTURBED ME that after the Office Visit I decided to ask for my money back.

How to be a Medical Patient Consumer

Rather than bore you with additional details as to why I felt so ripped off as both a Patient and a Consumer by this Ophthalmologist, I have pasted below the EXACT Fax I sent to him on the following Monday, which he responded to within one (1) hour by reversing the $50.00 Co-Pay charge to my American Express Card.  In short, I felt like a patron at a trendy restaurant with a Server who starts walking away from me while I’m still ordering as if he knows how to complete my sentences and what I want for dinner that evening.  The Server seems more interested in maximizing his tips by “turning the table over” rather than in ensuring that I have a pleasurable experience.  In the restaurant setting, I can tolerate such behavior because I don’t have to jump through too many hoops to find the joint and after all, it’s common to have a “one-off” experience.

If I wind up having a bad consumer service experience, I’m also always aware of the “buyer-beware” credo and I can easily “complain” by never going there again.  I can also tell all my friends about how rudely I was treated and I can even write a scathing Yelp Review or share my bad experience on some other social media platform.  These common sense remedies notwithstanding, I think it is just as important to take the time to compliment a new restaurant or business via these same consumer tools when the experience is positive.  We all seem to have more time to complain and protest to get our money back than we do to compliment or praise a business or service when it provides exactly what it advertises.  That’s just human nature and when we spend our hard-earned money and in return get a bad experience we tend to be more “motivated” to do something about it even if that is to simply ease our minds.  But I do try to keep my complaints and compliments in balance and I think my Yelp profile can attest to that.

But these consumer remedies are not as effective when it comes to our Health because there’s simply too much subjectivity involved with the healthcare transaction and the “time spent” vs. “proper treatment received” quotient doesn’t leave much room for a grave error or a disconnect.  Accordingly, while an arrogant abrupt physician to some can simultaneously be touted as a highly skilled and confident physician to others, the time invested in developing a new doctor-patient relationship gone wrong can feel like the most squandered of wasted time.

“Quantity over Quality” In-Network Doctors with some Exceptions

Ironically, in the middle of writing this Post I went to see an In-Network Surgeon for a Consultation as I need rather serious surgery to repair Crohn’s Disease-related damage in my Intestine.  It may have been the most thorough examination I’ve ever experienced as this doctor focused on me and my case until he and I were both satisfied that we had all of our questions answered.  By agreeing to operate on me, he was telling me that my problem was now his problem and I left his office SO relieved.  Perhaps it was the combination of the precise nature of his surgical specialty and the seriousness of my surgery which warranted such individualized treatment, but I have found the recent increase in Insurance In-Network Doctors clearly creating a “quantity over quality” atmosphere.  I can only imagine this trendy restaurant-like atmosphere to be a byproduct of the unreasonable provider reimbursement amounts and the allotment of shorter and shorter patient time constraints placed upon them by both our overall healthcare system and by the rules of being an In-Network Provider; the Network of which many Provider Doctors are forced to join simply for cash-flow purposes.

“Turning over patients” seems to be the name of the game in these types of practices.  It is quantity over quality; “LA” instead of New York City; Kathy Griffin over Louis C. K.  The question then becomes:  What to do about it?  I decided to articulate my grips in a respectful letter to the aforementioned Ophthalmologist asking for my money back and in the process I hoped he “gets it” so that the quality of the medical services he renders to other patients in the future gets better.  Below is that redacted copy of the fax I sent him [underlined and bold emphasis left in].

The Redacted Ophthalmologist Letter seeking Refund

As an experienced Patient, and a complicated one at that, I was deeply disappointed in the Ophthalmology medical services you provided to me on Friday, ————, and as I result I am reversing my $50.00 ——————– Insurance Co-Pay Charge with American Express (if charged; if not yet charged I am respectfully requesting that you do not do so) and I respectfully request that you mail to me my Medical Records you and your staff generated on ————-.  My address is —————————————————————.  Thank you for your anticipated cooperation.

For the sake of explaining my actions and for the purposes of hopefully preventing this from happening with other patients, set forth below are my  specific Complaints.  In summary, I just need my Doctors to be reasonably thorough and reasonably comprehensive given how pervasive my Crohn’s Disease has been and you clearly were not.  But, it is nothing personal.  Candidly, I think it is a byproduct of the ridiculous and unreasonable time constraints you are placed under by Health Insurance companies which in effect unfairly place your emphasis on “turning over patients” like waiters in a trendy restaurant instead of treating each patient with the time and focus warranted by each individual patient and case.  Nevertheless, I need more attention focused on the health of my eyes given that my Crohn’s Disease has already had a significant effect on my eyes.  In that regard, I must now see another Ophthalmologist for the same reasons I went to see you and therefore I would appreciate you not charging me for the ————————— Office Visit/Exam or not contesting my reversal of said charge when/if it appears on my American Express Card.  Thank you for your anticipated cooperation.

The Specific Patient-Consumer Complaints

  • I completed your New Patient forms in reasonable detail explaining the Cataract Surgery, Eye Sores, Extreme Crohn’s Medication Side Effects and Dry Eye I have experienced as a result of my Crohn’s Disease yet you merely confirmed the Left Eye Cataract Surgery and told me I have a Cataract in my Right Eye but that I shouldn’t worry about it.  That gave me no gauge whatsoever as to the status of that right eye Cataract considering that my Los Angeles, CA Cornea Specialist told me 3 years ago that I must watch that right eye CAREFULLY.  You did not even inquire about the eye sores or the Dry Eye and both are often symptoms of Crohn’s Disease and in my case they were so EXTREME to the point where I had CUTS in my eye that were so painful I almost had to be hospitalized.  As for the Dry Eye, I had some type of ducts inserted into each eye yet you did not inquire about Dry Eye AT ALL.
  • I spent more time with your cordial Vision Technician than I did with you and that concerned me given the complexities explained above and given my current exacerbating problems regarding Reading up-close.  I was worried that my chronic illness might be somehow affecting my vision (as my Crohn’s is apparently active and wreaking havoc inside my Intestines as I am awaiting a surgical date to have FIVE (5) Strictureplasties performed on me) yet I was “run through the mill” that you have established at your practice and while that may be perfectly fine for normal patients it doesn’t work for me.  I also asked this Vision Technician several questions which she had no answer for and I also had to remind her several times to check the prescription on my Sun Glasses as I was not sure when I had them made.  She was very nice and professional but she went through my exam like she was completing a checklist fixing a car’s Transmission rather than treating ME as a Patient.  I don’t blame her at all; I have no one other than you to blame because she should not be placed in a position to answer questions which necessitated answers from an Ophthalmologist.
  • When you gave me the eye exam and I complained that my right eye was VERY blurry from the dilation eye drops yet my left eye seemed fine, you said I shouldn’t worry that the vision you were demonstrating for me in that right eye wasn’t the best possible vision I could achieve with a prescription.  To that end, I still don’t understand how you were able to almost perfect the vision in my left eye with the manipulation of the different lenses in that machine but never came anywhere close to providing me with decent vision in my right eye.  Considering I have a small or “beginner” Cataract in that right eye, have experienced all of the above related to my Crohn’s Disease and what I set forth in the New Patient Forms, your answer to my repeated question about this was unsatisfactory.
  • I also told you after you were done examining me that I was having serious problems reading the newspaper and you told me that you were surprised by that statement based, I imagine, on the eye examination you had conducted.  Then, in response to my statement and in an attempt to help me, you had me go back to the prescription “machine” and you held up a sign close to the machine for me to read to test my reading vision.  However, your hand was not steady and the sign moved and that just added another variable to figuring out what my correct reading prescription is because I couldn’t focus on the answers to your questions regarding what was on the sign but you did not seem bothered by it.  You then put the sign down and changed my reading glasses prescription.  I asked how you knew what prescription to write and you simply answered: “I made your reading glasses much stronger.”  ????  With all of the complexities that must go into figuring out the correct eye prescription, what does “much stronger” mean and how did you arrive at that exact prescription?  Moreover, had I not insisted that you please make sure my reading vision was optimized; you would not have changed a thing.
  • I asked you about the right eye Cataract and again you gave me a “wishy-washy” answer by telling me “not to worry about it.”  Given the almost 20 major surgeries and 200+ hospitalizations I have experienced due to my Crohn’s Disease, I must worry about it because what can go wrong with respect to my health, always seems to go wrong.  This is all not even mentioning that I developed, and had surgery for, a Cataract in my Left Eye in July, 2007, when I was 44 years old and was told it was directly due to my Crohn’s Disease because I was too young to be developing a Cataract.  I was also told at the time that I had what appeared to be a Cataract in the right eye but that it was too small to operate on – at that time.
  • Then you walked out of the Exam room leaving me on the chair and I thought you were either coming back in or having another vision technician come in as I still had questions regarding the prescription to my Sun Glasses.  Then, after waiting a few awkward minutes in the exam room chair, I walked out of the exam room and asked someone to check my sunglasses.  The Vision Technician who had conducted a variety of tests on me was kind enough to take them from me and she then checked them.
  • I also recall always having drops placed in my eye to reverse the dilation drops because my eyes are SO SENSITIVE to Dry Eye and whatnot but that was not done and I forgot to ask.  As a result, I had trouble seeing clearly for at least FOUR (4) hours after I left your office.

Dr. ——–, I could go on and on but it is not my intention to be unreasonable or vindictive.  The whole experience simply reeked of an office trained to “turn over” patients rather than to TREAT THEM and I cannot entrust my health and well-being to such a Doctor.  That said, I am acutely aware of the harsh realities of our current healthcare system and I do sincerely understand the ridiculous reimbursement and time constraints you are up against but nevertheless I do hope you take this letter in the spirit in which it was written.  That is, to explain my actions and to provide you with some feedback so that you can make some changes to provide a better quality of care to your future patients since you certainly seem like a smart doctor with the best of intentions.  Additionally, I do not think it is fair that I should have to pay for my eye exam with you since I must now go to another eye doctor for the same thorough and comprehensive eye examination I was seeking.

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Posted in Assertive Patient, Doctor Patient Relationship, Doctor Ratings, Doctors, Empowered Patient, Health Insurance, Health Insurers, Informed Patients, Patient Consumers, Patients as Consumers, Physicians as Service Providers, The Empowered Patient

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Crohn’s Disease is “NFL-Tough” according to Matt Light, retired NFL Offensive Lineman

Posted on May 10, 2012 | Leave a comment

When Matt Light of the NFL’s New England Patriots announced his retirement this past week, he also disclosed for the 1st time that he has been suffering from Crohn’s Disease for the past 10 years.   He described his battles with Crohn’s Disease as extremely painful and ugly, with pain so bad it was often paralyzing.  In fact, a 2004 surgery to remove 13 inches of his intestine combined with post-operative complications landed Matt in the hospital for 30 days during which his typical NFL Offensive Lineman weight of 316 fell all the way down to 260.  Yet, through it all, Matt persevered and appeared in Five (5) Super Bowls protecting Quarterback Tom Brady and winning three (3) of them.  Matt Light’s candor and brave account about how painful and serious Crohn’s Disease can be should go a long way toward raising the public’s awareness of this often pervasive, debilitating, painful and incurable chronic illness.

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Posted in 1st Diagnosed with Crohn's DIsease, Bathroom Stigmas & Crohn's Disease, Celebrities with Crohn's Disease, Crohn's Disease, Crohn's Disease Mainstream Awareness, Marketing Crohn's Disease, Resilency, The Medical Minute

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What to ask before your 1st Crohn’s Disease Surgery

Posted on May 3, 2012 | 4 Comments

The Power of Crohn’s Disease

As a 49 year-old battling Crohn’s Disease for almost 30 years, people always ask me two (2) things:  1. What is so unique about Crohn’s Disease which makes surgery such a last resort?  2. Why has it been necessary for you to be hospitalized over 200 times for treatment of Crohn’s Disease?  The answers to these two (2) questions set up a foundation of knowledge that every Crohn’s patient should acquire so they are properly equipped to most effectively interact with their surgeon during that 1st surgical consultation.  But before I share advice about what to ask your surgeon before your 1st Crohn’s Disease surgery, I think it is also important to understand the disease, its possible progression, its medications and its potential effects on your life.  That’s why I’ve chosen to write this “advice article” from a story-teller perspective.  After all, surgery is surgery but there’s nothing quite like Crohn’s Disease.

Experienced Crohn’s patients are not Doctors but for what we must go through with the disease, we might as well at least have some type of Honorary Medical Degree! To that end, Crohn’s Disease forces each of its patients to learn a great deal about his or her respective “type” and intensity of disease since Crohn’s can affect one person mildly yet another so severely that he or she can be disabled.  There is no medical explanation for this wide and diverse range of brutality. Moreover, these mild vs. severe flare-ups and overall Crohn’s classifications can inexplicably go away over time or they can exacerbate.  The auto-immune element of Crohn’s can also introduce other chronic diseases and conditions into the patient’s situation and these Crohn’s “related” medical problems can be more debilitating than the vice-like grip Crohn’s itself often has on the life of its patients.

When you also consider the life-threatening and life-style altering side effects of some Crohn’s Disease medications, the potential severity of the disease really comes into focus. Like many other Crohn’s patients, I have come to experience it as a disease which has a mind of its own whose main attributes are unpredictability and in-curability.  How can a person plan a life around such an often pervasive disease which causes debilitating and painful flare-ups the timing of which are unpredictable? Oh, and the underlying disease is incurable? There are many more dangerous and debilitating diseases than Crohn’s Disease but few feast on a patient’s physical, mental, psychological, emotional, financial, professional, social and familial well-being as much as Crohn’s Disease.

 A Correct Diagnosis of Crohn’s Disease

Assuming you are accurately diagnosed and manage to dodge the months or years of being misdiagnosed with people close to you thinking you are crazy for trying to associate together seemingly unrelated symptoms as if they are all a part of one horrific and existing disease (which they are, and the disease is called Crohn’s Disease), you’ve ultimately found “the” gastroenterologist who fits your needs, personality and lifestyle.  During the first few years, under normal circumstances you would have likely been under medical treatment for a variety of Crohn’s symptoms that occur when your body’s immune system is ill-equipped to fight off inflammation.  In fact, when posed with the task of fighting inflammation, your Crohn’s Disease somehow confuses your immune system and causes it to attack itself instead of the inflammatory intruder.  This sounds like fodder for an old Jerry Lewis Comedy but the practical medical effects of this bizarre immune system malfunction make Crohn’s Disease potent and pervasive.

Despite the possible serious manifestations of Crohn’s, your gastroenterologist will start you off with the most conservative medical treatment and then gradually move you up that scale as your condition warrants.  But as you know, your condition may forever stay at that very treatable level or it can get rather aggressive like mine and that’s when your doctor has to move to more “systemic” medications or eventually have you consult with a surgeon about surgical intervention.

Crohn’s Disease Recurs which tends to negate Surgery

In answering Question 1 above, it’s important to understand that Crohn’s Disease tends to “recur” in that, by way of example, having surgery to remove 4 inches of diseased small bowl intestine might solve your pressing medical problem but the mere act of surgical intervention could start the need for continued removals or surgical repair of additional small parts of small bowel intestine.  The problem with that is there is only approximately 23 feet of small bowel in the human body and your small bowel is a very important piece of human equipment. Personally, I had a small bowel resection surgery which fixed an extremely painful then-pressing Crohn’s flare-up only to have Crohn’s come back or “recur” and affect the same area of my bowel a mere two (2) months later.  After almost another two (2) months of aggressive medical treatment to try and avoid another bowel surgery, this Recurrence of Crohn’s Disease in my small intestine required another surgery to remove more of my small bowel only one hundred twenty (120) days from the date of the prior small bowel surgery. Additionally, and as referred to above, the 23 feet of small bowel serves several different important bodily functions such as digestion and absorption of nutrients so each time a portion of the small bowel is surgically removed or altered, the patient will have to make significant lifestyle adjustments to remain healthy and appear normal.  There is also the reality that every surgery creates scar tissue or adhesions and these natural byproducts of surgery can, by themselves, cause Full or Partial Bowel Obstructions necessitating even more surgery.  This additional surgery creates more scar tissue to the point where a viscous cycle forms such that the following credo was created: “more surgery begets more surgery.”  In summary, these recurrence issues are the reasons surgeons don’t like to perform surgery to fix or repair Crohn’s Disease damaged intestine.

Crohn’s Disease Medications

Prior to having to consult with a surgeon, the traditional Crohn’s Disease treatments and medications with which you might be familiar generally fall within the different levels or degrees of the disease and are as follows:

Anti-inflammation medications: (Asacol, Dipentum, and Pentasa);

Cortisone or Steroids: (Prednisone, Budesonide);

Immune system suppressors: (6-mercaptopurine [“6MP”], azathioprine, Methotrexate, and Imuran);

Biologics: (These are injectable “Anti-TNF” Agent medications such as Remicade, Humira and Cimzia which have been proven to be very effective pursuant to current Crohn’s research.  More specifically, the most current research indicates that the injection of these drugs binds them to “TNF” substances and that will block the body’s abnormal inflammation response. Some studies also suggest that the usage of biologics may enhance the effectiveness of immuno-suppressive medications. While I can attest to the almost dramatic positive effects of some biologics, I can also attest to the fact that the use of biologics in Crohn’s Disease can have VERY serious long term side effects many of which are only now first coming to the attention of medical practitioners.  It’s one thing to be aware of these terrible consequences due to the  small print [or fast spoken] legal disclaimers on the packaging inserts [or in TV/Radio commercials] of the biologics but it’s an entirely different reality when these patients taking biologics start showing up in emergency rooms around the world with life-threatening Lung Disorders and Fungal Infections.  Almost forget, these biologic drugs tend to also be very expensive.)

Antibiotics: Antibiotics are used for a variety of purposes in Crohn’s Disease because in some patients doctors believe there is a bacterial component somehow involved.  They are also used to treat bacterial overgrowth in the small intestine caused by stricture, fistulas, or surgery. Accordingly, your doctor may prescribe one or more of the following antibiotics: ampicillin, sulfonamide, cephalosporin, tetracycline, metronidazole [i.e., Flagyl]. (Personal Note:  For whatever reason, Flagyl has proven to be VERY effective for me during certain types of Crohn’s flare-ups.  In such instances, I typically take the antibiotic for 5-10 days and then get off of it.  I mention this because even the use of antibiotics in Crohn’s patients can have serious complications such as the prolonged use of Flagyl causing Pancreatitis. Again, I am NOT a Doctor but I have been in contact with many Crohn’s patients who have contracted Pancreatitis after significant use of Flagyl.  Amazingly, I have thus far avoided that nightmare.)

Anti-Diarrheal Medications & Pain Medications: These are drugs used routinely by Crohn’s patients for lifestyle purposes because no one wants to spend their days in pain or stuck in a bathroom.  Some patients even see specialty “Pain Management Physicians” to specifically treat their Crohn’s pain. Whatever the reason, you should always tell your gastroenterologist what medications you are taking because this information will help him or her in devising your overall medical treatment and it will also be an important piece of information your surgeon will want to know about.

Why so many Crohn’s Hospitalizations?

In answering Question 2 above, I tell people my doctors are always doing whatever is necessary to keep me off the operating table for the “disease recurrence” reasons described above.  The practical result in the 1980s and 1990s were increased hospitalizations although due to subsequent changes in healthcare and in the health insurance industry, I’m not so sure I would have been hospitalized as often or for as many days each time I was hospitalized if I got as many of the same type of Crohn’s flare-ups now in 2012.  In any event, since there are a variety of effective Crohn’s Disease medications, many of which I outlined above, I was thus often hospitalized to take these medications intravenously or in combinations/strengths which are not available outside the hospital.  In that regard, my gastroenterologist preferred seeing me in the hospital, sometimes for 20 days, if necessary, in an attempt to get me through a flare-up with the administration of medications rather than through surgical intervention and the likelihood of losing more of my intestines.  I’m not so sure health insurance companies would now agree with this safe and conservative approach since they like to “turn over” hospital beds like waiters turning over tables in a trendy restaurant to maximize their tip income.  In any event, doctors still follow the same conservative medication principles but more of the patient “response time” is done at the patient’s home due to the increased cost of being hospitalized. This harsh reality of a Crohn’s Disease flare-up adds to the feelings of loneliness and isolation which many Crohn’s patients unfortunately experience.

Finding the RIGHT Crohn’s Surgeon FOR YOU

I have gone through this short summary of Crohn’s Disease treatments and medications because I think a 1st time surgical Crohn’s patient should be familiar with the possible roads not taken and with all that is involved in leading up to Crohn’s surgery.  The 1st time surgical patient should also know that when they consult with a surgeon and their gastroenterologist thinks they need surgery, they are likely going to receive a recommendation of surgery since that is what surgeons do!  Of course, there are numerous exceptions to this but my point is that you want to make sure you’ve exhausted all possible medical treatments such that the only appropriate answer to your Crohn’s problem IS surgery.  If you’ve arrived at that point, then your only responsibility is to pick the surgeon who is right FOR YOU.  This means consideration of skill level, personality, understanding of your lifestyle and of the quality of life you are seeking by having the surgery.  You also need to go through a battery of diagnostic tests prior to the surgical consultation and your gastroenterologist will naturally order these tests in trying to help diagnose you.  It has been my experience that surgeons like to look at the actual Films from a CT Enterography and a GI Series.  Depending upon your medical/financial and health insurance situations, you may have to undergo additional testing.  Regardless, try to always obtain the original Films from each test so that the surgeon you ultimately choose can use them to successfully operate on you.

The Crohn’s Disease Surgeon – What to Expect

It’s difficult to recommend questions to ask a surgeon in a Crohn’s Disease case because with few exceptions every surgeon I’ve ever encountered has been SO confident and thorough that they leave little room for elaboration.  Sometimes, however,  this “confidence” can be construed as arrogance but I’ve also come to learn that with supreme surgical skills in Crohn’s cases comes a certain “self-assuredness” which can be off-putting if not expected.  For example, these surgeons bring up money and the cost of the surgery earlier in the doctor-patient consultation than in any other medical situation I’ve ever encountered.  Again, there’s nothing wrong with making sure you will be paid promptly for providing your services but such “directness” during a medical consultation may be a turnoff to you.  If that is the case, please at least take away from the encounter that Crohn’s surgery is SERIOUS BUSINESS.  The surgeon is being asked to basically take apart your insides and then put them back together sans the Crohn’s problems.  If, even with that understanding, you don’t feel comfortable with that particular surgeon, look elsewhere but don’t forget you will encounter some aspect of this self-assuredness in almost every surgical consultation.

The Crohn’s Disease Surgeon – What to Ask

Prior to actually meeting the surgeon for the 1st time, you should write out your questions so that you are organized and respectful of his or her time.  You should also have a written list of all the medications you are taking. Every surgeon will appreciate you doing this.  However, LISTEN to them first and even take notes before you ask your pointed questions as they are accustomed to the nervousness and anxiety of 1st time patients and thus they are usually overly  comprehensive in their initial explanation of the surgery.  Besides the obvious questions related to the surgery such as the possibility of doing your procedure via laparoscopic surgery (i.e., instead of cutting your entire torso open), the estimated recovery time and the amount of pain involved, you should inquire about post-operative care and about the subsequent limitations in your work and physical activities and when you can start instituting your dietary preferences. Ask about the most likely problems which will be encountered with your particular surgery and what the ramifications would be to you if such problems occurred.  Getting back to the pain issue, I would ask about the availability of a Pain Management Team at the Hospital if you are overly sensitive to post-operative pain because Crohn’s surgery can be among the most painful surgeries performed. (For example, a day or two after my 1st Crohn’s surgery, a kind nurse gave me a pillow on which she had written what I thought were “girly” drawings and she told me it was my “Cough Pillow.”  I thanked her for her thoughtfulness but put the Cough Pillow as far away from me as possible in case one of my macho buddies stopped by to see me and found me cuddled up asleep with this girly pillow.  Well, after the first inclination to cough hit me and I tried to cough but nearly passed out from the pain, that Cough Pillow and its girly drawings NEVER left my side and I didn’t care who saw me use it!)

Always keep in mind that this very confident surgeon may have to attend to you when you’ve had an unsuccessful surgery and he or she will need to “problem-solve” to get you better.  Confidence is great but empathy and adaptability are also important.  Be realistic with what you expect from the surgery and make sure you are both “on the same page” with your expectations and the surgeon’s capabilities/intentions.  Understand the various costs involved with the surgery such as the Surgeon, Anesthesia, Hospital, Laboratory, etc.  The Surgeon will not be able to break down the other costs but the office staff will probably know from whom you will be receiving medical bills. Lastly, if this is the surgeon you choose but the price is too high, ask if there is a payment plan available.  It may feel strange negotiating over life or life-style saving surgery but you must and that’s why I think it is also always best to bring along someone (e.g., your mother, brother, sister, best friend, etc.,) who will respectfully act as your Patient Advocate of sorts because you will certainly need one when you are incapacitated from the surgery.  More to the point, it is always easier having a “buffer” to ask about or respectfully demand those difficult items or issues which you don’t want to get into a heated conversation about with the surgeon who will be presiding over you at your most vulnerable condition.  Besides offering you moral support, that Patient Advocate can more easily objectify the “transaction” just as the “self-assured” surgeon can since he or she has presumably done this hundreds or thousands of times before.

Now, you are ready for surgery.  Good luck.

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Posted in 1st Crohn's Disease Surgery, Anti-TNF Agents, Assertive Patient, Auto-Immune Disease, Crohn's, Crohn's Disease, Doctor Patient Relationship, The Empowered Patient

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Saving Money by “Working” Your Health Insurance Plan

Posted on April 22, 2012 | Leave a comment

 Having Health Insurance these days isn’t good enough.  You must know how to “Work” your Health Insurance Plan to best maximize your preferences and financial expenditures.

 **This Video is a summary of a Chapter in the upcoming eBook, “Chronic Illness:  Truths, Tales and Tips” by Michael A. Weiss.  The eBook is set to be ready for distribution during the Summer, 2012.

 Mr. Weiss is also the author of “Confessions of a Professional Hospital Patient” presently available at Amazon and Barnes & Noble.

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Posted in Dealing with Chronic Illness, Doctor Patient Relationship, Empowered Patient, Health Insurance, Health Insurers, Informed Patients, Managing Chronic Illness, Professional Patient, The Empowered Patient, The Medical Minute

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Impersonalized Medicine for Chronic Illness Patients

Posted on April 14, 2012 | 2 Comments

(This Blog Entry is excerpted from a Chapter in the upcoming eBook, “Chronic Illness: Truths, Tales & Tips” written by Michael A. Weiss)

 Interacting with my Pain Management Doctor

I was moved to write this Blog Entry because of a phone conversation I recently had with my Pain Management Doctor during which I told him I was exceeding my monthly dose of narcotic pain medication and I needed more medication prior to our upcoming appointment in two (2) weeks.  Patients who routinely see Pain Management Doctors can attest to the tremendous anxiety which builds up while making this phone call especially after you’ve committed to taking less narcotics and getting off them completely during recent appointments. That anxiety rises to the level of making you feel like a complete schmuck when you’ve documented this pledge of narcotic abstinence in a Video you posted on the Web which has been viewed by many similar situated patients around the world!  But, as I’ve learned with my case of a chronic illness, you can’t predict the future and lately mine has been a shit storm of one painful major medical catastrophe after another such that I’ve had to postpone my genuine pledge to reduce my monthly intake of narcotic pain medications.

My doctor is very compassionate toward my plight and he doesn’t doubt my veracity regarding these recurring medical tsunamis because I always fax him details of each situation (i.e. specialty doctor names, diagnostic test results, etc.) which could impact the management of my pain.  But during this phone call and within the context of looking out for my best interests, he unintentionally scared me a bit when he explained how repeated patient “violations” of regular monthly amounts of narcotics (i.e., repeatedly calling and asking for more than were prescribed for a given month) will eventually raise red flags with health insurers and soon these bureaucrats might go over his head and make me “defend” my medication requirements. I remarked that the logic in this potential bureaucratic practice of medicine seems to run contrary to the sacrosanct nature of the Doctor-Patient relationship because any red flags should be first noticed by my doctor and thus he or she would speak to me about them and I would have to change my behavior accordingly.  But since my poor genetic makeup, bad luck and auto-immune chronic illness have been causing one painful nightmarish medical problem after another, shouldn’t the documentation approved by my health insurer of the NUMEROUS specialty doctor visits and diagnostic test results make my absolutely necessary pain medication request beyond scrutiny by this same health insurer?

My doctor assured me that he understood my frustration but this is where he believes the practice of pain management is headed and I need to be mindful of it.  His point was duly noted, we agreed to discuss this matter further during my next appointment and he prescribed a specific amount of medication to adequately treat my pain until our next appointment.  After I thanked him and hung up, I thought of the following question which I should have asked him but I sensed he was busy and needed to accommodate my request and then move on to another of his daily responsibilities:  “When I saw you on March 1st and your prescribed a certain amount of monthly medication for a painful Crohn’s Disease flare-up I was having, how was I to know that this flare-up would escalate so substantially by March 12th that I had to take more pain medication per day AND around the same time I began experiencing such severe pain in both breasts and nipples from some unrelated but serious medical problem that taking a shower made my chest feel like a broken-down dart-board and this sometimes added further to my pain and required even more daily pain medication?”

Documenting Complex Medical Problems for Doctors & Insurers

I thought I had “protected” myself from the aforementioned understandable scrutiny when after seeing my NYC gastroenterologist and going for the variety of diagnostic tests he ordered, I faxed every result to my Pain Management Doctor.  Moreover, when one of those diagnostic tests revealed that the “dart-board pain” was likely the result of my body having NO testosterone, I faxed that to him as well.  At this same time, at the bequest of my NYC gastroenterologist I rushed to see an Endocrinologist for the testosterone problem and he sent me for even more tests because my blood levels revealed a startling lack of testosterone. This new “in-network” Endocrinologist was so concerned with my “dart-board” pain that he also prescribed a hormonal drug to help offset that pain.  He also indicated I had to go for additional diagnostic tests to check my Pituitary Gland as a possible source of the problem.  However, within 2 or 3 days of taking this new drug to fix the “dart-board,” my body reacted violently and my already painful Crohn’s Disease flare-up got even worse that being hospitalized was a distinct possibility because I could barely control the pain. As a result, I had to discontinue the medication and I also faxed all of this information to my Pain Management Doctor.

While I am still battling the testosterone problem, my NYC gastroenterologist believes it is due to the massive amounts of Prednisone I had to take last summer to treat a life-threatening lung condition (i.e., “B.O.O.P.”) I contracted from certain Crohn’s Disease medications I had taken for a few years.  However, the four (4) months of taking 60 MGs of Prednisone each day did not ease my B.O.O.P. breathing problems and I had to then endure a four (4) month course of Chemotherapy but I knew all along of the potential short- and long-term problems associated with taking such potent drugs.  Thankfully, my breathing is better due to the Chemo but it has made my Crohn’s Disease much worse, albeit hopefully temporarily, and now I have a painful testosterone problem likely from the Prednisone as a consolation prize for the Prednisone not working on the B.O.O.P!.  Call me crazy, but I couldn’t possibly predict these problems and given that I have substantiated each and every aspect of what I am going through to try and alleviate the pain so that I can finally move forward, I don’t like having to defend or explain why I need more pain medication when there are many days I can’t get out of bed because I am in agony.  I know my Pain Management Doctor will understand once I have the opportunity to remind him of all I am going through but I get worried that health insurers are getting too hands-on and that a cursory review of my primary Crohn’s Disease case will not accurately reflect the pain I must live with on a day-to-day basis.  Given the possibility that the lingering effects of both the aforementioned Chemotherapy and Prednisone may never abate, I am also worried that these complications will never be given their due deference in evaluating the severity of my medical problems.

Living with the Chronic Illness, Crohn’s Disease

In my almost 30 years living with Crohn’s Disease, I have learned that the pain it causes varies depending upon the type of Crohn’s flare-up AND the genetic makeup of each patient.  I am not qualified to comment about genetics other than to say I wound up with “used car”-like genes but from LOVING PARENTS. In that regard and based on how difficult my life has been because of my Crohn’s Disease, I would never have my own child for fear of passing along this often horrific illness.  That’s the bad part about my “inheritance” but the good is that my parents also passed along some great genes which have made me compassionate, tough and resilient so that I can help others who must live with this often pervasive and devastating disease.  They’ve also given me a sense of humor and a whole lot of love. I could not survive without either.

Playing the Health Insurance Game & Working Your Policy

My resiliency and coping abilities notwithstanding, I am beginning to worry about how my increasingly painful and unpredictable Crohn’s Disease flare-ups will be treated by an impersonal healthcare system in which even longstanding doctor-patient relationships are being terminated due to patients being pushed toward unfamiliar in-network doctors who accept lower reimbursement fees from health insurers in exchange for an increase in their volume of patients. Ergo, what was once a relationship-based service industry is now strictly a bottom-line business.  Unless a patient is wealthy, due to financial constraints and the alluring option of seeing their inexpensive in-network doctors, patients can no longer afford to see their familiar physicians who know them best.  This sense of unfamiliarity has a disproportionate negative effect on people who suffer from chronic illnesses and who thus come to rely upon their physicians to maintain some semblance of a quality of life.  In any event, by the time the new in-network doctor is brought up-to-speed, the patient’s employer has likely changed insurance companies to save money and the patient has to choose a new in-network doctor all over again.

I’ve tried to “work my insurance plan” in this in-network manner but my case of Crohn’s Disease is so complex (and now even more so because of the Chemotherapy and Prednisone problems) that I always wind up back with my New York City gastroenterologist who either identifies the problem and/or finds an answer because he sees more Crohn’s patients than most other doctors, he’s a very experienced gastroenterologist and he is also very smart (as not all doctors are smart just like not all lawyers are smart).  That said, my unique case of Crohn’s Disease has cost me so much money over the years because each time I’ve tried to use an in-network gastroenterologist I’ve had a bad or nightmarish result because he or she lacked the expertise, experience or smarts to handle my situation.  More specifically, I went from having MY SPECIFIC CASE OF Crohn’s Disease treated by the NYC doctor to having A CASE OF Crohn’s Disease treated by a local gastroenterologist who could recognize it on an x-ray and could spell it correctly but beyond that, the proscribed treatment never took into consideration my almost 30-year case of Crohn’s which has necessitated over 200 hospitalizations and approximately 20 surgeries.

Another threat to a patient’s choice of physician can occur when the patient’s disease or situation requires such “personalized” care that it raises red flags with health insurers because such treatment is either not within their normal or typical boundaries of care or the treatment required to care for that specific patient is more expensive than the care required for the typical patient suffering from the same ailment (said standards are as determined by the health insurance company). Moreover, that medical treatment solution could be implemented by bureaucrats from the health insurer which will only serve to placate the patient and will not at all address his or her lifestyle, quality of life and it will probably keep that patient in an unfair amount of pain.

Understanding the Severity of Crohn’s Disease

My fear about chronic illness patients receiving impersonal healthcare is because I get the feeling that some doctors, and all health insurers, don’t understand the severity of my Crohn’s Disease and likely the severity of many other chronic illness cases.  This makes me worry about my future because my disease can get even worse.  What am I to do then?  How will it be possible to still get such quality specialized care when I am financially tapped out?  Naturally, these are rhetorical questions but they represent issues which are not unique to me so I find it therapeutic and simultaneously helpful to others to identify them for contemplation by writing Blog Posts like this one.

Bowel Obstruction Pain

Thanks to late night television commercials and general stigmas, many people think Crohn’s Disease is all about diarrhea, bowel control (or lack thereof) and mal-absorption issues. What comes across in those ominous television commercials is fear about losing control and possibly having to defecate in the middle of a business meeting or on romantic date and there is not much mention or imagery of the disabling severe pain caused by the disease.  In my experience, not only is the pain severe but it is also unpredictable and that adds another element to trying to manage it. It is unpredictable in terms of its timing, duration and intensity.  Typical Crohn’s severe pain involves inflammation at any point of the digestive track but predominantly in the intestines.  This swelling of the intestinal walls reduces the diameter of the “pathway” for food and gas to get through the body until eventually the narrowing of the pathway becomes completely occluded and a Bowel Obstruction occurs.  The cramping pain of food and gas trying to nevertheless pass through this intestinal roadblock is VERY painful.  It’s no help that the body’s natural process of peristalsis to move everything down (and out!) the pathway also kicks in and it adds pressure and intensity to that pain.

Experienced doctors and patients have described Bowel Obstruction pain to be similar to that caused by Child-Bearing Labor pain.  If you are lucky, the inflammation of the intestines subsides and you can avoid surgery.  But that can take days or weeks of lying in a hospital on steroids.  It can also become life-threatening if the food and gas threatens to perforate or break through the intestine because then it’s time for emergency surgery. Note:  Since Crohn’s is an autoimmune disease, it can cause or enhance painful inflammation in other parts of the body.  For example, I have had sores on the cornea in my eyes that have hurt as much as Bowel Obstructions. It is a different kind of pain but brutal nonetheless.

Auto-Immune Gas Pain of Crohn’s Disease

In addition to the above typical Crohn’s Disease Obstructional pain-inducing scenarios, I have learned over the years by keeping a daily food/pain diary that Seasonal Allergies (and certain foods) always trigger unique Crohn’s “inflammatory” flare-ups because of the auto-immune component of the disease.   Doctors have never been able to explain this phenomenon to me but if you witnessed it you’d understand why these types of flare-ups are more disabling than any others. I have also noticed that since undergoing Chemotherapy for treatment of the lung condition B.O.O.P., my intestines are much more sensitive and therefore these types of flare-ups are more volatile, frequent and intense.  To that point, it has been surmised by several medical experts that when my body is exposed to any type of allergy it responds by attacking itself due to my auto-immune illness.  The fight my body puts up is with itself and not with the outside agents causing the energy-draining effects of allergies.  It’s as if I have tiny “immune system soldiers” inside me attempting to ward off illness but instead they act more like soldiers from the movie, “The March of the Wooden Soldiers.”  When I need these soldiers the most, they robotically march directly into a brick wall exactly like the Marching Band members in the final scene of the movie, “Animal House.”  Seriously, the “Animal House” movie scene in which the Marching Band members march straight into a concrete wall and continue to bump into one other and cause chaos in the process is how I envision Crohn’s Disease affecting the operative parts of my immune system which should be limber, dynamic, strong and at least pointed in the right direction!

While I may envision allergies attacking my immune system in a rather humorous manner, in reality it is these effects of the auto-immune component of my Crohn’s Disease (and probably also due to having had many surgeries which have left behind scar tissue and a uniquely shaped intestinal tract) which make me cry from bearing down on the pain and feeling so ostracized by the situation.  I caution readers who do not have experience with Crohn’s or other serious illnesses to have an open mind when they read my vivid description of this specific pain and discomfort as even only a few family members have witnessed it due to its completely debilitating, embarrassing and excruciatingly painful manifestation. To start, let’s just say those wooden soldiers inside of me get confused when I’m exposed to allergies and instead of banding together and building up my immune system they do everything but and for some reason related to my Crohn’s Disease the result is an inordinate amount of painful gas quickly building up inside my abdomen.

As this gas builds up inside of me, it stagnates and causes my intestines to become so Grossly Distended that I look like I’m pregnant.  Doctors have never adequately explained this to me but the gas either builds up in other parts of my body or overflows into them from my intestines and I start to look like “The Michelin Man.”  The production of exponentially increasing amounts of gas stretches parts of my insides and causes excruciating pain.  It also comes on suddenly and with seemingly different warning signs each time so I never have been able to anticipate it. During this initial phase I cannot expel gas no matter how hard I try even though that would greatly alleviate the pain.  With each body movement I generate more gas or the gas inside me moves and creates a “gas pocket of pain.” A bed is the only place for me and I often must be physically assisted to get to that bed.  I then pray I fall asleep and dream about watching the air coming out of the “Macy’s Day Parade” Floats.

“I Love Lucy” & the Fury of Gas Pain

These gas pains move fast and furiously inside my body but for 1-3 days I can’t expel the gas no matter how hard I try.  I also become so tired from the combined effects of the allergies and my immune system attacking itself that sleep is all I can do but the painful rumblings inside me make it difficult to fall asleep.  It’s like a form of Broccoli torture where your enemy lets you gorge on the gaseous vegetable but they don’t let you fart for 3 days.  But around Day 3 of this Crohn’s Disease seasonal allergy torture I begin to expel the gas but my body seems to manufacture it faster than I can expel it.  The best way I can describe this seemingly perpetual “gas imbalance” is by suggesting you think of the “I Love Lucy” classic television show with Lucy and Ethel in the “Candy Factory” episode and then imagine those lame immune system wooden soldiers inside me saying to the gas producers: “Speed it up.”

Long story short, each time I expel the gas and release some of the pressure, my rear end hurts in ways I find hard to explain other than it feels like the exhaust from jet propelled engines are being thrust out of my backside.  I want to expel the gas to alleviate the gas pains but I dread the fallout pain in my rear end.  This sounds funny but it happens to me several times a year and without warning.  Around Day 4 expelling the gas becomes easier so the pain above my waist gets better but the gas is still so pressurized coming out of me that my butt hurts as if razor blades were coming out of it.  Every time this type of Crohn’s episode happens I feel like a Leper because I don’t know anyone else who experiences it and I can’t be around anyone while I am going through it.   I feel as if I am not in control of what is going on inside my body and it scares me.  I don’t know why it started and I don’t know when it will end.  Taking narcotic painkillers takes a little edge off the pain but soon every 4 hours turns into every 2 ½  hours and 1 pill becomes 2.   Crohn’s Disease seems to be different for each patient but when I can’t get some doctors to understand the aforementioned gas pain flare-ups how will I ever be able to convince skeptical, bottom-line oriented health insurers of its severity?

Without a Witness, No One would Understand my Pain

If my Mom hadn’t witnessed all of the above, no-one would believe it.  I guess there is a reason why I had to move back home when I began to get so sick a few years ago.  I suspect many people with chronic illnesses go through the same types of complex problems which require treatment that is in excess of the norm or different than the norm but personalized medicine for the chronically ill is going to become less available due to health insurers invoking actuary-like limits to the medical treatment of human beings with real and painful medical problems.  I worry about such a healthcare system in which the treatment of abnormal medical problems could raise a red flag which takes away the doctor’s power to treat the patient he or she knows best and instead places the treatment responsibility in the hands of insurance bureaucrats who intend to ignore complex personal patient histories and decide what is best for that patient based on statistics of normal cases and, of course, on their bottom line.  Healthy people may not feel the effects of this yet but those with chronic illnesses know far too well how it feels to be treated like a number.  Our bottom-line:  It’s hard to live with a chronic illness these days.

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Posted in Auto-Immune Disease, Chronic Illness, Chronic Pain, Crohn's, Crohn's Disease, Crohnie, Crohnies, Health Insurance, Health Insurers, Living w/ Chronic Illness day-to-day, Managing Chronic Illness, Narcotic Pain Medications, Pain Management Doctors, Personalized Medicine

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Chronic Disease – a Teenager’s WISE Perspective

Posted on March 25, 2012 | 1 Comment

This Video features an email I received from a then-19-year old, Jennifer Wheeler, now a talented artist in college who was battling various social aspects of living with Chronic Illness and Crohn’s Disease.  Yes, you can be THAT BEAUTIFUL and have Crohn’s Disease.  When her Date asked, “Is Crohn’s Disease contagious?” she knew there was something not being communicating to people about the etiquette of inquiring about chronic disease.  After listening to her being upset, I thought her insights and perspective were wise, prophetic and truly indicative of what people go through who must battle chronic illnesses of all kinds.  So I asked her to write down these thoughts and send them to me in an email as I thought this would be a therapeutic exercise and it would help her get through the experience.  However, when I received her email I was impressed with her overall Perspective and how she was able to communicate various issues about Chronic Illness that often go unaddressed.  To that end, I told her that I wanted to share it with others because it contained many nuggets of helpful information which I thought they (and many others) could use in coping with their respective chronic illnesses.  As a testament to Jen’s strength, courage and genuine interest in helping others, she didn’t hesitate for a second and gave me the permission I needed and the result is this very powerful Video.

(Please note:  I will be slowing down a bit with my typical production schedule of One (1) Video per week partially due to my continuing health issues and also because I have started to pen what I hope to be the most helpful Resource about “Managing Chronic Illness” tentatively called “Chronic Illness:  Truths, Tales and Tips.”  Depending on my Health, I hope to finish it in a few months and have it out as an eBook and hopefully also as an Audio Book by mid- to late- summer.)

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Posted in Auto-Immune Disease, Bathroom Stigmas & Crohn's Disease, chrones, chrones disease, Chronic Illness, Colitis, Coping Strategies, Crohn's, Crohn's Disease, Crohnie, Crohnies, Dating with Chronic Illness, Dealing with Chronic Illness, IBD, Living w/ Chronic Illness day-to-day, Managing Chronic Illness, Relationships & Chronic Illness

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EHRs, Crohn’s Disease & Chronic Illness – Viewer Feedback #1

Posted on March 11, 2012 | Leave a comment

EHRs, Crohn’s Disease & Chronic Illness – Viewer Feedback #1

This “Medical Minute” Episode is the First “Viewer Feedback” show. In it, I share what I have learned from the many Comments my Videos elicit from their diverse audience. In Viewer Feedback Episode #1, I share Physician thoughts on Electronic Health Records, Viewer comments on Raising Awareness of Crohn’s Disease and the thought-provoking Tweet of a chronically ill person.

For more detailed tips, analysis and funny Patient “war stories,” please go to Amazon.com (or BN.com) and purchase my critically-acclaimed book, “Confessions of a Professional Hospital Patient.” Thank you.

Copyright (c) 2012 Michael A. Weiss All Rights Reserved

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Posted in "Confessions of a Professional Hospital Patient", Chronic Illness, Crohn's, Crohn's Disease, Crohn's Disease Mainstream Awareness, Crohnie, Crohnies, Electronic Health Records, Electronic Medical Records, Managing Chronic Illness, Marketing Crohn's Disease, Mental Aspects of Chronic Illness

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Crohn’s Disease: Raising Public Awareness & the IBD Umbrella

Posted on February 28, 2012 | Leave a comment

Crohn’s Disease is essentially defined as an incurable, autoimmune, inflammatory bowel disease or “IBD.” However, it is presently most effectively explained AS IBD instead of as “Crohn’s Disease” or as its own illness with its own very specific symptoms. I think Global Positive Social Awareness of Crohn’s Disease would be significantly expanded and enhanced if its “Awareness Campaigns” gave Crohn’s Disease its own identity thus forcing it out from under this “umbrella” of IBD.  Perhaps then people around the world would understand the often horrific nature of Crohn’s Disease as well as the pervasive and multifaceted effects it has on patients. These multifaceted effects include, but are not limited to,  medical, psychological, emotional, financial, professional, social and familial.  In that regard, I think following the lead of Breast Cancer Awareness Campaigns and also focusing on the everyday heroes who battle and successfully manage Crohn’s Disease might then lead to a more Fundraising-Friendly Global Identity.

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Posted in CCFA, Crohn's, Crohn's Disease, Crohn's Disease Mainstream Awareness, IBD, Marketing Crohn's Disease

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Doctors passing onto Patients the cost of adopting EHR systems

Posted on February 24, 2012 | Leave a comment

 

For so many years, the business of healthcare was managed pursuant to the handwritten notes of medical professionals.  However, the advent of technology and recent legislation has made the adoption of “Electronic Health Records” or “EHRs” mandatory.  It is my contention that medical practices adopting EHR programs are simply a “cost of doing business.”  So, why are some Doctors sending out letters to their patients asking them to choose an EHR “plan” and pay accordingly?  Also, is it fair for Doctors to pass on the cost of adopting Electronic Health Records to their patients when all they are really doing is bringing their medical practices into the 21st Century Age of Technology?  This 2-3-minute Video examines these questions from my personal Patient experience.

“The Medical Minute” (“TMM”) is a Continuing Series of Short Videos produced by veteran Crohn’s Disease Patient, Michael A. Weiss, which highlight informative aspects of chronic illness, healthcare and healthcare reform.  Mr. Weiss’ TMM Videos can also be found on the following YouTube Channels:  The Medical Minute, Health Care Reality and Pro Patient TV.

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Posted in Assertive Patient, Doctor Patient Relationship, EHRs, Electronic Health Records, Electronic Medical Records, Empowered Patient, EMRs, Informed Patients, Patient Consumers

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“The Medical Minute” – Understanding the often Long Wait at the Doctor’s Office

Posted on February 18, 2012 | 1 Comment

 Have you ever made an appointment with a Doctor and he or she sees you on the exact time of your appointment?  Probably Not.  This 1-Minute Video explains why that often happens and it has more to do with being a Considerate Patient than anything else.

This Video is one in a Continuing Series of SHORT VIDEOS (i.e., in and around 1-2 minutes) which provides helpful insights and information regarding Healthcare, Chronic Illness and the Practice of Medicine.

Copyright (c) 2012 Michael A. Weiss  All Rights Reserved

For more detailed tips, analysis and funny “war stories,” about navigating our healthcare system, please go to Amazon.com (or BN.com) and purchase Michael’s critically-acclaimed book, “Confessions of a Professional Hospital Patient.”

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Posted in Chronic Illness, Doctor Patient Relationship, Doctors, Empowered Patient, Patients as Consumers, Physicians, The Doctor Appointment, The Medical Minute

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