Cash For Medical Care

There is something wrong with a healthcare system that won't see cash paying patients. Recently, I had a patient who had no medical insurance. She had just finished her practice teaching and was in between college and her first job. When I saw her she had signs and symptom that one would have with a brain tumor. I recommended that she see a neurologist for a comprehensive work up including a MRI. Much to my dismay, I could not get her seen by any private neurologist in the Nashville area. Why, you ask? Because she had no medical insurance. That's right she was paying cash. How many businesses walk away from cash? Not many!

I did not stop there. After all this is Nashville, home of Vanderbilt and Meharry Medical Schools. Surely, one of those institutions would see my patient. After all, they have future doctors to train. Wrong again. No Luck at either institution.

Eventually, she was able to see a retired neurologist practicing a few days per week in a free medical clinic. He saw the importance of getting an MRI and made a few phonecalls. He was a former staff member at Vanderbilt and was able to call in an old favor and get her in for testing. No tumor was found and the patient has been monitored for the strange tumor-like appearance of her optic nerve for a little over a year now. Had this been a severe brain tumor, the patient might have died during those weeks it took to get her in for a MRI.

Don't get me wrong. I am not sure what the fix to our healthcare system is but I do know the system is broke. Health insurance costs are skyrocketing at 16-23% a year. Believe it or not, these increases are not going to the doctors. Over the past several years doctor reimbursements have remained level or declined in most cases.

I am not sure where the blame lies or what the cure is. I am anxious about what lies ahead for patients and for doctors. I do know one thing and that is when I have a patient with a condition that could be life threatening, I want them seen, even if they have cash.

English-My Second Language

Arkansas has it's own language and accent. As much as I try, I can't quite shake the Arkansas accent. In fact, my son makes fun of me and my accent frequently. He says that the closer I get to Arkansas, the more my native dialect (aka Arkansas English) comes out of me. He even has noticed the distinct accent when I am around friends and family from the "Natural State" as it is known.

I have decided to not fight this transformation which occurs as I travel closer to my home state. In fact I am embracing it. I am thinking that maybe those of us who are lucky enough to be from Arkansas should really get more credit in life. In fact, if Arkansas English is really a language of it's own, shouldn't those of us lucky enough to be from there get foreign language credits for English in high school and college.

Where's Your Smile?

Do you know anyone who never smiles? What is it with these people? It has been proven that the mere act of smiling releases hormones that make one happier. When I am driving down the road thinking about the problems in "my world", I try to remember this little fact. When I smile, guess what? My problems don't go away but most of the time, I do feel a little better.

I have one acquaintance in particular who never smiles. I am not kidding, this person never ever smiles. Sometimes when I see this person, I make a game out of trying to make her smile. I know my humor can be bad sometimes, but even on a bad day I can elicit a small smile out of most people. Never happens with this person! I know smiling won't solve all the problems of the world, but I think it's a start.