surgblumm Posted February 26, 2013 Share Posted February 26, 2013 [TABLE] [TR] [TD=width: 100%][/TD] [TD][/TD] [/TR] [TR] [TD][/TD] [TD=width: 100%, bgcolor: #ffffff, align: left] [TABLE] [TR] [TD] [TABLE] [TR] [TD=colspan: 2] [/TD] [/TR] [TR] [TD=width: 100%, colspan: 2] [TABLE] [TR] [TD] [TABLE] [TR] [TD] [/TD] [/TR] [TR] [TD] [/TD] [/TR] [/TABLE] [/TD] [TD] [TABLE] [TR] [TD] [/TD] [/TR] [TR] [TD] [/TD] [/TR] [/TABLE] [/TD] [/TR] [/TABLE] [/TD] [/TR] [TR] [TD=colspan: 2] [/TD] [/TR] [TR] [TD=colspan: 2] [TABLE] [TR] [TD=width: 100%] [TABLE] [TR] [TD=class: news_heading]We All Die Once by Dr. Larry Kessler[/TD] [TD=class: news_sub_heading, align: right] February 25, 2013 [/TD] [/TR] [/TABLE] [/TD] [/TR] [TR] [TD] [TABLE] [TR] [TD] [/TD] [TD=width: 10][/TD] [TD=width: 100%]About the Author Bob Blumm, MA, PA-C, DFAAPA Past President, ACC[/TD] [/TR] [/TABLE] [/TD] [/TR] [TR] [TD] My eyes fell upon the new book on my kitchen table; I soon discovered its source. My wife had a severe URI and went to a new Urgent Care Center 5 blocks from my home. She was examined quite well, and struck up a conversation with the physician. The conversation so engaged my wife’s interest in the perils of health care that she left the office with a copy of his book. I passed it several times and was intrigued by the title. I looked at the table of contents and I was illuminated by an inner challenge to dig deeper. I discovered a gold mine for all my medical colleagues but also for administrators, insurance agents, and most importantly, for every citizen who will one day be a share taker of the title, patient. This book is illuminating and demonstrates a walk into the inner sanctum of this thing we call life and expresses the truth that so many of us avoid. Yes, we all die once but it is in how we choose to die or what we do that can stave off this concluding chapter for a few decades. Recently I read an article in Clinician Reviews written by Marie-Eileen O’Neal, PhD, CPNP, FAANP. Her article was entitled “Who Decides What Comes Next?“ She reminded us that we as health care providers must embrace that Primum non nocere (First Do No Harm) might include not initiating treatments in an attempt to prolong life when the outcome is inevitable. Health care providers have spent their careers dedicated to preventing or treating illnesses and eliminating suffering. Advances in technology have allowed us to prolong life. However, many of these advances do not improve the quality of life; rather they often delay the dying.”This is a major discussion of Dr. Kessler’s book and is written so clearly that every practitioner and every intelligent patient should purchase the book and make it a best seller. The first two chapters take us through the life of a medical provider (himself) and the scenarios that he experienced that struck his heart and helped him to put aside questions for the future. He followed up these real life dramatic stories with a chapter entitled “But at what cost?” It was the beginning of self discovery and discovery in general for all of us who are partakers of the health system, which means every human being. The great eye opener for me was Rationality and Rationing, using the premise of who gets better care, the chief of a tribe or the villager. This is society as we encounter it and the analogy is bitterly true. Now we move on to Insurance which is the chapter that defines what we are willing to gamble on a catastrophe in our lives. We discover the types and the cost and the rationing that we have experienced over the past decade and what many fear for the future. This chapter is worth the cost of the book. Move on to the checks and balances that are part of the hospital system and how we learn from them. More importantly, is what we learn from them. We discover the deep motivating factors and the realities of a deeper corporate experience. The next two chapters segue into health and taxes and Worker’s Compensation. These all stand side by side in determining your eligibility, your choices or lack thereof as well as why a majority of people in the USA spend 1/3 or more of everything they have saved and built in the last few months of life. We have not planned for the closing curtain call and how we will cast the characters, especially ourselves. We have all fallen under the spell of listening to ads on TV between our favorite shows which speak of some of the ne pharmaceuticals that can perhaps change our lives. In honesty, they then proclaim the complications or say you can experience a six hour erection or you may become suicidal or even die. We as American citizens have become deaf to these comments and to these medications and this chapter is called;”How not to learn about medicine.” The following chapter deals with taking care of business. Every time we enter a health care institution or hospital or clinic, we are entering into a business agreement and there is the personal assumption that we are just entitled to the extraordinary techniques, studies and additional tests that are being performed. We exit these universities of medicine and become recipients of a 100,000.00 bill that can be paid in full or in parts with interest. So we learn that there is a price to gain a prize and often, for three more months of poor quality life, the price would be better spent on a vacation with the family. As I read the following chapter I sustained personal conviction as the author is about 6’2” and 165 pounds and like most of my cardiologists, an excellent example of what a controlled human being that possess will power and a brain can look like. Unfortunately I and many of us lack the self control, discipline or the considerations of reality and feel these medical conditions only fall on the other person. Dr. Kessler puts the blame exactly where it belongs, we are the Captains of our ships and we steer into dangerous waters when we fail to heed medical advice and common sense. I felt sorry for my internist who on every year’s annual physical exam has written diet and exercise. I feel just as upset when one of my surgical patients fails to follow instructions and noncompliance becomes the order of the day. Medicine is difficult because we learn daily, it takes lifetimes to attain perfection, so we settle with perfection is the enemy of good. We can only lead the horse to water and cannot make it drink. For some, this is a medical catastrophe and leads to early illnesses that lead to early deaths. There are numerous other chapters that deal with familial illnesses, mal-practice cases, the suffering physician who sits before the OPMC and a chapter of statistics that can make your head spin with the laws of averages and how patients and health care providers try to manipulate them. The more outstanding chapter was about birth and rebirth, a chapter about a new life being brought into the world and the hopes that this entails. It is great to end a book on the subject of hope without diminishing the previous chapters that demonstrate our responsibilities to ourselves, our families and to the realities that surround us. I would suggest this as Bob Blumm’s Book of the Year as both the medical provider and the patient may be able to form a contract that cannot change the outcome, death, but can change how we approach it, are we ready to meet it and have we done our best to follow the rules of the road that stall it’s fingers. This book by the author Dr. Larry Kessler can be purchased at Amazon.com. I was so impressed that I sent his business my CV and requested a per Diem position and have now enjoyed six weeks of Urgent Care Medicine. The years spent in surgery and the 16 years spent in emergency medicine prepared me to be an active member of their clinics and I learn a new concept almost every time I do a shift. He practices what he preaches and we all become better healthcare providers because of it. Bob Robert M. Blumm has received national recognition as a distinguished fellow of the American Academy of Physician Assistants (AAPA). He is the past president of the Association of Plastic Surgery Physician Assistants, and was past-president of the American Association of Surgical Physician Assistants, past president of the American College of Clinicians and NYSSPA, as well as Chairman of the Surgical Congress of the AAPA. In addition, Bob received the John Kirklin MD Award for Professional Excellence from the American Association of Surgical Physician Assistants. Along with his associate, Dr. Acker, Bob was the first recipient of the AAPA PAragon Physician-PA Partnership Award. He has been a contributing author of three textbooks, written 300 plus articles and is a sought out conference speaker throughout the United States. [/TD] [/TR] [/TABLE] [/TD] [/TR] [/TABLE] [/TD] [/TR] [/TABLE] [/TD] [/TR] [/TABLE] Link to comment Share on other sites More sharing options...
rcdavis Posted February 26, 2013 Share Posted February 26, 2013 Strong words. Strong work. I will buy his book. although the patients I serve are little inclined to listen to any argument which includes the two letter word "no" regarding the evaluation of their health, I cannot help but enjoy a novel approach. And lord knows, I really ought to take more of the advice I offer than I do. Thanks for the review. I'd be interested in a synopsis of the demographics of his practice... Medicaid patient's? Medicare? Single payer commercial? Self pay? Eg Are his clients likely to listen to the thinking behind 'not every cold needs an antibiotic'? Link to comment Share on other sites More sharing options...
surgblumm Posted March 2, 2013 Author Share Posted March 2, 2013 Strong words. Strong work. I will buy his book. although the patients I serve are little inclined to listen to any argument which includes the two letter word "no" regarding the evaluation of their health, I cannot help but enjoy a novel approach. And lord knows, I really ought to take more of the advice I offer than I do. Thanks for the review. I'd be interested in a synopsis of the demographics of his practice... Medicaid patient's? Medicare? Single payer commercial? Self pay? I started working for his group less than two months ago. He accepts all payors, has a very evenly mixed practice and his patients are more reasonable than I have seen in the ER when it comes to antibiotics. Sometimes I give them the opportunity with an explanation and they wait out the antibiotics, particularly on OM. The info in the book is invaluable to any PA on this Forum practicing Primary Care, Family Practice, Urgent Care or Emergency Medicine. It is also great general information for all PAs, all clinicians and all patients. This is a blockbuster that will open your mind, help you contemplate and assist you in giving sound advice. Bob Eg Are his clients likely to listen to the thinking behind 'not every cold needs an antibiotic'? I'd be interested in a synopsis of the demographics of his practice... Medicaid patient's? Medicare? Single payer commercial? Self pay? I started working for his group less than two months ago. He accepts all payors, has a very evenly mixed practice and his patients are more reasonable than I have seen in the ER when it comes to antibiotics. Sometimes I give them the opportunity with an explanation and they wait out the antibiotics, particularly on OM. The info in the book is invaluable to any PA on this Forum practicing Primary Care, Family Practice, Urgent Care or Emergency Medicine. It is also great general information for all PAs, all clinicians and all patients. This is a blockbuster that will open your mind, help you contemplate and assist you in giving sound advice. Bob Link to comment Share on other sites More sharing options...
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