Healthcare why is it so………

I apologize for the rambling questions below.  So many questions. Just so you know up front – I currently work for a medical group with a patient base of about 300k patients. You answers would mean a lot to me. I have strong feelings and ideas about how to improve the current state of healthcare in America.  Some realistic, some crack-pipe smoking crazy.  Before I share my thoughts I’d like to start with a little Q&A. Your participation would be wicked awesome.

Here we go….please feel free to add other observations and thoughts at anytime.  If you don’t want to post your responses you can email them to me at  Thanks

I need to know your expectations of the healthcare experience. 

Do you expect to be able to see your doctor the same day you call?  Regardless of the medical issue or need?  Does the experience meet your expectations? How long did you spend with the healthcare provider at your last visit? Was it satisfactory to get all your questions answered?
Do you expect to be seen by a doctor? Advanced practitioner? Nurse? Other?  If you’re not seen by a doctor is that ok?

How “smart” are you about healthcare? Today the popular phrase in marketing is to call a patient a healthcare consumer. Are you a healthcare consumer?  What tools do you use to educate yourself as a healthcare consumer? How does one become a healthcare consumer?

Does a healthcare consumer actually shop for healthcare? Do you compare Urgent Care facilities based on cost, convenience (hours) and quality? How would you even start to get that informaiton?

I’d love to hear your feedback on all personal experiences, good and bad.

What is the billing experience like? Do you understand your healthcare benefits? Do you even opt to have healthcare?

Do you understand your bill for healthcare services?

Do you perceive value in preventive services?  Do you actively participate in leveraging preventive services?

Do you go to the emergency room for non-emergent care?  Why? Why not?

Have you used an Urgent Care facility? Good, bad?

Talk to me about being a caregiver for a loved one.  What was that experience like?  

What is the role of the employer with your healthcare?  Do you get your health insurance through your employer?  Do they have a “wellness” plan or incentives? Do you participate? If yes, why? If no, why?

What financial responsibility does the employer have in healthcare?

What do the following terms mean to you:

Private exchange


Mobile health


Fee for service



What is important to you when deciding on a doctor?  Flashy sign? Modern office? Good access? Pleasant customer service folks? The need to feel better? Convenience? Quality of care? Cost of care?

In the healthcare arena what does value mean to you? What does quality mean to you?  How important is cost?

Thanks in advance for your help. I can’t wait to here from you all.

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The Goal of One

My new nemesis is this thing strapped to my wrist.  No it’s not some kind of law enforcement tracking device, worse, it’s a new FitBit thingee.  It tells me how much or how little activity I do during the day. It also tells me how well I slept.  It records it all in mocking detail for all the world to access. You have the ability to set “step” goals and to monitor your heart rate and it will even track your walks, hikes, runs, etc.

So I was talking with someone the other day.  Someone who wouldn’t typically engage me in conversation but they saw the evil thingee on my wrist and figured we were now some way connected.  “Joy, oh joy,” I thought.  Next they’ll want to friend me on face book and then have me join their little activity measuring online sorority or in my case fraternity.  Ugh

So before even asking a question they started the conversation by stating their step goal for the day.  “My goal is 12,000 steps a day,” they enthusiastically proclaimed, “what’s yours?”

I stood there for a moment, knowing full well that the goal on my activity nemesis was half their total of 12,000, not wanting to be judged a wimp I looked at them and said, “my step goal is one.”

They looked at me like I was some kind of three headed, Plutonian alien.

“How can one be your goal,” they asked with a hint of snarkiness in their voice.  “One isn’t a goal at all,” they continued.

I stood there for a moment and then said:

One is my goal, it’s your goal and it’s the goal for everyone else out there.  For all us of our day starts with that one step we take after getting out of bed.  Without that one step the rest doesn’t happen.  For so many people with either physical or mental disabilities that one step is the most important. That one step may, in some cases, be impossible without help from others.

I waited for a moment to let what I just said sink in and then looked at them and continued.

What we need is a day when everyone with these damn activity tracking thingees on their wrists sets their personal goal to one and we use the opportunity, just one day, to focus as a society on those who need help taking that first step and working to help them achieve that goal.  The goal of one step.

They stood there for a moment, shrugged their shoulders and said, “cool idea, we should really do that,” they then turned and started adding steps to their lofty goal of 12,000.

The Goal of One.

I like the idea.  What a neat way of helping many.  So what do you think?  Any interest in setting your activity tracking thingee to a goal of one for one day?

Let’s make this happen.

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What do you do for a living?

So what do you do for a living? How many times have you been asked that question? How many times do you answer with a description of your current job? I know, so many questions.

I know many people who for them, their job, is their life. At some point they’ve worked at their job for so long they see it as their life. They know nothing else. At some point they come to believe that their job makes them.

For some folks their job is their passion. I am not sure if they’re passionate about their job or their job is their passion. If you can work at your passion, you are very lucky.

For some folks, when that job goes away, either layed-off or retired their life is never the same. Some times, especially in the case of being layed-off, bad things can happen. How man times do you read about someone who worked their whole life and then they retire and after a short while after they pass away.

You make the job. The job doesn’t make you.

What you do for living should be what makes you smile. It should be what makes you feel passion in that place they call a soul. What you do for a living should make other people feel good. What you do for a living should make you feel good. What you do for a living should positively impact this place we call home. What you do for a living should make a positive difference.

What I do for a living, or a least try to do for a living is make people smile, laugh and feel better about being part of this thing we call the human race. What I do for a living is challenge people to be better. To think. To aspire. To love. To care.

So you have a little time to think about your answer. What do you do for a living? I can’t wait to hear.

One last thought, if you really want to fuck with people (like you really thought I’d get through an entire blog posting without using the word fuck – HA. I am my mother’s son after all).

Like I said, if you really want to fuck with people, the next time someone casually asks you, “What do you do?” Look at them with a most puzzled look on your face and reply, “About what?” Hahahaha, it gets them everytime.

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The price is night

Hello loser. Hey you fucking loser. What, are you trying to sleep? So here it comes. Every fucking thing I’ve fucked up, everyone I’ve hurt, everything I’ve lost decides at this moment to come flooding back into my conscious thought process. Oh no, you couldn’t keep quiet tucked into my subconscious. You couldn’t be satisfied with knowing it’s only a matter of time before I add to the considerable pile stashed in the recessed corners of my mind. Oh no, it’s time. I can hear my conscious Bob Barker shouting, “come on down, the price is fucking right, let’s fuck with him now.”

I’d pay big pharmaceutical dollars to not be typing onto this screen at this moment. I’d love to be in a blissful pharmacological stupor. I’d love to not have fucked up literally everything in my life.

The voices are so loud tonight. Louder than they’ve been in a long time. I keep feeding them. I don’t mean to but it all stays inside. It all stays inside.

My earliest memories are of the screaming voices in my head. Not playing in the backyard on a sunny day, not swinging on a swing, not some warm family moment captured forever on the cover of some hallmark card. I remember the feeling of the screaming in my head. I remember how the screaming in my head made me feel. It hurt my stomach.

It’s funny, I don’t recall ever being able to discern words. It was more the physical impact of the screaming inside my head. I guess it’s like people’s reactions to the sound of fingernails on a blackboard. But not really.

A recoil. How do you recoil from a sound in your head. Unlike the blackboard you can’t physically move away from sounds in your head.

Ormond Street. Right off of Bridgeport avenue. That’s where I first heard them. Actually, that’s where I first felt them.

I remember trying to cover my ears so I couldn’t hear them. It didn’t work. Nothing worked. Nothing works.

It’s okay though. They’re my noise and my voices. Weird though, they are not my screams.

There you go, are you happy now? You bastards of cranial cacophony.

Don’t be afraid, it’s all in my head.

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Karma Gargoyles

The karma gargoyles are loud tonight. I like when they’re loud, It means that they’ve evened a score somewhere for someone. I don’t mind that the sound of the crunching and snapping of bones keeps me awake.

It’s a good awake. At least for me. Somewhere, someone didn’t enjoy the night. Somewhere, someone incurred the wrath of the karma gargoyles.

Somewhere, someone is no more. Somewhere karma evened the score.

They are going crazy tonight. I never realized how much the snapping of bones sounds like branches breaking. Based on what I can hear it sounds like a karma ice storm hit a whole bunch of people tonight.

The karma gargoyles aren’t quick. Sometimes it takes them a while to react. They do have a pretty full agenda.

Ouch, that was a juicy one. I think I heard a little splatter after that snap.

I love these little stone enforcers of the good way. May your pozitoodinal righteousness light up the night.

Rock on you bone snapping righters off wrong, eveners of scores and balancers of the day. Rock on.

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The Company We Keep

The company we keep is all in my head
it’s safer that way
Given what gets said
Sometimes it’s laughter
and sometimes it’s not
Banter and chatter
it’s all what we thought

The company we keep is all in my head
it’s safer that way
That’s what she said
Sometimes it’s laughter
and sometimes it’s not
A complex disaster
Of emotions and thought

The company we keep is all in my head
Alone in a crowd
A feeling of dread
We look in the mirror
They’re laughing at me
The picture is clearer
It’s only one we can see

The company we keep is all in my head
Strike up the band
It’s a long road ahead
Let’s all sing along
Thou we can’t hear a note
The noise is too strong
Don’t touch the remote

The company we keep is all in my head
It’s standing room only
says the sign overhead
We ask them to stop
and they laugh at me more
Climb up to the to top
We know we can soar

The company I keep is all in my head
it’s safer that way
Given what gets said
Sometimes it’s laughter
and sometimes it’s not
Banter and chatter
it’s all what I thought

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yesterday, today and tomorrow

What the fuck happened to yesterday and why is tomorrow so pissed off at today?

Yesterday is pissed because yesterday knows it’s all but forgotten. What really pisses off tomorrow is that it may never happen and if it does happen it’s today and tomorrow is still left waiting.

Time is a funny thing. Not in the true sense of funny but in more of an ironic way.

I heard someone say today that, “they have too much time on their hands.”

What? How can you have too much time? There is never enough time. I told them I’d be happy to take the time off their hands. I mean really, who can’t use more time.

They looked at me like I was crazy. “I can’t give you my time, it’s my time, not yours,” they said.

“Come on,” I said, “you said you had too much. I’m just trying to help you lighten your time load.”

“Piss off, I don’t have time for this” they said as they walked away shaking their head.

“What,” I said. “You just said you had too much time on your hands and now you say you don’t have time for this? Make up your fucking mind you time pyscho. I mean really, it would be time well spent.”

They picked up their pace and continued to walk away.

For a moment I thought about clubbing them in the head and knocking them out and taking their time. But then I looked at my watch and realized I didn’t have the time so I let them go.

Time is a relentless bastard. Like it’s cousin gravity but worse. At least gravity is predictable….for the most part. Time is a real fucker. Just when you think you have plenty of it you don’t.

That’s why it’s important to make the most of time. If you assume time it will bite you in the ass. When time does present itself to you, you need to hop on that motherfucker and ride it for all it’s worth because it’s today, not tomorrow and not yesterday. Hop on today and enjoy. Here’s to tomorrow becoming today.

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