Tips For Choosing The Right Hospital

All hospitals are definitely not created equal. Specialty and “boutique-type” hospitals are popping up in every good sized town and the ones that used to be of the “general” variety, have also restructured, added or deleted services and found their niche in the new world of hospital services. To make it even more confusing, many free-standing surgery centers, 24 hour emergency centers and other ancillary service centers are proliferating at a phenomenal rate. As a retired health care business development specialist, I can only imagine how hospital systems are scrambling to keep up and position themselves as the leaders with the newest and best equipment and services.
But, as a consumer, how do you know that the hospital you choose is really the right one for you?

There is an enormous amount of very clinical (and sometimes confusing) information about any hospital that is licensed to operate in the United States. You can find it all over the internet or just by calling the hospital association for your state and requesting information such as mortality and morbidity statistics (cheery reading) or how the hospital scored on its most recent Joint Commission survey. The Joint Commission is an independent group of experts in all areas of hospital operation, from safety, to bedside care, to the food served in hospitals. Most hospitals voluntarily submit to these often grueling (and surprisingly subjective, not to mention inconsistent) surveys because their ability to accept most of the larger insurance carriers requires a certain minimum score to participate.

But, most health care consumers want to take a “snapshot” of a hospital, make a quick decision….and hope for the best. The following hospital tips have been compiled by the people who know the hospitals best: hospital professionals, themselves. They are often indicators of how the hospital operates, overall, and can be a quick and easy way to determine what kind of care you are likely to get.

1. The hospital’s appearance is an important and surprisingly often overlooked indicator of how the hospital functions. Look at the flooring. Are the carpets worn and dirty? Are the elevators polished and bright or do they look old, dingy and downright grimy? What do the public restrooms look (and smell) like? Are the hospital personnel well-dressed in proper uniforms? Is the signage appropriate and easy to read? Can you find your way around without assistance? Are the common areas bright and clean, with healthy plants and comfortable chairs? You can be pretty certain that if the hospital looks bad, the care probably will be, too. (The exception to this rule can be the downtown trauma hospitals in big cities. These often grungy places can be the best places to go if you have suffered some horrendous trauma, such as a gunshot, dismemberment, etc. In that case, you will hardly be noticing your surroundings. But, don’t go there to have your baby and expect a lovely environment!).

2. Find out what the hospital is well-known for. This can be difficult as hospitals tend to advertise, just like any other business and they sometimes have quite inflated ideas of what they are (or should be). An example of this is the hospital that advertises itself as “for children” and directs a lot of their advertising budget towards convincing the public that it is. True Children’s Hospitals are just that: for children ONLY. They don’t treat adults. They are the only hospitals who can accurately claim that children are their specialty.

3. How hospitals staff their nursing units says a lot about the level of care you will receive should you wind up in one of them. However, this is not information that most hospitals will share with you. What you want to know is the nurse to patient ratio. A hospital that tends to staff down will have too many patients being cared for by exhausted and overworked individuals. Before you choose a hospital, take advantage of a visit to a friend or acquaintance who might be a patient there and use your powers of observation. Or, just hang out by the nurse’s station for awhile. If it looks and sounds like chaos and there are a lot of call buttons going off and no one answering, this is a red flag.

4. All hospitals do not charge the same for same or similar services. Surprise! So, how can you comparison shop between hospitals? One way would be to contact the hospital association for your state and request that information. But, you can also call a few hospitals ahead of time to get an estimate on the cost of your surgery or procedure. You will need to give them all the information you can including what kind of insurance you have, the exact condition you have and what the surgery or procedure will be that you are contemplating. You might find that you could save several thousand dollars by choosing one hospital over another (assuming your physician/surgeon is licensed, and willing, to perform your surgery there).

5. Have lunch or a snack in the hospital’s cafeteria. The same food is served to the patients, so pay attention. Is it fresh and acceptable? If not, you might want to cross this hospital off your list. (You would be surprised by the number of times people have been made sick by eating the food in some hospitals). You should also know that most hospitals, nowadays, farm out their food services to outside companies such as the ones who provide food services to large venues, like ballparks and convention centers.

This checklist can provide you with a very revealing snapshot of the hospital you are considering without wading through mountains of data. And when it comes down to it, the place you choose should be one that you feel safe and relatively comfortable in. If you do just a little bit of homework in advance of your choosing a hospital, you might find that it pays off in the end with a better hospital stay.

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Twelve Etiquette Tips for Physicians and Medical Staff

Declining reimbursements, increased overhead, implementation of the Affordable Care Act, the rush to litigation are but a few of the reasons to “sweat the small stuff” in the medical arena. If you don’t think you need to pay attention to the details when it comes to making your patients happy as well as healthy, think again. If ever there was a time to mind your medical manners, it’s now.

Patient satisfaction is becoming the key phrase in healthcare. That is not to say that patient outcomes are no longer important. However, it is now obvious that there is a direct correlation between how patients are treated personally and how they are treated clinically.

Using good manners and following the rules of proper etiquette can make an incredible difference in how physicians and their staff are viewed by their patients. If patients feel valued by their physicians and have positive interactions with the staff, they are most likely to become longtime loyal customers. Yes, patients are customers, too.

Let me suggest twelve simple rules of etiquette that can have a positive effect on patient relations and outcomes:

1. Stop, look and listen. This rule does not simply apply to the train rumbling down the tracks. It has great value in a physician’s office. While doctors can rarely spare as much time with patients as they once did, the people they treat need not wonder if their doctor is wearing a stop watch or has set an alarm on his smart phone or on his new Apple watch. Slow down. In some instances, stop.

2. Make eye contact with patients while talking with them. Focus on the patient and not on the computer screen. If your computer is placed in such a way that you must turn away from the patient, get a laptop or reconfigure the computer’s placement.

3. Listen. What a novel idea. When you ask the critical questions, pay attention to the answers. Use good listening skills such as nodding at the person, repeating what you have heard and paraphrasing what was said. Avoid the urge to interrupt or finish the patient’s sentence. You could miss valuable information.

4. Practice professional meeting and greeting. Make your introduction warm and friendly.

5. Smile and make eye contact. This helps to put people at ease and makes them feel welcome and valued.

6. Use the patient’s name as soon as you can while adhering to patient privacy laws. Address people by their title and last name until you receive permission to call them by their first name.

7. Introduce yourself even if you are wearing a name badge, which you should be. Don’t forget to give your title or position so patients will know if they are speaking to a nurse, a technician or a housekeeper.

8. Let the patient know what is going to happen next. For example, “I am going to get your vital signs now. Then you may have a seat in the waiting area until the doctor is ready to see you.” That is something that is done in my own doctor’s office. The usual custom is to tell the patient that you will be leaving the room and that the doctor will be in shortly.

9. Someone should keep track of how long the patient has been waiting in the exam room and check back from time to time. Even a prolonged wait will pass more quickly if the patient sees other humans from time to time.

10. Dress like a professional. Most physicians offer a professional appearance if for no other reason than that they wear a white coat to hide their sins. The office staff is another issue. Some employees wear whatever they choose. Others are required to dress in uniforms. The result is that there is a wide variety in office attire-some of it neat and professional and the other not so much.

11. Dress policies should be put in place and enforced by the officer manager. Lack of attention to office attire can give patients a poor impression and even lead to doubt as to the level of care they will receive.

12. Keep office differences under wraps. Not everyone in the office is best friends with or even likes their co-workers. This should not be the patient’s problem. If employees cannot resolve the trouble between themselves, they need to take up their problem with the office manager, not gossip to others in the office and definitely not make their issues public.

Invest time and money in training physicians and medical staff in the importance of soft skills. While interpersonal skills may not seem as critical as clinical skills in a physician’s practice, without them there soon may be no patients to treat. People have choices in where they go for their medical care; you want that to be in your office.

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The Difference Between Good Doctors and GREAT Doctors

“Do you like your family practitioner?” my sister asked a few weeks ago. “Would you recommend him?”

“Absolutely! I adore my doctor-he’s great!” I answered immediately, and then I started a long, emphatic testimonial, as if I were my doctor’s publicity manager. During my monologue, I used words like “smart,” “logical,” “listens,” and “respectful.” Afterwards, I realized I had not uttered the words “qualified” or “well-trained”-not even once.

The conversation with my sister made me ponder the factors and characteristics that set the great doctors apart from the good ones. Websites rating and ranking doctors crowd the Internet. On these lists, medical professionals earn the title of “Top Docs” based on surveys filled out by their medical peers. And so I posed questions to a panel of six doctors, nurses, and health care professionals. I asked: What do you look for when considering a doctor to oversee the care of your own family? In your opinion, what qualities do the very best doctors possess?


By choosing a doctor who is Board Certified by one of the twenty-four American Board of Medical Specialties (ABMS) Member Boards, you can feel confident he or she meets nationally recognized standards for education, knowledge, experience and skills to provide high quality care in a specific medical specialty. Board Certification goes above and beyond basic medical licensure. Determining if a particular doctor is Board Certified is fast, free, and easy. Simply visit the ABMS website, register, and plug in the doctor’s name and city.

Mike Lipscomb, MD, an Emergency Room doctor at North Fulton Hospital in Roswell, Georgia and a physician with Apollo MD believes that doctors at the top of their fields have solid educational and training foundations to draw upon as they practice medicine. But Lipscomb also offers a warning.

“I wouldn’t put much weight on the big-name schools,” he says.

He explains that tuition expenses at these elite schools can reach well over $50,000 per year making them unrealistic options for many medical students.

“Many state schools are less than a third of this,” he continues. “High price doesn’t correlate to a better education. Some of the best physicians I know went to large state universities for school, and they made the choice to come out with as little debt as possible.”

“And I wouldn’t put much stock in research,” says Lipscomb. “Being good in the lab doesn’t necessarily correlate to being clinically competent.”


“When seeking a physician for myself or family, I regard credentials as a bare minimum and the physician’s experience as a second layer, depending on the nature of care required,” remarks Adedapo Odetoyinbo, MD, SFHM, Chief Medical Officer and Director of Hospital Medicine at Emory Johns Creek Hospital in Georgia. “Experience plays a key role when the need is more technical in nature or when decisions need to be made quickly in an emergency situation. More important to me than research itself, is the physician’s ability to integrate research results and evidence-based medicine into their everyday practice.”

Odetoyinbo refers to the doctor’s practical ability to decipher a puzzle-to select pieces of knowledge from his or her education and experiences and correctly apply them to the situation at hand. In the physician’s pursuit to protect and restore a patient’s well-being, knowledge enhances reasoning and rational decision-making, and experts agree that some doctors are simply better than others at applying what they know.


Many of the experts polled remarked that the best of the best have a toolbox full of excellent soft skills-those personal attributes and qualities that enhance an individual’s one-on-one interactions and performance.

“What separates the good doctors from those we consider top docs is their ability to listen to patients-to really hear them and respond to what they are saying,” says Cindy Hardy, a Physician Relations Manager at North Fulton Hospital who worked as a nurse for years.

She notes that master physicians allow patients to set the tempo for the first few minutes of an interaction while listening and gathering valuable information. Only then, do they respond.

A study published in The Journal of the American Osteopathic Association in 2005 (Travaline, Ruchinskas, and D’Alonzo) found that in many cases, effective patient-physician communication can improve a patient’s health as quantifiably as many drugs. Patients who understand their doctors are more likely to acknowledge health problems, understand their treatment options, modify their behavior accordingly, and follow their medication schedules.

“And the great ones communicate with the patient and the family,” notes Hardy. “The great ones listen to input and speak at a level ensuring everyone in the room understands what’s going on, which is particularly important when a physician, patient, and patient’s family are discussing a plan of care.”

Dr. Robert Campbell, Chief of Cardiac Services at the Children’s Healthcare of Atlanta Sibley Heart Center adds that great doctors usually surround themselves with staff members who are committed to listening, as well.

“Good communication helps support our team culture,” Campbell says. “Given high volume, high patient acuity, and high patient throughput-both inpatient and outpatient-it’s clear that no one single provider can function alone. Therefore, it’s important that we work as a cohesive team and that requires excellent communication to coordinate our efforts.”


Top docs not only maintain technical competence, but also nourish and exercise humanistic qualities-kindness, warmth, and compassion-when a patient needs it most.

“Again, the credentials are a given,” says Debbie Keel, Chief Executive Officer of North Fulton Hospital. “But when a patient isn’t feeling well, or they are afraid, or they are facing long, expensive care and are concerned about the costs, they need compassion, and the very best doctors have a compassionate presence about them.”

Keel, a mother and grandmother herself, encourages her staff to see patients in a different light.

“I say, ‘That’s your mother in that bed,'” she adds. “Top doctors treat their patients with the same compassion that they would have with their own family members.”

But showing compassion is harder today given that doctors are stretched thin and must care for more patients than ever during the course of the day.

“We can’t create more hours in the day,” she says. “It is hard to show their caring sensitive sides when they only have a few minutes with a patient, but the most-respected doctors do it.”


All physicians pledge to promote and encourage the highest level of medical ethics, a system of moral principles that apply values and judgements to the practice of medicine. But most healthcare experts say that ethics go far beyond a doctor’s moral obligations. Ethics encompass how they perform when no one is looking and how they treat others.

“When I interview physicians who are joining us, I tell them they will not survive long if they are lazy or unethical,” says Steve Waronker, MD, Department Chair of Anesthesiology at Emory Johns Creek Hospital. “I also tell them that if they cannot live by the Golden Rule and treat the environmental services employee as well as they treat the CEO, they need not apply.”

Indeed, many doctors-especially the really great ones-view the Hippocratic Oath as a sacred covenant. By reciting it, physicians swear to practice medicine honestly, avoid acts of impropriety or corruption, keep conversations confidential, among many other codes of moral conduct. It’s their guide to ethical behavior.

Among other attributes that transform good doctors into truly great ones are intuitive perception-a sixth sense, accessibility, common sense, bedside manner, and a doctor’s willingness to be a team player. But perhaps it’s a doctor’s ability to be multifaceted and multidimensional that makes some shine more brightly than others.

“They possess compassion, common sense, command of a large body of knowledge, and the humility to ask for help when things get complex and confusing,” Waronker says. “Ultimately, the best physicians have it all.”

Amber Lanier Nagle has published hundreds of articles in national and regional magazines.

She is the brainchild behind Project Keepsake (, a published collection of nonfiction stories about the origins and histories of keepsakes-a pocket knife, a cake pan, a quilt, a milking stool, etc. She says, “Everyone has a keepsake, and every keepsake has a story to tell.”

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Treating Pain Without Drugs – 5 Tips to Feel Better and Use Less Medicine

Most patients think doctors never hurt. Not true. I’ve lived with pain every day for the last 40+ years, so I know a thing or two about what I’m saying. Not that I never take pain medication, but Tylenol or an occasional Advil is about it – no narcotics.

Does that mean my pain isn’t worthy of anything stronger? I don’t think so. But I would say my attitude toward pain is different than many of my patients. For me, it’s just a part of life. Many older adults would say the same thing.

But in 20 years as a family physician I’ve met thousands of people who see pain differently. For them, pain is something to be avoided at all costs. Fear of pain is a big issue for them. Also, many people spend too much time resenting that life isn’t fair. Get over it! You’ll be much happier.

Pain isn’t all about a physical problem. It is shaded by our emotions, or energy level, or degree of happiness. If the underlying problem cannot be remedied, controlling other factors will help you find ways to deal with the pain without resorting to addictive drugs.

Here are 5 proven tips that have helped me as well as my patients deal with on-going pain.

1. Get enough rest. Pain is often a cumulative thing. If you can nip it in the bud, your body can reset to a lower level of discomfort. I learned long ago that I’m not a person who can live on 4 hours of sleep. It is counterproductive for me to even try. Although occasionally I’ll go with 5 or 6, for the most part I must have 7 to 8 hours nightly to function at my best. Sometimes this means taking a nap. Nighttime rest helps the body recover from the stress of life and gravity, but afternoon naps also give the body a boost in several ways. They help muscles relax, and temporarily relieve the pressure on joints and body parts that are subject to the compressive effects of gravity. A nap can refresh the mind, allowing a person to tackle a job with renewed energy. Also, as the body is falling asleep, chemicals are released (endorphins and others) that are natural pain killers and muscle relaxants. You do not have to sleep long for this to occur – 20 minutes will do – but it does require falling into at least a light sleep.

2. Do things that make you happy. I love music and direct a choir, which requires standing continuously for two hours. Now, if I had to wait in line that long for a roller coaster, I’d find myself in terrible torment. I hate wasting my time, especially for something I don’t much want to do in the first place. But as long as I’m engaged in my music, the pain is at bay. Of course, I may collapse into my seat afterward, but an activity that engages your mind in a positive way will not only take your mind off your discomfort, but helps release endorphins as well.

3. Use wraps and supports. Pain medication is not the only answer to swollen limbs, bad backs, and aching joints. In fact, pain is our friend. It tells us that our body requires maintenance or TLC. Sometimes taking pain medicine just hides the problem, like a fresh coat of paint over a mildew-stained basement. In fact, pain medication may disguise a problem, allowing you to be more active that your body can tolerate, resulting in additional damage. It can be a fine line, however, knowing how active to be – a good question to discuss with your doctor. However, little if any harm will result from using splints, ACE wraps, compression hose, or back supports that relieve part of the exertion-related strain on an injured body part.

4. Be careful how you sleep. A pillow under the knees can relieve lumbar strain for a back-sleeper. A flatter pillow can relieve neck strain for a stomach-sleeper. A pillow between the knees can decrease pain related to the knees, hips, or lower back. A carpal tunnel splint can keep your wrist in an anatomical position so you don’t awaken with a painful hand.

5. Find a comfortable exercise. For many people with back problems or arthritis, swimming is the best answer. For others, walking 20 minutes a day helps maintain sufficient limberness to decrease joint pain. Some amount of exercise helps nearly every physical problem, however too much can worsen the condition. It’s really up to the patient to determine what is best, although your doctor, chiropractor, or physical therapist can offer you guidance and advice. For example, I’m sure I have a torn cartilage in my knee, but it doesn’t usually bother me. I can walk 25 minutes without a problem, but at 35 minutes it’s starting to ache. However, it actually feels better if I do walk daily than if I rest it all the time. My back feels better if I do a little weeding, however 10 seconds of tugging my 70-lb. goldendoodle into the car can do me in for several days. Get to know your body, your tolerances and limits, and stop short of what causes pain.

In summary, get up with a smile, try to keep it all day, get a good night’s rest, don’t push yourself unnecessarily, and remember: early to bed, early to rise makes a man healthy, wealthy, and wise.

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Diabetes – The Secret to Blood Sugar Control

It’s not the food. It’s not the medication. Nor is it lack of exercise or merely aging. If your blood sugar is poorly-controlled, the problem is something else entirely.

In decades of treating diabetes, I’ve become convinced the problem is one of relationship.

Now why would I say that? Doesn’t medication matter? Yes. Isn’t diet important? Also yes. But the most important factor in the whole equation is your relationship with your doctor, and even more so, with yourself.

People don’t lose weight for the same reason they don’t control their blood sugar. We nibble, we cheat, we avoid exercise – basically, we lie to ourselves, all the time. Tomorrow will be different, we say. A little won’t hurt. We’ll go for a walk when it cools off.

Believe me, doctors know when their patients aren’t taking their insulin, or watching their carbs, or getting any exercise. It doesn’t take a rocket scientist to know, either. Just ask your kids. They know why your blood sugar is high.

But just like Dr. House says, patients lie. Patients lie to their doctors all the time. Why? Good question. Why would a patient lie when it’s in his or her best interest to be honest?

In many ways, the doctor-patient relationship is much like any other. We want to look good in our parents’ eyes. We want our children to think highly of us. We can’t bear for people to know who we really are.

Wouldn’t it be wonderful to have a doctor with whom you could be 100% honest? Someone you could tell anything to without fear of reprisal?

But then, what would a doctor expect from us? Would a physician pat us on the head and say, “That’s OK”?

People aren’t merely afraid of disappointing their parents, or their kids, or their doctors. It’s not just that we’re seeking approval. The problem is, patients know that if they’re really honest and confess their failings, their inadequacies, their doctor will ask them to do something more. It’s like asking my own teenagers to help with the dishes. They know, next it’ll be empty the trash, do your homework, sweep the floor. Better to hide from mom, from the doctor, from ourselves.

If you want your sugar to be better controlled, get honest with yourself and get honest with your doctor – a tough prescription, but truly the only answer.

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Top 10 Reasons Your Blood Sugar is Too High

Are you diabetic? Is your blood sugar too high?

In 20 years of seeing diabetic patients, one becomes familiar with certain patterns of illness and behavior. Any seasoned physician can list a dozen reasons why a patient’s blood sugar may be uncontrolled.

Here is my top 10 list of reasons why your blood sugar may be too high.

1. Your overall calorie intake is too high. For most Type 2 diabetics, the body is still capable of producing some insulin, but perhaps not enough to help you metabolize your food adequately. Cutting your calories back by a third may be all you need to do.

2. You eat foods with a high glycemic index. When it comes to diabetes, not all food is created equal. Simple carbohydrates (sugars, bread, cereal, rice, potatoes, pasta) are absorbed quickly, thereby elevating the blood glucose level quickly – too quickly for the pancreas to respond adequately. Eating the same calories in the form of foods that are absorbed more slowly (protein, fat) will cause less of a spike in your blood sugar.

3. Your body mass index is too high. Having too much adipose tissue within the body makes it more difficult for the body to utilize insulin. Once you’ve dropped your extra weight, you may be able to eat the same number of calories, but have your diabetes under better control.

4. You don’t take your medication as directed. Many patients not only ‘cheat’ by eating a cookie now and then, but by skipping their medicine more frequently than they admit to. Lying to yourself will make it difficult for both you and your doctor to keep your diabetes under control.

5. You’re not on enough diabetic medicine. Although your diabetic treatment probably started with only a single medication, it’s quite common to require additional medicine as time goes by. This may be accomplished by using either a higher dose of the drug you’re already on, or by taking a combination of two or more medications.

6. You don’t exercise enough. Exercise not only helps lower blood sugar, but also builds muscle mass, which utilizes blood glucose more efficiently than fatty tissue does.

7. Your pancreas is wearing out and you need to be on insulin. By the time you are taking three or even four oral diabetic medicines, you are getting to the point where your pancreas is just not able to produce sufficient insulin to counteract your blood sugar. If your pancreas is simply wearing out, there is no medication that can make it ‘young’ again.

8. You have an infection. Some infections are obvious, others less so. Urinary tract infections, for example, frequently elevate the blood sugar, but may cause few other symptoms. Patients also commonly confuse the frequent urination associated with an infection with that caused by diabetes. Any type of infection may raise your blood sugar, from stomach flu, to ear infection, to influenza or pneumonia.

9. You’re taking medicine that elevates the blood sugar. Steroids and diuretics are the two most common drugs that elevate the blood sugar in both diabetics and non-diabetics. Any time you start a new medication and notice that your blood sugar is running higher, you have cause to question your doctor whether the medicine might be the culprit.

10. A combination of several of the above. This is really the most common. Diabetics often eat too much and/or too much of the wrong foods, exercise too little, are already overweight, and are taking multiple medications.

If your blood sugar is too high, the above list is a place to start. Talk to your doctor about what you can do to modify your lifestyle. Diabetic teaching classes are a good idea and can provide you both general information and specific guidance relevant to your particular situation. Once you’ve identified the cause, you’re well on your way to finding an answer.

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5 Reasons Doctors Love Dr House

Most doctors I know get a kick out of the television show, “House.” Though we’re all aghast at his bedside manner and cavalier attitude, still there is a certain attraction. Those not in the medical field may wonder how physicians can enjoy watching such a callous fellow.

Here are the five top reasons doctors love Dr. House.

1. Dr. Gregory House says things doctors would like to say themselves, but don’t have the nerve. Most doctors filter what comes out of their mouths. They may think curse words, but seldom say them. We rarely accuse our patients of lying, even when we suspect it. We may think our patients have behaved foolishly, but we keep our thoughts to ourselves. It comes as a catharsis to finally hear a doctor (albeit an imaginary one) say things that cross every doctor’s mind.

2. Dr. House doesn’t do any paperwork. Doctors hate paperwork. It’s not only beyond boring, but sometimes perceived as interfering with patient care. The benefits are usually invisible, uncompensated, and extend the workday (needlessly, he would add).

3. Dr. House walks away from boring cases. Few doctors have this privilege. Physicians take patients as they come, without guarantee of intellectual stimulation. For family physicians, this means seeing high blood pressure patients, day after day after. For dermatologists, it’s acne, psoriasis, and eczema, and for cardiologists it’s heart attack, heart attack, heart attack. Even poor Dr. Wilson sees cancer, cancer, cancer.

4. Dr. House doesn’t worry about getting paid. He’s apparently on a salary, and gets paid the same no matter how few patients he sees or clinic hours he skips. Other doctors get paid by the patient or by the hour and are expected to produce. Most of us would be happy to have an afternoon to spend watching TV or surfing the web, while others are busy doing our work for us.

5. Dr. House doesn’t worry about what anything costs. For a doctor it’s a burden to not only worry that the right tests are ordered, but that they’ll be paid for, either by insurance, the patient, or the government. House simply doesn’t care. He orders every test in the book. In real life it’s not the hospital administrators who are looking over our shoulders to see what tests we’ve ordered – it’s the insurance companies that require pre-authorization and proof that less expensive therapies have already been tried. Being an advocate for our patients, and taking the extra time to make sure appropriate testing is obtained, generally amounts to more uncompensated paperwork. Bullying your way through simply does not work for real doctors.

Aside from his diagnostic skills, Dr. House is the antithesis of a good physician. But still he’s funny, and now and then I learn a thing or two. Once or twice a season I solve the case before the esteemed Dr. House – which keeps me coming back for more. The cases are true, by the way, all oddballs that the average doctor might see once in a lifetime. In medical school we’re taught that when you hear hoofbeats, you should think horses, not zebras. But in Dr. House’s case, he’s got a stableful of zebras.

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