Transitions are always bitter sweet  and never  seamless .Currently the country is preparing for a national transition at the Presidential level .We all are closely following the journey and rooting for one or the other candidates .

With transition , we are hoping a change for better . First lady , who is an excellent orator ,urged the people to change their views about the other “America “, which  is  very much a part of the” Big America” , on the other hand , GOP’s  too envision an America , which should be very different  from the present America .

There is a constant parallel play and never the twain seem to meet .

America was conceived with  very distinct values and ideologies and as long as they are upheld , the country would continue to progress in its path of excellence and beyond .

As we currently witness transitions all over the world  , at some places  with greatest upheaval and with most unfortunate results ,we pray that the present Presidential transition should be democratic and peaceful .

We could be hacked or rigged , swayed by populism or troubled by our emails but at the end of the day , we vision an America where people together are ready to walk the peaceful middle path to transition . 

The present election campaign of GOP took an unimaginable twist and it seems to be descending its free fall .No amount of experience , qualifications or logic could make it happen in the past  , to the dismay of democrats . But when the  courageous women shared their experiences with a certain powerful person , without caring about consequences , it touched the right chord .

All of us, as women, in our life time have experienced these unfortunate incidents in various severity .Sometimes it could be a family member, sometimes a stranger on the street , sometimes a  fellow traveler and surprisingly sometimes a patient walking into  the doctor’s office  and defying all forms of decency 

Hardest part is the aftermath when you want somebody to believe you , to empathize with you and agree with you that at least you deserve some form of justice delivered .

Enablers are   a huge obstacle in the  above mentioned process .The fellow travelers in the plane who choose to ignore such incidents ,the people who think that women are supposed to take these things in stride and are just minor aberrations of day to day routine or  even your female bosses when you want to discharge such erring patients .

People who do not vote , are they some form of enablers too ?

Think so 

 

Most of the physicians in their later part of careers have been known to take sabbaticals . It prevents an early burn out and also helps them to extend their working years .One is supposed to come back rejuvenated to face the future challenges . One can spend their sabbatical in various ways ;Most commonly one does a mission trip or a teaching assignment in another country ;You can do exotic holidays or learn new skills or some times just introspect about your life choices .

Its presumed sabbaticals are intentional and not forced .

But what happens when its a  forced sabbatical ?

Like a job termination ,medical issue or a family necessity . Does picking up the thread is as easy even if financially you are not burnt .Are you emotionally stable and strong ?Do you have the same amount of enthusiasm ?Are you ready to fail one more time?

As we near the final election days in the US , Presidency for Trump is getting bleaker .One wonders , why these revelations are  coming to the fore front now when there is no way to undo whatever has been done . There were many accomplished , experienced and  educated candidates who started the race with him but had to drop out . Would they treat it as forced sabbatical and pick up the threads again ?Would luck and milieu be on their side the next time ?Only time will tell  

 

 

 

 

Doc , I have a  shoulder surgery tomorrow .Can you clear me ? Doc , my son has a dental procedure tomorrow . Can you clear him?Doc, my son had a concussion on his head couple of days back .I hope he can resume his practice tomorrow 

These are very common scenarios in a primary care office . These appear to be  very simple issues and when patients are explained that it is not just a matter of filling forms , they are confounded 

But the responsibility of a primary care physician or for that matter any physician , who is giving any kind of clearance, is immense.

Because each life matters

Specially if you are clearing someone for any kind of transport industry

Last week , we saw a major train accident in Hoboken , where a bystander lost her life and hundreds  were injured .The driver was very experienced and had been on the job for quite some time . At this point , medical emergency cannot be ruled out .

Health is of utmost importance for every body and when on your well being depends the life of thousands of people .the importance cannot be understated

 

 

As the Presidential race gains  momentum , so does confusion galore .Every kind of media is spewing out their own statistics and in the process veering us away from making informed decisions . Its come to a point where the future electorate is like playing a Roulette . If you choose the right number , you are a winner otherwise , sorry . you loose .

The same questions stare at us , what we started the race with .

Are these promises for real? Are we  deciding for collective good ?Should be practice segregation or integration ?Does diplomacy give optimum results ?Would war bring peace ?

And so many more questions 

All we have is huge amount of unconfirmed data with no straight answers 

As my  gym instructor says – Dear , There are very few straight things left in life . But one of them has to be your right leg .So keep your right leg straight and then raise your left leg side ways with your both arms up .

Well , that’s not easy too 

As I said , Nothing is straight in this tough tough world .

HIPAA- in expanded form is Health Insurance Portability and Accountability Act which was enacted by Congress and signed by President Clinton in 1996 .It ensures that Medical information  remains protected and is a right of every patient .It is also the duty of the treating  Medical Organization to cooperate in the best possible  manner .

When we start the medical practice , as physicians , we have to do  HIPAA training .Its a part of standard care .We have to   update it every year as a part of oraganizational  CME. Failing to maintain HIPAA standards has dire consequences . 

As  per HIPAA – we can’t discuss patient details where other people have easy hearing access to it .We cannot let the computer on in the work area when we are not working on it . We cannot let the forms be placed face up  in the public area and so on and so forth 

But surprisingly as we reach higher echelon in public offices – all HIPAA goes out of the window .Every shred of your body is a public property . The whole world discusses your health prognosis , correctly or  incorrectly .

The recent uproar about Secretary Clinton’s pneumonia was  unfortunate .When we do not trust presidential  nominees,  whether they are physically or mentally  healthy enough to carry out their jobs , how  can you trust them with decisions , which are in the best possible interest for the country and the whole world ?

Well , that’s the way we are .

 

In today’s world of  web search , our patients are not left behind .By the time they come for their appointment , they already have a tentative diagnosis and a management plan.Most of the time , it is helpful for the physicians as patients and physicians are on the same page .

Another thing that has really infiltrated our lives are the various IT applications .I don’t think anybody is left untouched by them . For every problem , there is an app based solution .Booking a cab, Grocery shopping , getting the chores done , keeping an eye on kid or getting their homework completed …, you name it and their is an app in the market .

Same stands for medical field .Total Calorie count , healthy eating , ideal weight , fitness routine ,cardiac risk , stroke risk …

So, one of our app savvy patient decided to take it a step further .She confirmed her pregnancy with an app by downloading the app with $10 and then placing her iphone on her belly . And yeeah  it confirmed her pregnancy . When she wanted to register herself for prenatal clinic , we were all very amused . Our Obstetricians have not heard about it as yet 

Big surprise – She was really pregnant and it was her 9th pregnancy