- Del Meyer, MD - https://delmeyer.net -

Post Mortems

Received the following note from the Department of Health Services: Dear Dr Meyer: Medi-Cal’s Medical Case Management Program has been coordinating the medical services needed by your patient, xxxx since August 6. Effective October 28, Medi-Cal will no longer provide case management for the following reason: PATIENT EXPIRED. This decision does not affect your patient’s Medi-Cal eligibility or his/her ability to receive medical services from you. If you would like further information, or if you feel at a future date that your patient needs medical case management, please feel free to contact Jane xxxx, RN, at 916-255-xxxx. . . . I guess that says it all.

Two patients discussing their last appointment: How long does an office call take these days? Well before I could say, “health main-te-nance org-an-i-za-tion,” my check up was over.

Reminds me of a doctor some decades ago who designed his office with two doors and no chairs. He stated that in many cases, he could glad hand the patient at one door, put on the smaltz, listen to the heart and lungs while walking, write the Rx at the standing desk and usher the patient right on through. He bragged that only about one in ten required the use of the examining table – presumably for the occasional abdominal exam. This efficiency was only superceded by the one-line entry on the 4 x 6 inch medical record card which never caused him to break his stride. . . Wonder if today he has a desk outside the second door for the required lengthy medical record to cover the E & M guidelines?

Overheard at a business round table discussion: Sending money to Washington is like pouring blood to sharks – you have a feeding frenzy.

A fellow member called to me across the parking lot at Mercy San Juan Hospital recently asking me why we let the society close the library? With MSJH reducing their library staffing by 50% and decreasing the number of journals, he felt that eventually all the hospitals would be essentially eliminating this nonrevenue-producing function. He felt that a medical library benefits doctors primarily, and the doctors should always be assured that they own their repository of medical information.

Just received the latest issue of California Physician. Nice looking journal with lots of pages. Too many to read as it comes in the mail so it is placed on the stack for later, more-serious reading. Unfortunately, for many physicians, this comes after retirement. I noted that California Physician has been quarterly for over a year, and six issues had accumulated on my credenza unread. I then started asking the doctors in the staff room what they thought of the new format and if they are reading it. The majority response was similar – more than can be quickly read with time never increasing. In the past they were able to spend five or even ten minutes with it every month before being interrupted, but that was still an hour or two per year. Everyone I spoke with had not spent an hour on the new format during the past year. Another case where our administrative leadership comes up with a more beautiful, cost-effective, although less useful product. Will the same fate await our Sacramento, El Dorado and now Yolo readers? Will we get out of the monthly habit and lose touch even more? Feel free to email your comments.