While there have been no more 9-1-1 calls and unexpected visits from police officers, this experience is another one of those parenting life lessons. Most of all, I am thankful the deputies “dropped by” when the scene was calm. If they were on my doorstep on any other regular evening, things might have turned out differently. I wish all of you a Happy Thanksgiving, and may you enjoy a day free of a surprise visit from your local Sheriffs’ deputies.
It is in heartfelt gladness we should celebrate and remember my father, Dr. Saad Al-Agba. He knew the souls of the children for whom he cared would dwell in a future he would never see; yet, he accepted while he could not visit that tomorrow, even in his dreams, he could touch it in a small way through his connection with each and every one of us. He freely shared his tears and his smiles with so many and for that; I thank God from the bottom of my grieving heart.
After my father passed away, each child has grieved in their own way, sharing things about him they will miss most, while my four year old has only said “I am sad papa died, mommy.” Knowledgeable on the developmental capacity at the tender age of 4, I considered excluding my youngest from the graveside service last week on the presumption he didn’t “need’ to see a process which he could not place in a larger context. That decision would have been short sighted. Instead, I asked my youngest child if he wanted to attend the service. He chose to go with all of us to the cemetery. It was a solemn affair and the children understood the significance of the occasion.
“I am so sorry,” I said. I was sorry for many more things than I could say. This is one moment I wish could be erased from my memory and done again, though differently. Ideally, I would greet the mother and child with a warm smile, take an extensive history, perform a thorough physical exam, discuss a list of possible diagnoses with mom, and send blood tests accordingly. I would reassure this mother we would properly evaluate her concerns.
Many families have brought their children, grandchildren, and great-grandchildren to us for more than 40 years. We have seen them through the darkest moments of their lives, at their most vulnerable, and brought them into the light. Now, our patients must guide me through unimaginable heartache and grief.
Washington State Law allows vaccine exemptions on the basis of religious, philosophical, or personal reasons; therefore, immunizations rates are considerably lower (85%) compared to states where exemptions rules are tighter. Immunization rates are directly proportional to the narrow scope of state vaccine exemptions laws. Immunization rates are used to “rate” the primary care physician despite the fact we have little influence on the outcome according to scientific studies.
While childhood injuries will continue to be a rite of passage, pediatricians have the opportunity to reduce those with long-term consequences, such as skull fractures and intracranial bleeds. Educating parents will go a long way toward ensuring the next generation grows up to make their own mark on the world in the future.
The American Board of Medical Specialties (ABMS) eliminated “lifetime” certification to shore up their financial outlook; a modification having little to do with quality and much to do with rate of return. Between 2003 and 2013, the ABMS member boards’ assets ballooned from $237 million to a staggering $635 million, an annual growth rate of 10.4%. MOC is outrageously lucrative. Almost 88% of their revenue came from certification fees.
The idea of micro-hospitals is gaining traction because costs of construction are far lower than that of more traditional hospital facilities –costing anywhere between $7-$30 million, depending on the range of services available, according to Advisory Board statistics. Micro-hospitals can meet 90% of the community healthcare needs. They seem to flourish best in markets with critical service gaps. Ideally, micro-hospitals are located within 20 miles of a full-service hospital, facilitating the transfer of patients to larger facilities if higher-acuity needs arise. Hospital stays anticipated to be longer than 48 hours are sent to higher-acuity facilities.
Since the birth of our nation, labor unions have existed in one form or another in the United States. Unions are a force to protect the ‘working population’ from inequality, gaps in wages, and a political system failing to represent specific industry groups. The existence of unions has already been woven into the political, economic, and cultural fabric of America; it may be time for physicians and surgeons to unionize.
