Welcome to the Ideal Medical Care Blog ~ where politics, health care, and humanity intersect ~ your home for intelligent, provocative commentary on the movement to achieve ideal care for all. Inspired? I welcome your comments.
Pamela Wible MD
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Thanks Pamela for leading the way toward ideal medical care!
In gratitude,
Bodhi
Hi Pamela (and followers)
As a 44 year old changing careers in to nursing, people ask me, “Why?” I have yet to fully narrow that down to a simple sentence, but viewing the world as a giant triage unit, I simply want to focus my attention where there is the greatest need, where I can do the most good. Now that my children are all but grown, that place is medicine.
Accompanying my desire for maximum impact is the reality of my own physical degeneration, which I sometimes fin impossible to ignore. I must face the challenges of an aging nurse even before my career begins. It impacts the focus of my education and will play a great part in the specialty I choose. Without a doubt, med/surg is out, since I have already noticed that a 240 pound man is viewed as the resident Superman, called for every change, turn and transfer. Even paying special attention to body mechanics, there is sometimes no good way to maneuver a 400 pound bilateral BKA with exacerbated COPD. Logically, I look to the OR, ER, and clinical medicine.
Oddly, I have found that the Public Health Service, a branch of the uniformed services, offers excellent care to some of the most under-served populations, without the assembly line pressures of for-profit medicine. How is that possible? How can our government train, equip, and support an agency devoted entirely to care without regard for profit? They chose to. Those who are employed by the agency are given full health benefits and work toward a federal pension. It presses me to ask, “Why do we not treat ALL health care workers this way?” My friends working in government clinics in the Philippines and Brazil tell me they work under similar arrangements.
OK, I didn’t begin this comment as an endorsement of PHS, but as I network with doctors and nurses, I hear similar comments- “I just want to provide care.” “I am not looking to get rich, but need to pay my loans and provide for my family.”
There are certainly many organizations out there where one can lend her/his passion and expertise, but how many of them are designed respond and meet the needs of a medical professional offering a lifetime commitment? Few.
So, as I am FULLY on board with you, Pamela, ready to go where I am most needed and give my all, I want to make sure I will not be cast aside when my body can no longer do the job. I am most interested in models where health care becomes a circle of service, where the servant becomes the served, and would welcome your thoughts.
I do not have experience with the Public Health Service, but your description sounds wonderful. Unlike pilots (who have to retire at 60), docs can work until “death do us part.” I love medicine and I’m in it for the long haul. That is the beauty of medicine, especially the cognitive specialties – like primary care. . .
Dear Pamela: Pilots now have to retire at age 65, was changed by FAA a few years ago. Sincerely, George
Please tell me your thoughts – I hope this doesn’t seem like a silly question. What is Nursing? All I know about it is like being a forensic archeologist. I think the profession disappeared (under suspicious circumstances) about twenty years ago, and I suspect foul play.
What I can tell about Real Nursing was that it used to be a partner and complement to MD work. I suspect the myth of authoritarianism was somewhat true, and MD’s weren’t as supportive of nursing. But something killed off Real Nursing. What are your thoughts?
The same thing that killed Real Doctoring killed Real Nursing. We can bring both back.
I think what you are doing is fantastic. There truly should be more physicians like you. I have worked as a nurse for 21 years and have seen my share of doctors that move through patients as if they were in a cattle line. Frankly, it is down right sad….
I had actually applied to med school and was accepted. To make a long story short, I didn`t continue on to medical school but decided instead to remain in nursing. In nursing there is more of an opportunity to form a therapeutic relationship with the patient and I personally believe that it is essential for providing exceptional care.
On a personal level, I have been blessed with a wonderful family physician. She is simply a kindhearted soul that genuinely cares. Patients are not fools and they can clearly tell whether their doctor truly cares or not.
If all physicians had the same attitude as you, the world would most certainly be a wonderful place. I wish you the best of luck as you continue to work against an assembly line approach to health care.
Take care of yourself and keep up the great work!
Pamela, on your comments down the page, in Feb as I recall, on pt privacy, you omitted the problem that office copy machines save a copy of everything copied — on its hard drive. More problems with privacy when the hospital or doc office sells/recycles the machine.
Really? I don’t delete anything except spam. You are spot on regarding the widely-unknown risk to privacy of copy machine hard drives.
I wish there were more caring doctors like you. I was a herby 56 year old when I was told I needed gall bladder surgery. 3 years later I have mabsorption, incontinence, heart disease, hair loss, vascular disease, unable to taste or swallow and being last around the health care system totally drained, weak. Sore throat for 6 months, told by Ent vocal chord eroded by acid, referred to Gastro she said she sees nothing in throat–severe gastritis in stomach did not compare with prior exam. Primary wants to give me sleeping pills, morphine. I don’t want any of that. I want what I had—a life without pain, where I can breathe (nose broken during intubation and dried out) lift more than 5 pounds, work, play golf, swim. The dry skin and rashes and deformity caused by this surgery and the surgeon not owning up to his mistakes leave me disenchanted. Saw a compassionate internal med/rhemotologist and she thinks I have wound botulism. However blood work still not in and I struggle each day. I wanted to get to mayo clinic early on and male pcp did not fill out properly. My neck so swollen now I don’t know what to do. Stomach constantly churns. Afraid to travel far as always need a rest room. Note bowels were not functioning after surgery told to live on laxatives. After chelation they are running soft. I live in 08723 area code and I am wondering if there is some center for multiple ailments where I should go. Thank you very much.
Hi Sue ~ So sorry about everything you have been through. Your case reminds me why it is so important to have a compassionate primary care physician overlooking your situation and guiding you properly. Feel free to email me from https://www.idealmedicalcare.org and if you click on “ideal clinics” and then “find one near you” then you may find a physician who can help you.
Hi Pamela~ throughout the years as my Primary Care Physician you have always inspired me to go beyond my perceived limitations. You take the medical system by the horns and shake it up to create a system of your own that not only suits your needs but provides for the needs of your patients. In this new era of mandatory health insurance pinning every life to a dollar bill through insurance and deductibles are there loopholes people can utilize to sidestep the conformity of the system. Signing peoples assets away for incurring costs of medical expenses as one ages and needs more assistance is a legal way for the government to take assets from inheritors unless they pay a hefty fee. How do we get out of this rat race? It may sound like I may be a bit paranoid, yet I have read the fine print at the end of a lot of these forms that many people may simply fill out and send in before the deadline with no time to read the claws at the end of the form. Health Care for the people is important and very necessary, my concern is that people will not get the care they deserve and it will come at such a high price that those who need it will not be able to afford it without giving their lives away to government corporate interest.
These concerns are paramount for my husband and I because we are paying off a lean the state put on my husbands grandfathers property for past medical expenses, a claws his uncle was not aware of when his father needed assistance. This is information people need to be aware of. We cannot predict when we will need assistance and to pay premiums and deductibles for coverage most of our lives and then not be able to give a small gift to our children without putting them in debt is a crime.
It would be great to have health insurance that is affordable for everyone, and there are many countries who are prime examples of how it works. Thank you for providing an example of how to get off the medical assembly line, transforming a corrupt system is a worthy endeavor, and you have created a model that other doctors can aspire to create in there own practices. May affordable primary care Physicians pop up around the globe and a world of healthy living be born again through the actions of kindness and compassion created by the model that was once established in a few town hall meetings by one amazing visionary who had a dream of ideal medical care. Thank you Pamela Wible. You make a difference.
Hi Pamela,
I just discovered you today!! (oddly enough, from following links and links and links, – starting with the science-based medicine blog of all things)
Your TED talk was priceless and I can’t wait to read your pap and goat book.
I LOVE your stuff and I LOVE your approach. You are amazing!!!!!
As an ND, the best part of my job is hugging patients, touching patients, belly laughing with patients, and holding and crying with them during times of grief. I live a very simple life and have a very simple practice.
However, I struggle terribly with other parts of my job, and often see death as failure, occasional lack of patient improvement as medical flaw, and I struggle at times to find a hybrid strategy between science-based proven data and empirical observations by both patients and myself, knowing both are valid and important.
I see that your retreats are also open to NDs. Has any ND ever attended your retreat? Are you holding any more this year after May?
Kathy
Hi Kathy! Yay! Thanks for your feedback and I am thrilled to share my inspiration with others. I actually love helping people die and prefer death to birth. You’ll love Pet Goats & Pap Smears. The last section is on death stories and that’s my absolute favorite part of the book. Oh, do hope you will attend the retreat. Other NDs have and loved it! The May retreat will be the last one I am offering.
I live in Wichita Ks close to where the infamous Dr. Schneider was arrested and convicted of supposedly overreacting pain meds. Every since it has affected people who have serious conditions and chronic pain. Me being one of them. I’ve been in pain management for over 15 years and also benzodiazepines for panicked disorder amongst several other meds. My Dr. Fired me out of the blue claimed I was 10 minutes late, breaking my “contract”. So with no instructions on tapering. I almost died. After 4 emergency room visits and being shoved out hearing the buses I was “faking” I had seizure at home and at hospital also with my pants full of incontinence, and vomit still running out they shoved me in cold with no options. Next WE visit I learn the “truth” My Dr. Who I trusted for years found my boyfriend was older black and he stated was a “pump” and drug dealer. This doctor in ER put his hand on my shoulder and apologized that i was not told the TRUTH. Also my doctor placed me on a “blacklist” and office refused to send my records to pain management. Also because of this blacklist created by “tracks” I cannot find another physician to care for me. I have been continuously vomitting and lost 50 pounds in +2+ months. I didn’t know how bad withdrawals would be and the immense pain which left me immobile. I cannot even get P.T. at this point OR a hone health nurse. I feel my house is out of control and becoming unsafe. I feel abandoned and that my trust was abused. I cud only think of the option of methadone clinic which creates stigma . And another reason most doctors won’t want to treat me. I did finally find psychiatrist to help me TAPER off xanax yet remain to suffer from insomnia. I also feel that this somehow has violated my patient privacy, for war I also didn’t get to explain to my doctor the identity theft I suffered from 3 years ago when all my identification was stolen. All reports were made each time from credit cards to cell phones, cable, doctors, to filing fraud on my medical fraud. I feel this to be very lunatics and abusive. Violated my trust. And the only thing he could say not even look in my face “I had to go with what my staff told me” I’m very curious what else he wrote about me, yet, they are not forthcoming with my records. I lived, trusted, and followed directions to a T at this clinic and feel so slandered, ratial profiling AND abandonment issues hurting and salting that wound đ
Dear Pamela,
I stumbled upon your TED talk.
You gave me a jolt of energy.
Kudos for your honesty and integrity. I too have traversed to “the other side”.
all the best, hugs and kisses too!
Ana
As a nurse, these posts from physicians truly break my heart. I know some of my colleagues only experience the “kick the dog” syndrome, experiencing the same kind of abuse from these abused clinicians. (Nurses are also famous for “eating their young”.) We better than anyone see the behavioral changes that occur among the idealistic, excited residents as they move through to become bitter, apathetic, harried physicians. It is so sadly ironic that we are ALL in this to relieve suffering and yet we suffer at the hands of each other! Each of us in our role is capable of providing the most skilled support and compassion to each other. I am grateful for your courage for voicing the paradigm shift that MUST come not only in healthcare but in in all of society for us to survive.
Well stated Elizabeth. The health care we truly want can never be legislated top down. Real health care happen from the bottom up and the inside out when we begin nurturing and caring for one another.