Dr James Schaller
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Consumers Guide To Getting Quality Medical Care

As I look around my walls, I see a number of the "Idiot's Guide's" for a wide range of areas in which I know Zippo. What could be a more important topic then making sure you have quality health? Do you want an ability to live long, happy and healthy? Of course if you dislike your family and loved one's you could ignore these topics, so they will have to handle your health limitations. But who am I to joke about this -- doctors take terrible care of themselves.

Here is a two minute look to see if your physician is as good as you wish.

  1. The routine 5-10 minute physical is a must, but is a joke in terms of "catching" many evolving problems. Your doctor has palpated tens of thousands of prostates, breasts and listened to as many hearts and lungs. Once in a while you get lucky and one of these organ problems is caught by a yearly visit. Keep it. If this is it, however, we have a stand up comedy routine.
  2. The typical series of "organ failure" labs will typically only catch massive disease. If you have 3-5 tubes of blood drawn, you are getting these kinds of tests. Please do not misunderstand. These are useful labs. But acting like they are sophisticated disease prevention is ridiculous. Perhaps it makes some insurance clerk happy at the cheap lab bill, and some Ivory Tower doctor who thinks in terms of "what labs can we afford for 50 million people a year." Frankly, I do not care about treating entire states. I treat individual people, and want them to get the best care. The best. Period. Not what is functional economically for 50 million folks.

    See this link for some sample labs that seem to me to be required in a full lab testing work-up. Chronic Disease Prevention: Keeping a Healthy Life

    To the labs I have listed in this older article, I would add: TNF-a, PAI-1, aMSH, Leptin, Insulin. I would also have a disease gene reading done by Lab Corp, which is called, a HLA DRB, DBQ Disease Evaluation. Many physicians are not familiar with this type of testing yet. Perhaps an early birthday present might be a book on Biotoxins and HLA Disease reading?
  3. Is your physician open to new ideas? Do they seem to only be reading in their own highly narrowed specialty? Do they seem inappropriately rigid? Anal? Constipated? Globally conservative in all areas?

    I once spoke on youth behavior disorders and ADHD/ADD to a tiny group of pediatricians. I have a 400-page handout and also a book in final preparation on these topics. I have published on these topics internationally. One freakish, bizarre and rude old doctor seemed to think he was the Dean of some self-appointed medical school and constantly tried to correct and interrupt me.

    He is frankly interpersonally impaired, and yet is seen as some type of veteran. His cognitive rigidity is a common sign of neuron death in aging doctors and sad. His comments fit an old 1980's practice. The fact he actually felt superior, while not even a peer with me on any of these areas, was stunningly frightening. Like me teaching Michael Jordan basketball—he would eat me alive with one functioning leg and two broken arms.

    I came back to the office and threw out his business cards from my referral binder and also threw out the cards of the doctor who said he was "the best pediatrician in the area." My patient's would drive to distant lands if needed!

    If your doctor is not a true learner, he or she is already useless. Move on.
  4. Is your physician is opposed to nutrition? Is their only suggestion other than to take a "one a day" type nutrient. Assume they are very traditional and limited in progressive medicine. You will have to learn that from someone else. My research and massive samplings of essential nutrients, esp. minerals, shows they are often pathetic. We are talking about essential nutrients.
  5. Do they refer outside their business group? One sign a physician is clueless in quality medical care is that they see all people outside their specialty as equally gifted. I suppose Lance Armstrong is only as good as all those Saturday bikers on a beach boardwalk? The really troubling thing here is the act of referring to someone in your "network" not because they are good, but in the hope they will refer back to you. In other words, keep the cattle inside our pen!
  6. You get what you pay for. I am very surprised that folks who will spend a fortune on hair care, a stylish car, nice clothing, pretty landscaping, a nice vacation or plastic surgery, attack me for charges that would not match their monthly car wax costs. Some of the folks that have been the worst are successful fellow health care professionals who run assembly line practices. Practices with objectified type care in which "the beef" are run through like a meat market. Be careful in looking to your doctor as your replacement mother, father or friend. They can handle some dependency but they do have a practice to run, and just like all professions, the best are usually the more expensive as a trend. My kindergarten finger paintings do not draw a high price, and the real masters are priceless for a reason.

    I have found in non-surgical medicine that the reason why medicine is falling to new levels of alienation and sloppiness is the poor reimbursement and massive overhead and malpractice. The point? Only 75% of doctors ever take time to discuss side effects of a prescribed medication, because they are too rushed to do so, and their group expects a certain number of "bodies" seen in a shift. Wonder why ER's have less and less services? Communities do not want to pay for it. So you will be sent to farther and farther away to hospitals with expert specialists. You may have to go hundreds of miles away or waste hours getting to these facilities. By then your injury or illness may be too advanced, and leave lasting damage or result in death.

    You see, ultimately, you pay for anything that undermines physician's doing thier calling. You pay for the malpractice payments, state boards picking on creative doctors or those willing to treat pain seriously and poor payments to ER's. You also pay in dozens on ways for threats by trial lawyers and lawyer politicians to remove a liscence after three career malpractice settlements... So an OB resident or Neursurgery resident or Trauma resident is supposed to close the ER door when a disaster "case" comes to the hospital? You pay for threats to open and publically shame hospital staff for "errors." People are willing to fix errors if they are not in the paper or attached by trial lawyers. Otherwise, all errors will evaporate.

    Threats to the best doctors means, the best will not accept anything that puts them at risk. Why? Because they are not going to put thier career in a blender--three malpractice cases are very common in areas of medicine which involve a high risk of complications, injury and mortality.

    All these actions and anti-MD threats do is make the best doctors with full practices merely aviod all ER and high risk patients like they had the plague. Why be attacked in depositions and spend 500 hours on a malpractice cliam or lose your lisence trying to help desperately ill people who are likely to have a bad outcome. Trail lawyers make teribble doctors. Big surprise! Let them control medicine and all your state's physicians will be under 40, your very best physicians will leave, you will drive a long distance for an OB doc, hand surgeon, trauma sugeon, and a hundred other specialty needs. So you should go in on a co-opt helicopter or plane, to take you to the part of the state or a state that is MD friendly.

  7. Do they publish? Anything at all? My experience is that physicians who publish are at least trying to learn more than the basics. And it shows a dash of passion to learn. The best docs are usually those who have a passion to learn and advance their initial basic training.
  8. My Best in Your Search!

    Dr. J



Bank Towers, Tamiami Trail, Naples, FL
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