For example: Peggy Pesty has, CAD, sleep apnea, diabetes, thyroid cancer(she does not know she has), osteoporosis, high cholesterol and of course high blood pressure as she is extremely overweight but insists during each visit that she is starting on a new diet. Peggy Pesty is upset because she has to bounce from doctor to doctor for all of her ailments and would just like to be seen by one doctor under one roof. Her physician Dr. Makemoney has done all he can to coordinate her care, afterall he has a life filled with family and extensive vacations, hospital obligations and of course his other patients. Dr. Makemoney spoke to a colleague about Peggy Pesty and the fact that he has done all he can to help her as her primary doctor, but he can't seem to convince her that he has. Dr. Wrongsideofthebed explained to Dr. Makemoney the problem. "Years ago medicine was hit or miss. It either worked or it didn't. In that scenario you lived or you did not have very long to live. Medicine had not reached it's prolonged life way of appropriation. So when patients like Peggy Pesty come in with several problems, years ago she may not have survived this long. You help coordinate her care and to keep all of her medical care for her ailments in sync with each other, yes you may be her cardiologist too but, those other duties she expects from you and your office staff are time consuming. Please, understand that you are the umbrella that moves her through the rainfall of illness. That is a lot of work and can seem like a burden on a staff who were not medically trained. Lots of people have life experience but I think it's abusive to expect you and the staff to be a 24 hour office medication surplus supply, an educational room and instructor for the use of C-PAP machines and diabetic injections and of course they want you to perform biopsies as well. These people don't understand the time it takes to do all of this and the fact that a patient may be jeopardizing his or her own life by seeing a doctor that has not spent as much time on the study of one illness as opposed to another of course making him or her a specialist in that area of medicine. You would think they would care about themselves more than that!" said Dr. Wrongsideofthebed. "You're right" answered Dr. Makemoney. My greedy little butt did more than I was able and I did a thyroid ultrasound on this woman right before I did her echocardiogram. Her thyroid is enlarged and I suspect cancer but I didn't want to tell her because I was real busy." "So what are you going to do?" asked Dr. Wrongsideofthebed. "I told her I am going to do a biopsy on her thyroid in the office here. She didn't seem to mind because she loves to visit me. But the problem is now I'm scared because I don't do this very often and I need the technician to assist me in finding the thyroid with the ultrasound machine." said Dr. Makemoney. "This is why you should have sent her to a specialist whose patient care is directed around these types of diseases and illnesses. Yes, many physicians can do a little of everything but a specialist would best handle what to do afterwards." "You're right, I'm going to send her to the hospital for all of this and then refer her to a specialist." said Dr. Makemoney. "And you be the umbrella that guides her through the maze of all of her illnesses, even this one. Now that you're here I wanted to tell you about something I am working on. You know how patients say we are not doing enough and want to see us for everything." said Dr. Wrongsideofthebed. "Yeah" said Dr. Makemoney. "I have developed a program that uses markers or upper limits of severity in order to titrate a patients care. This means that depending on the results I can either continue to treat them or I refer them to a specialist. This assures them that I am doing my best by referring them to a physician who has a more specialized study of a particular illness. For example I have a patient who is borderline diabetic, slightly elevated hemoglobin A1C, so I tell them to control their diet and even take a supplement or two. Because the program tells me that, I can continue to treat them based upon their test results. I also do this with bone density tests too. Now I have other patients with diabetes who need insulin and must be on a strict diet, since these results are upper limits and very abnormal and sometimes critical I give them these results and I do this with patients who have COPD also and I refer them to a specialist." said Dr. Wrongsideofthebed.
"I get it!" said Dr. Makemoney,"Patients-computing-specialist for patient=umbrella to guide the patients through..."