Why isn't ALL EARS just about EARS?
Good Question. I could have easily called this blog "I'm ALL EARS." In other words, I listen. Listening is probably the best attribute of a good clinician; or person, for that matter. All day long, both in my clinic and on WebMD's ENT Board, I am asked questions. I listen. I try to respond, promptly and to the best of my knowledge.
I didn't fall into the ear-biz by choice. It just happened. As a parent, I had five children, many of which had untimely and painful ear infections. Most of my clinical career involved caring for people of all ages; cradle to grave as they say. In my family practice days, my happiest patient encounters were with children. In the last six years, I have limited my clinical practice to children exclusively. Why? It is time in my career that I listen to my own heart and do something that I love.
Ear infections or problems concerning the ears are among the number one reason why children are brought for medical attention. Over two decades ago, I started teaching parents and child-care providers how to use a home otoscope - the simple device that allows the examiner to peer inside the ear.
By doing so, I caused quite a stir in a doctor-dominated community that feels patients should be bare (not just feet) and stupid. I strongly felt that medicine was much too complex to do it all myself. I wanted patients and families as partners. To become partners, they needed the tools: knowledge, permission to participate in their own care, and of course, an otoscope and other medical tools. I stuck to my guns and now people using home otoscopes are not that strange anymore.
The ear classes led to the need to write a book, so I wrote and published my first book entitled, Ears: An Owner's Manual, now in its second (albeit, small) printing. Amazon has it, but the competition is enormous. I received a $99 check last week for books sold. Now, that will definitely put me in new tax bracket. I am about ready to just give it away; certainly less trouble than packing and mailing books for a few cents profit.
Most medical providers are good at what they do, but are often less successful at these side ventures. Personally, I think the book is good. It was written for the consumer, not AT the consumer. It is in plain, human language; not medicalese.
I have also written four primary care textbooks with a bit better remuneration, but when you add up those hours writing, editing, re-writing, etc. over the two years it takes a person to get a textbook on the market, it comes out to about a buck an hour. My wife threatened to divorce me if I did another book, which would cost me more than a buck an hour. I turned down McGraw-Hill when they asked me to write another. I also published about 200 or so magazine articles in my career; mostly for free or pittance. A person writes because they have something to say, not because they expect to get well-paid for it. A Stephen King I am not.
I work three, 12-hours shifts per week in my clinic and see about 120-130 patients. This 12-hour day is really about 15-16 hours when you add in commute time, phone calls (phone advice, refills, etc.), referrals, consultations, etc. I do take a half-hour per day to eat something. Going to the bathroom used to be optional, but since my untimely kidney stone a few years ago (while seeing a patient!), I try to drink more water, which results in a more frequent need to urinate from time to time. All of God's creatures gotta pee.
On my days off, I write this Blog and answer questions on the ENT board (formerly, the Ear Board). Recently, we added nose and throat to the mix, since I was fielding questions in this area anyway. As a primary care clinician, and not a board-certified otolaryngologist, I am both honored and humbled to run a board. This is what WebMD wanted; someone with down-to-earth, primary care experiences to share. This frees up the otolaryngologists to do what they do best; namely, surgery. Thank God for specialists.
I refer my own patients that need surgery, or a surgical consultation to an ENT specialist when needed. I do not send my patients unless there are no alternatives. ENTs are surgeons, and surgeons like to do surgery. If I do not think that surgery is really needed, or if I am not stumped by what is going on with the patient, I would prefer to handle things on the primary care end. After 33 years of taking care of patients, I know when to call in the ENT cavalry.
When I make referrals, I have a choice. It is mind-boggling for me to get feedback from my patients that the ENT was not people or child-friendly, or informative. Many leave frustrated with lingering questions and much confusion. ENTs see a LOT of children. Not to be child-friendly is inexcusable. Not being child-friendly is a good way NOT to get future referrals; at least, from me. I don't care how technically qualified a surgeon might be; if they come off uncaring, condescending, or downright rude, they are not going to be on my referral list. I guess I should be thankful for rude and uncaring ENTs, for these are the people that make the ENT so busy.
Medical knowledge should be freely shared and I think it is a wonderful service that WebMD is providing. Free. We all have gifts of knowledge that we can share. My neighbor is teaching me how to run a backhoe; I taught him how to take his own blood pressure. My mason is teaching me how to lay cement blocks; I taught him how to deal with his recent testicular infection (See, it is NOT just EARS!). My wife (another primary care clinician) is teaching our granddaughter how to sew. She is teaching us how wonderful it is to be grandparents. Before we leave this world, if we can just impart some of our knowledge and experiences to others, we will leave this world a truly better place.
Thank you for your ongoing support, both on the blog and on the ENT board. You have allowed me to humbly share who I am.
Related Topics:
Technorati Tags: medical practice, ear infections, WebMD
I didn't fall into the ear-biz by choice. It just happened. As a parent, I had five children, many of which had untimely and painful ear infections. Most of my clinical career involved caring for people of all ages; cradle to grave as they say. In my family practice days, my happiest patient encounters were with children. In the last six years, I have limited my clinical practice to children exclusively. Why? It is time in my career that I listen to my own heart and do something that I love.
Ear infections or problems concerning the ears are among the number one reason why children are brought for medical attention. Over two decades ago, I started teaching parents and child-care providers how to use a home otoscope - the simple device that allows the examiner to peer inside the ear.By doing so, I caused quite a stir in a doctor-dominated community that feels patients should be bare (not just feet) and stupid. I strongly felt that medicine was much too complex to do it all myself. I wanted patients and families as partners. To become partners, they needed the tools: knowledge, permission to participate in their own care, and of course, an otoscope and other medical tools. I stuck to my guns and now people using home otoscopes are not that strange anymore.
The ear classes led to the need to write a book, so I wrote and published my first book entitled, Ears: An Owner's Manual, now in its second (albeit, small) printing. Amazon has it, but the competition is enormous. I received a $99 check last week for books sold. Now, that will definitely put me in new tax bracket. I am about ready to just give it away; certainly less trouble than packing and mailing books for a few cents profit.
Most medical providers are good at what they do, but are often less successful at these side ventures. Personally, I think the book is good. It was written for the consumer, not AT the consumer. It is in plain, human language; not medicalese.
I have also written four primary care textbooks with a bit better remuneration, but when you add up those hours writing, editing, re-writing, etc. over the two years it takes a person to get a textbook on the market, it comes out to about a buck an hour. My wife threatened to divorce me if I did another book, which would cost me more than a buck an hour. I turned down McGraw-Hill when they asked me to write another. I also published about 200 or so magazine articles in my career; mostly for free or pittance. A person writes because they have something to say, not because they expect to get well-paid for it. A Stephen King I am not.
I work three, 12-hours shifts per week in my clinic and see about 120-130 patients. This 12-hour day is really about 15-16 hours when you add in commute time, phone calls (phone advice, refills, etc.), referrals, consultations, etc. I do take a half-hour per day to eat something. Going to the bathroom used to be optional, but since my untimely kidney stone a few years ago (while seeing a patient!), I try to drink more water, which results in a more frequent need to urinate from time to time. All of God's creatures gotta pee.
On my days off, I write this Blog and answer questions on the ENT board (formerly, the Ear Board). Recently, we added nose and throat to the mix, since I was fielding questions in this area anyway. As a primary care clinician, and not a board-certified otolaryngologist, I am both honored and humbled to run a board. This is what WebMD wanted; someone with down-to-earth, primary care experiences to share. This frees up the otolaryngologists to do what they do best; namely, surgery. Thank God for specialists.
I refer my own patients that need surgery, or a surgical consultation to an ENT specialist when needed. I do not send my patients unless there are no alternatives. ENTs are surgeons, and surgeons like to do surgery. If I do not think that surgery is really needed, or if I am not stumped by what is going on with the patient, I would prefer to handle things on the primary care end. After 33 years of taking care of patients, I know when to call in the ENT cavalry.
When I make referrals, I have a choice. It is mind-boggling for me to get feedback from my patients that the ENT was not people or child-friendly, or informative. Many leave frustrated with lingering questions and much confusion. ENTs see a LOT of children. Not to be child-friendly is inexcusable. Not being child-friendly is a good way NOT to get future referrals; at least, from me. I don't care how technically qualified a surgeon might be; if they come off uncaring, condescending, or downright rude, they are not going to be on my referral list. I guess I should be thankful for rude and uncaring ENTs, for these are the people that make the ENT so busy.
Medical knowledge should be freely shared and I think it is a wonderful service that WebMD is providing. Free. We all have gifts of knowledge that we can share. My neighbor is teaching me how to run a backhoe; I taught him how to take his own blood pressure. My mason is teaching me how to lay cement blocks; I taught him how to deal with his recent testicular infection (See, it is NOT just EARS!). My wife (another primary care clinician) is teaching our granddaughter how to sew. She is teaching us how wonderful it is to be grandparents. Before we leave this world, if we can just impart some of our knowledge and experiences to others, we will leave this world a truly better place.
Thank you for your ongoing support, both on the blog and on the ENT board. You have allowed me to humbly share who I am.
Related Topics:
Technorati Tags: medical practice, ear infections, WebMD
3 Comments:
Thanks for everything you do both on the boards and on your blog. I read it whenever you have new post and I love it. Thanks you.
I am a grandmother of a beautiful and bright year and a half old boy. Ethan was born with large tonsils. He also has lumps on the side of his neck. one particular lump that seems to show it's self larger when Ethan is ill. Can anybody who has had this experience share their story with me? He pulls at his ears a lot. He has never had an ear infection. I'm stressing over this. : )km_tomko@yahoo.com
To the anonymous grandmother above: Try visiting our Parenting message boards where the community will share what they can with you. This article might also help you not to worry.
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