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with Rod Moser, PA, PhD

Stories from behind the examining room door, as told by Rod Moser, PA, a primary care physician assistant with more than 35 years of clinical experience.

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Monday, November 19, 2012

What are Medical Providers Thankful For?

By Rod Moser, PA, PhD

Doctor

I have been caring for patients for nearly four decades; a few hundred thousand patients. I have three generations in my practice — babies of babies of babies that I have cared for! I have had a wonderful career and I am thankful for many things. Here are ten of them…

  1. I am thankful for vaccines. Although some of my patients may not agree with my enthusiasm, vaccines have saved countless lives in my lifetime. I had measles, mumps, rubella, chicken pox, influenza, and whooping cough as a child. Fortunately, I did not have any adverse problems, but some of my friends became deaf; one died. My cousin developed polio.  Worldwide, measles is still the second leading cause of death, yet some younger parents refuse the vaccine. I think they are foolish and I tell them so. I push the flu vaccine, but I people don’t seem to fear influenza. I guess they do not know any of the 40,000 to 50,000 people who die each year from influenza.  They may not have a fear of getting the flu, but they better not expose grandma if she is not immunized. Grandma could die.  Infectious diseases are not jokes. They are killers and should be treated as such.
  2. I am thankful for antibiotics. I don’t shell them out like candy in my practice, but when they are needed, antibiotics are true miracle drugs. The first antibiotic was used in the 1930’s (sulfa), followed by penicillin in the 1940’s. Penicillin, alone, saved countless lives in WW II and the years that followed, combating Streptococcal bacteria. Now, we have an impressive armada of potent antibiotics at our disposal, but like most advances in medicine, it can be a double-edged scalpel. With emerging, resistant organisms, antibiotic stewardship is more essential now than ever before.
  3. I am thankful for contraceptives. Humans will always have recreational sex, so why not have methods of limiting unintentional pregnancies?  Before the Pill, there were several semi-effective methods, including  abstinence, withdrawal, condoms, and the diaphragm. Vasectomies and tubal ligations were available but not commonly practiced. Contraception methods seemed to be guarded secrets. Now, we have hormonal implants, IUDs, progesterone injections, and more advanced oral contraceptives.  I will always be grateful for careful family planning. Five kids are enough.
  4. I am thankful for analgesics and anesthesia. During the Civil War, field surgeons would remove limbs without anesthesia; the only pain medication available was booze, or highly addictive opiates like laudanum.  Ether and laughing gas soon followed. Women gave birth without the option of an epidural, and surgeons performed surgery on conscious patients.  I can’t imagine enduring a surgery without safe anesthesia or post-operative pain management.
  5. 5. I am thankful for (good) health insurance. My parents did not have health insurance. When I had to have my appendix removed in the 1960’s, it was cash up front. Medical visits were inexpensive, even adjusted for the cost of living and salaries ($3 for an office visit; $5 for a house call).  Medical care is unbelievably expensive, but so is insurance.  I am grateful that my company pays for my health insurance as a benefit, and I am anxious waiting to qualify for Medicare (I have been paying toward it for decades now).
  6. I am thankful for skilled medical professionals. Doctors were not always highly trained. Some simply called themselves “doctor” after a short apprenticeship. Barbers practiced medicine (the red and white strips on the barber pole symbolized blood and pus). Growing up in Appalachia, there were folk medicine practices and many of us had mothers who thought they were doctors. We survived, but not without a considerable amount of luck.  Medical professionals today are highly trained in technical skills, but often not so much in social skills. We need both.
  7. I am thankful for advanced imaging. The only way to diagnose appendicitis in the early days of my practice was to make a clinical diagnosis (based solely on symptoms and physical examination findings). The definitive diagnosis was during surgery. If the appendix was red and inflamed, we were correct. It was removed. If the appendix looked normal, then we were wrong. We took out the appendix anyway, since we were there. Now, with advanced imaging, we don’t have to rely on a plain x-ray or use a laparoscope. We have CT scans and MRIs to peer beneath the skin and tissue without dropping a speck of blood. We can look inside the brain for the smallest tumor, or find breast cancer when it is the size of a grain of rice. Amazing.
  8. I am thankful for truthful and compliant patients. Medical care is a team effort and the most essential part of the team is the patient. A person who provides an accurate medical history makes the diagnosis easier, and a patient who is compliant to medications and medical orders is a blessing. There is joy in my life when I get a patient to stop smoking, or lose a hundred pounds, or manage their diabetes. Medical providers are just travel agents. We can show you the best way to go, in our professional opinion, but it is really up to the patient to make the journey.
  9. I am thankful for medical researchers. Over the years, we have had bad drugs and harmful devices hit the market. Doctors once felt it was a good idea to use radiation to treat tonsillitis, or to prescribe thalidomide to help a woman relax. In spite of those serious and deadly mistakes, medical researchers have made some incredible advances in the last 40 years of my career. We are curing cancers that once were death sentences. We routinely transplant organs without fear of rejection. High blood pressure is no longer treated as a nervous disorder. Vaccines have been developed to combat illness before they hit. Researchers have made more advances in the last decade than in a hundred years prior. And more advances are coming. It is a wonderful time to be alive.
  10. I am thankful for a great career. I have absolutely no regrets about my decision to have a medical career. Sure, I might have been a good chef, but medicine has been good to me. I have worked with some wonderful colleagues. I have been blessed to be involved in medical education, training the medical professionals who will be caring for me some day. I was able to publish several books, write hundred of articles and blogs, and work intimately with WebMD and the millions of on-line followers. Although I get tired working long shifts, I still get a charge out of caring for patients and their families. There will always be sick and injured people, and I have been blessed to participate in their care.

Finally, I am thankful for a supportive family that allowed me to pursue a medical career: a wife who shares my passion for medicine and has worked side-by-side with me for over three decades. I am thankful for my five now-grown children and five grandchildren who tolerated getting sutured on the kitchen counter top or getting vaccines at the breakfast table.

Have a Wonderful Thanksgiving!

Photo: iStockphoto

Posted by: Rod Moser, PA, PhD at 1:00 am

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