Introduction: If Only I Had The Time

“It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of Light, it was the season of Darkness, it was the spring of hope, it was the winter of despair, we had everything before us, we had nothing before us, we were all going direct to heaven, we were all going direct the other way - in short, the period was so far like the present period, that some of its noisiest authorities insisted on its being received, for good or for evil, in the superlative degree of comparison only.”

Charles Dickens, A Tale of Two Cities

The statement that described the tumult that accompanied the French Revolution nearly two centuries ago would be an aptly describe the state of American healthcare today.

Never before in the history of this nation have there been the resources to control the ills that plague Americans and never before have these resources been unavailable to so many , often the populations most in need of them.

The impetus for this blog are the many apologies that I have made to my patients as I often entered an examining room many minutes late and exited prematurely often not addressing many of their concerns.

These delays were rarely deliberate.

They are an excuse for a healthcare system that demanded that as a practicing Internist I see as many patients as possible in as little time as possible and yet address appropriately all their concerns.

The failure to achieve these almost impossible goals would result in a decrease in my income and my patients’ health status.

To compensate for my failings I decided to describe for my patients and the patients of physicians who daily face similar predicaments methods to best prepare for their medical visits and use the time appropriately.

In addition I would like to describe some frequently encountered medical ailments, the background behind them, the investigations used to assess them and the treatments used once they are diagnosed. This is not intended to be a medical tome nor a “Treat Yourself” manual.

I will attempt to discuss as fairly and dispassionately as possible some of the controversies surrounding these discussions.

I would have preferred during the course of my professional life to have performed these tasks personally with each individual I had occasion to care for.

The views expressed in this blog are mine alone, they do not reflect those of the Group with whom I practice. The views are mine personally and must never be associated with those of my practice associates.

I will also try as often as is convenient to provide the reader with references to resources so that they can also independently evaluate them.

The views expressed must not be interpreted as medical advice and though they may be used as a point of reference I hope they help improve the relationship between a patient and the physician. This relationship is individual and sacred; unfortunately it is too often impacted by commercial or other interests that demean it.

The posts are of two types.

The first long articles detailing common but controversial medical conditions. I will mantain these indefinitely.

Every week I will also have a new post of a current medically interesting event .

To the reader who I have had the privilege to treat I apologize with the lame excuse “If Only I Had The Time”.