welcome to the organic green doctor blog

i am a family physician who was diagnosed with
early mild cognitive impairment(mci) amnestic type on december 21, 2010
this is a precursor to alzheimers disease
because of this diagnosis i have opted to stop practicing medicine
this blog will be about my journey with this disease
please feel free to follow me along this path
i will continue blogging on organic gardening, green living,
solar power, rainwater collection, and healthy living
i will blog on these plus other things noted to be interesting

Thursday, December 6, 2012

doctor vs patient


i was a family practice doctor for 30 years
and enjoyed almost every day that i practiced

early in my career i delivered babies took care of icu patients
covered the emergency room for admissions for pediatric
and adult patients took care of sick newborns and pediatric patients
and worked extra in the emergency room

it was a hectic schedule during those earlier years
keeping my office schedule flowing each day was not easy

about 15 years ago i stopped all hospital care and only worked
in the clinic
this made my life less hectic and made my office schedule more
flexible and much easier to flow each day since there were
not all the interruptions from delivering a baby a new icu patient
helicoptering a patient out of the emergency room to a tertiary care
hospital or taking care of a new admission

things were just better in the office the last 15 years
better for me and better for the patient

that said
it sometimes is harder to stay on schedule in the office
the day can be unpredictable
a broken bone an asthma attack sick kids a heart attack
counseling a dying patient counseling a depressed patient
an abused child an abused wife a flu outbreak and all
those other things that can disrupt your day
phone calls lots of phone calls charts labs xray reports lots
of chart reviews
it is hard to stay on schedule almost every day in the office

i spent a lot of time reviewing different schedules and what
made them more efficient and tried to incorporate them into
our schedules
some worked and some did not

i was the guru of scheduling and of insurance coding so that
we would get paid and so that your insurance would pay your
i taught those things to other doctors

so from a doctors view
it is hard to stay on schedule every day
that said
there is not excuse for not starting on time and maintaining some
resemblance of a normal schedule
if you start behind the day only gets worse
some are chronically infected with this disorder
not me

remember if your doctor always always stays on schedule
he she is new he she is not well liked he she is just not busy
he she is in a very competitive market and
maybe he she may not be a good doctor

that should be some type of red flag

i usually stayed on schedule but because of what else can
happen in the day it was hard to maintain it

now im on the other side and sometimes have another perspective
your perspective

my primary doctor i know real well
i chose him
not because he stays on schedule all the time
he may be one of the worse
but because i worked with him for several years
read his charts
saw his patients
saw how he manages patients
sat in medical meetings with him
so i know what kind of doctor he is
hes probably one of the smartest one in the group
he doesnt miss much
and i felt like he would provide the best care for my health problems

that said
hes one of the worst offenders of the being late on his schedule
im willing to accept that
knowing how competent he is

one way i beat the system is for my routine appointments is i
always get the first appointment of the day
that has worked well over the last 3 years usually

another doctor i see is a specialist who is busy and is in
a surgical specialty
i chose him because my patients liked him and because he
had good results from his surgery and treatments
he also had a good bedside manner
but i knew when i went to see him
he would not be on schedule
its usually a 1-2 hour delay when i go in
i accept that because i know ill be getting good care

my ophthalmologist i see i selected for the same reason
however although she is busy she is generally always on time
i know though that she is good

my neurologist i see i selected from her involvement with the
alzheimers research center and the universitys memory clinic
shes always on time with the early appointments but can
be later with a later in the morning or afternoon appointment
again i know she is good

so what triggered all of this is a facebook posting of a former
patient who was left in the waiting room for 30 minutes then
in the exam room for 30 minutes before she was seen
glad i wasnt the one who had to see her

one suggestion to patients
do not piss off the receptionists or the doctors nurse
i repeat dont piss off those two people
make someone else mad at you even the doctor but
not those two people
thats reality thats just the way it is
speaking from years of experience

but if you feel mistreated talk to the clinic supervisor
and or to the doctor
they do listen
its a competitive market now days and administration
listens to complaints
but remember
do praise them when they do good

my suggestion if you are like this person who has experienced
this before
change doctors to one who is more schedule friendly for you
but be choosy whom you see
or accept the delays like i do within reason

i know a busy mom who works has kids who are sick
takes care of most of the work at home doesnt have
a lot of time to be wasting on late appointments
but try earlier appointments in the morning or afternoon
as later in the morning and later in the afternoon things get worse

consider an acute care place for some illness if appointments
arent available and yes complain if lateness is chronic
they do listen
but if you are not happy with them change providers

ive found its not fun on this side of medicine
the patients side
see this blog posting of my recent experience
this posting by my blog friend who was in the er
with her sick child and later went to see his doctor
the next morning

i sure wish i could go back to practice medicine now
i would do a lot of things differently
all for the patients benefit

i hope you get your situation with your provider fixed
he is a good one
he is my doctor also

but if you cant tolerate the lateness then change providers
there are a lot of good competent ones to choose from
who do a better job on their schedule
just be careful whom you choose

what do you think

the organicgreen doctor


  1. I want to go back to Dr. Nash!!

    1. i really wish i could go back and start practicing
      medicine again
      i would be a much better doctor after what ive experienced over the last two years
      maybe all doctors should take a break from medicine
      and experience the other side some or do volunteer medicine

      i would enjoy each visit more
      listen more and do less talking
      be more compassionate
      and try to take care of whats really important
      for patients


  2. Dr. Nash, You were a good listener, my family and I enjoyed your talking and you were compassionate. We miss you! Being that patient yesterday who sat in the waiting room for 40 minutes, I knew that the doctor wasn't busy. My apptmt was scheduled at 8 am, I showed up at 7:45 am and at 8:25 am the receptionist (my favorite one from that office)realized I was STILL sitting out there so she called back and asked if they had forgot about me and sure enough they had. When the doctor heard me questioning the nurse about whether or not I was a scheduled apptmt or just being squeezed in he quickly told the nurse to get me in a room and he'd see me next. The sad thing is this has happened several times in the last year (since you left). I know doctors get busy. I understand some patients have more serious pressing issues but I am a busy mom of three with a job and my time is valuable too! Thanks for posting from your perspective as a patient. We miss you!!

    1. thanks for your comment
      yes i miss my patients also but have enjoyed keeping contact with them through the blog facebook twitter and email
      some i have got to know better outside of medicine which i have enjoyed
      yes i think about other peoples time more since i retired
      i help much more at home with the house work cooking cleaning etc than before
      i think all the time how do some of these moms like you and like my wife when my kids were younger get all this stuff done and work
      i certainly understand your need to find a more efficient health care provider for you
      when i read about your experience i thought she got up that morning got ready for work got her kids up dressed fed and took them to school then went to the doctors appointment knowing she needed to be at work then an hour was wasted of her time that shoulnt have happened
      good luck with your decision
      hope providers read about this and look at their own practices
      yes wish i was back but im happy in what i do every day

  3. Thank you so much for your perspective. It had never occurred to me that a doctor who was always punctual might not be in high demand.
    For 19 years I had the greatest primary care doctor, Dr. Robert DeVries of Dallas. He was so kind and so on the ball that I kept going back to him even after I moved back to Austin. He was always running late, because he really listened to his patients and the extra listening time seemed impossible to schedule. All his patients accepted that. I'd still be going to him if he were still alive. Unfortunately, he smoked cigarettes, and the smoking killed him. RIP, dear Dr. DeVries.

    1. thanks again for the comments
      i drive there for my neurology appointments
      i drive an hour to see my dentist lawyer and accountant as ive had them for years
      when you have good ones its worth the drive