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Have you ever had a long one-on-one conversation with a president?
Yes! I had an opportunity to talk to a President of a Country for 10 full minutes. He heard me out fully. He asked me searching and pointed questions, and then shook my hand, and wished me all the best.The above statement is both true and false.The President I am referring to is the former President of India, Dr. A.P.J. Abdul Kalam!I did speak to and listen to him as described above.But, he wasn’t the President of India when I spoke to him.That ends the answer for those who like brief answers.Those interested can read further:Here is the story in brief.Flashback: Sometime in the latter half of the 1980s. I was one of the senior-most and lead Structural Design Engineers handling some prestigious design assignments for very big clients at my company, MECON. We had just bagged the consultancy contract from Bharat Dynamics Ltd, who were setting up the project for making the Prithvi and Trishul Missiles. APJ was heading the DRDO at that time. (Defence Research and Development Organisation) and was deeply involved in the missile project.A kick off meeting was organised at our office in Bangalore where a top team of DRDO Scientists involved, led by APJ was invited to our office for a presentation that we wanted to make about how we planned to execute the project and all the project highlights, estimates, specifications, time schedules, procedures, etc. This was also an ice breaker meeting for seniors on either side to get introduced to each other.Each department in our office, that was involved in the project was expected to prepare well and make a presentation (not Powerpoint!) before the client’s representatives in our conference hall. I was picked to represent my department and had prepared a half hour presentation (talk, slides, drawings, etc) about all the steel structures (both building and technological structures) coming under the scope of the project.APJ arrived on the scheduled day exactly on time. Hardly anyone in our office knew him from Adam at that time. He looked the least distinguished in the group and only the fact that he walked ahead and his team followed, indicated that he was the leader. With his long hair, short stature he looked nothing like the head of a prestigious organisation like the DRDO in charge of a project of such national importance.The conference hall was packed with about two dozen of us. Our top management was present and department heads or their deputed representatives were present. I represented the Structural section. At the last minute my Director told me I had just 10 minutes to finish what I wanted to say. After all the preparation for a half hour presentation, it was disappointing to be told to cut it short to 10 minutes. But I rose to the occasion.APJ listened to me with rapt attention. He allowed no one to interrupt me for the entire 10 minutes I spoke with my drawings spread out on the table.He then grilled me for the next 10 minutes with questions. The details are too technical and I will omit them.He then shook my hand, patted me on the back for an excellent presentation.When the meeting ended I came out and was walking back to my seat when one of my colleagues, not involved in any way with the project, casually asked me “अरे यार! कौन था वह जोकर जैसा लगने वाला?” (Hey! Who was that guy looking like a joker?)What a pity! If anyone had even dreamt that this man would be the President of India later, we would have arranged a photographer for the occasion!But my memories of this meeting will be clearer than any picture can be. I designed some very special structures for this project. Some day I will talk about them.GV
Do doctors get a kickback for referrals?
No, that is basically a federal offense.I tend to refer people to the doctors that send me back the best notes, and who seem to be most responsive to me when I try to get a patient seen rapidly.Also, I tend to refer people to doctors who are in my same network that have the same EMR system, so that I can see what is going on. Sometimes if you refer out of network you don’t always get the information back in a timely manner.A couple of specialist groups sent boxes of chocolates to our office for Christmas. That is about as “kickback” as we get. The staff loves chocolate.
To all the doctors, have you ever asked a patient to leave your office?
We just had one on Monday. We are a primary care office in the middle of the COVID-19 crisis. Patients stopped coming to our office because they were afraid we were treating COVID-19 patients. Our volume of patients plummeted to about 20% of our normal patient count in late March and early April. We laid off 50% of our staff and switched to Telehealth. Gradually, patients have started coming back in when they could no longer put off going to the doctor. We are seeing about 50% of our patients in the office and another 20% through Telehealth. We have strict protocols for seeing patients now, but tensions are high among the staff. We are bringing back our staff slowly but surely.One of our patients had been discharged from the hospital last week for non-COVID-19 problems. This 35-year-old woman followed up with her doctor through Telehealth, but needed to be seen in person for her condition and also to fill out FMLA paperwork. She confused her follow-up date and time (after confirming twice with our email and text reminder service), so we rescheduled her to the next day, a Saturday. Again, she arrived at the wrong time and the office was closed. She paged her doctor who was on-call and demanded her paperwork be filled out over the weekend. This doctor offered to come into the office exclusively on Monday to see her and fill out her paperwork as a courtesy. He was only scheduled for Telehealth which he had planned to do at home.The patient again arrived late and the doctor was busy on Telehealth with his scheduled patients. She offered to come back in an hour when he had a slot to see her. Again, she arrived late. She refused to wear a mask in the office, as is our protocol and mandated by our state — insisting she was a nurse and it’s not necessary and it is a bunch of silliness. She was put in a room and told to wait, as the doctor was in the middle of seeing another patient.After two minutes, she stormed out of the room causing a scene, demanding to be seen this instant, get her paperwork, and her narcotics Rx filled. Just then, the doctor came down the hall from his office to see her. She started swearing at him and berating him for making her wait. He threw up his hands and let her know he would not be treated that way and she can leave. He escorted her out of the building. He would not fill her prescriptions or do her paperwork. The patient left.The next day she started pounding on our door when it was locked, yelling and demanding her prescriptions and her paperwork. The doctor ended up giving her two weeks of her medications and two weeks of FMLA and referred her off to her specialist to finish her care. This patient is being discharged from our practice. This patient consistently runs a balance with our office, has multiple missed appointments, and is rude to the staff. There is no need for this behavior — especially at a tense time like this.
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