Dr. Malo's Adventures

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Everyone is talking about the economic bailout for the banking industry, and how our country nearly fell apart. We acted swiftly and quickly to fix the situation.

It's time to discuss a healthcare bailout. The healthcare system in place is non-sustainable and the fundamentals are weak (unlike our economy).

What's wrong with the healthcare system? Lots of things, but where to start?

Dr. Alo's Health Care system Bailout:

1. Either fix medicare for good, or fund the heck out of it. Unfortunately, medicare has become a disaster. Over spending and being defrauded in some areas and not paying enough in others. Who suffers? Patients. Especially those that don't have medical insurance. They get stuck with medicare, which works for now, but not well enough.

Some of the problem is that this is a government program and hence, is bogged down by typical governmental red tape. The problem with eliminating medicare, is that tons of people will go uncovered.

Medicare, if it is to remain in place, needs to be funded properly. Real properly! Fund medicare so it can start paying hospitals, clinics, and physicians. Almost every few months, congress has to enact emergency legislation to not slash medicare funding.

Medicare pays so poorly, that many physicians can not take medicare patients, because it costs them more to see these patients than they will ever recoup. For an orthopedic surgeon to grow his practice and start seeing medicare patients, it will cost him more in additional malpractice insurance than it will in additional revenue from medicare. So they don't do it. Try finding an specialist that will see medicare patients? Very rare. These patients end up getting subpar care.

It's extremely complicated, but medicare needs to be fixed or funded properly.

2. Stop the malpractice lawsuit lottery. People should not feel like they can sue the healthcare system, be it hospital, physician, clinic, and win the malpractice lawsuit lottery. Cap lawsuits at a maximum of $10,000 and no lawyer or patient will bring frivilous lawsuits. The amount that physicians and hospitals have to pa in insurance premiums is so much that physicians and hospitals have to rush patients in and out to try and keep up and make any money at all. A hospital should not have to count "empty bed days" and find ways to fill their beds, just to make a buck. Physicians should not have to see 8 patients an hour to make a buck. They should be able to see a few patients, spend extra time with them, and still be profitable. The revolving door and rush makes this crazy and dangerous. Physicians are to blame. They should just stop paying malpractice premiums, until they come down. They should all do it together. It's a never ending cycle. The more we pay in premiums, the more insurance companies get sued for (deeper pockets), the more they raise our premiums, the more they can be sued for. Bad cycle.

3. Pay physicians and hospitals what they are billing. Doctors are just dumb. Why they accept not being paid till 90 days later, I don't understand. They bill $150 per visit and after months of chasing down insurance companies, hiring 4 staffers to call the insurance companies daily, and writing letters to insurance companies, they finally get paid $18 dollars for that visit 6 months ago. This is ridiclous! You spend hundreds of dollars a month chasing eighteen dollars. Wow. Next time your plumber or refridgerator repairman asks for $150 bucks, tell him you'll pay him $18 in 6 months and only after he sends you 4 letters, has five staffers call you daily for three months. That'll work.

4. Physicians are being squeezed and squeezed every day. They are being pushed around and walked all over. As an economist, I know that when you squeeze smart people, they find other places to put themselves to use. If we keep squeezing the brightest people, they will find other ways to use their intelligence and make a living. Many physicians are already retiring early and putting a strain on our healthcare system. They are finding other ways to be productive and earn a living. This leads to healthcare being managed and administered by less qualified individuals (Walmart MiniMarts and Minute Clinics) and people's lives at stake. I have nothing against Walmart clinics, the more competition, the better (I am a free market capitalist), however, our system is now designed to force the intelligent, good physicians into other sectors. This does not bode well for our system. We alread have a diminishing supply of physicians and by 2020 we will see further decline in supply. Physicians need to band together and take healthcare back and stop allowing others to dictate healthcare.

5. Pay primary care physicians and fund preventative medicine. If every American were forced to see their physician yearly, we would have fewer heart attacks, strokes, hypertension, diabetes, and other disease would be caught early. Physicians are trained in prevention. The way medicare and the insurance system is set up, we pay for catastrophic health care, rather than prevention. We will pay for the heart attack, cath, stents, but not seeing the doctor once a year and getting on lipitor. Unfortunately, more and more people are shying away from primary care. After being saddled with $250,000 in debt from medical school, they can't afford to go the primary care route and live a normal life. Pay these people more! And keep physicians in primary care, they know how to keep people healthy. It's unfortunate that these Quick Clinics are being run by nurses and people are using these as a substitute to medical care. No matter how good a nurse may be, they are not physicians. What the nurse thinks is a little nose bleed, could turn out to be some major issue. Don't denigrate health care to such a low level.

6. Healthcare Insurance should not cost that much. Families should not be paying thousands and thousands of dollars for their healthcare insurance. Further, if they show up to their prevantative visits, they should get discounts.

More to come...

At almost every step of the way you are shocked by how very little you actually know about medicine.

When I started medical school, I was in complete awe at how much is known about the human body, our cells, and what can go wrong. It was a serious shock to the system.

When you finish your first two years of medical school and start your clinical rotations, you are shocked once again because you really know very little. You really don't know anything. The cycle just starts over and keep repeating itself.

When you finally finish medical school and are finally considered a real doctor and start residency, again, you are shocked by how little you really know once again. You may have a lot of information and experienced stored, but now you have to put it together and take care of patients.

I remember my very first rotation as a third year medical student, you can read about it on this blog, I was asked by Dr. Luhrwick why I did not examine a patient's abdomen that had abdominal complaints. All that book knowledge and all those classes, but no one really taught us how to put it all together.

When I first began my residency, I had to ask how to order breathing treatments, one of the simplest orders in medicine. This is as a fully graduated doctor with a shiny new long doctor white coat and the new initials behind my name.

"So, Dr. Alo... you don't know how to write for breatihng treatments?"

The education of a physician is long, ardous, and humbling. Every day you are reminded how little you really know. If you think reading helps, it only makes this worse. The more you read, the more you realize that there is that you don't know, and may never know. But you have to keep reading. Read, read, read!

Medicine is an ever changing field. It's so vast, wide, and exhaustive. It's nearly impossible to know even "some" medicine. Now I can fully appreciate why there are so many specialties and sub specialities. And even sub specialists don't know everything about their little niche.

I used to wonder as a student, why is this doctor (ob/gyn or orthopod) sending this guy to another doctor for hypertension? Can't they just fix it. Sounds easy enough?

I always tell my medical students that as a physician you will always be a teacher and always be a student.

One of my favorite sayings is, "If you know something, tell someone. If you don't, ask."

This is the real Grey's Anatomy.

Pictured above from right to left are the following residents:

1. Joanna: She is one of our ER residents. She loves ER and does a mighty fine job taking care of the crazy stuff we see in the ER in Chicago. You aren't going to find a better trained group of ER residents than what they have here in Chicago. She is fun loving, outgoing, and is a team player. Very easy to work with and very reliable. You need to be reliable and dependable, and Joanna is.

2. Mike: Our wonderful Chief Resident. Mike is Internal Medicine and is a great guy. Great personality, fun loving, easy going, and easy to get along with. He gets along with everyone and everyone loves him. His management stle is very chill and easy going. He leads by example and rarely gets riled up. It's very rare that he gets upset with you. You gotta be a really bad resident to get his attention. And even then, he deals with most situations with composure and professionalism. Mike already got one of our cardiology spots, he is a graduating 3rd year IM resident.

3. Jim: This is one of our surgery residents. Jim is an Ohio State grad and loves Ohio State more than anyone else I've met. He's been to a million games. Jim enjoys life and is a hilarious person to hang out with. Jim is always excited when major traumas come in and handles his bsiness with poise. A guy may come in missing body parts, or has very few still attached, and Jim just handles it. You aren't going to get better trianing than what we have here in Chicago.

4. Mohammed: That's me! I am a second year internal medicine resident working towards cardiology and interventional cardiology. I am a pretty cool, calm, and relaxed resident. I don't get too excited about anything. I'm pretty even keeled. I love what I am doing. I love playing sports. Football, basketball, soccer, whatever it is. I find medicine fascinating. I really enjoy trying to figure out what it going on with people and what is making them sick. It's like trying to solve a mystery. The sicker the patient, the more fascinating. I love reading about medicine and trying to learn more and more. I love teaching the medical students. When I am on general medicine, I give tons of student lectures. It's enjoyable, and I have a knack for speaking and explaining things in simple terminology and helping students figure it out. The students really enjoy my talks (based on feedback they have given me). I am a huge Denver Broncos fan and Ohio State fan. I just try to make the most of every situation. Some people whine and complain, I just try to have a good time! Just enjoy life! Make the most of every situation!

Is Grey's Anatomy real? No!
I will address this in a future blog. But no, Grey's Anatomy is not real. No one on earth has sex at the hospital. This will be a future post.

For us, week 9 wasn't about the undefeated Patroits and the undefeated Colts (Superbowl 41.5) facing off. It wasn't about Adrian Peterson setting a rushing record. For us, it was about row 2 seats at Detroit. Row 2!!!!!!!!

We made it to the Denver at Detroit game without incident. We love Ford Field, we've been to many Toledo and MAC championships at Ford Field. It's a great facility, great venue. Awesome football facility. However, I must say, the RCA Dome is much louder. Like I mentioned in a prior post, in the RCA Dome I was sitting next to Arwa screaming at the top of my lungs into her ear, and she had no idea what I was saying. No kidding. At Ford Field you can always hear the people around you.... it's not loud at all.

I wish we would have been about 20-30 minutes earlier, so we could get more autographs and chat with players, but that didn't happen. We arrived around 11:30Am for the 1PM kickoff.



We're talking Row 2. I mean Row 2! On Denver's sideline. We could hear and see everything. Above is our good friend Cutler and the Denver offense huddling before a play.

Of course, being this close, means you get to see everything, even the ugly. Below is Cutler being sacked by Rodgers, on the very play where he injured his lower leg.



We were right there when he got injured. He got up, started walking towards us, then the coaching staff motioned to him to go down. Apparently, if he goes down on the field, that allows a few extra moments for the backup to warm up as they go to commercial break. (Smart move!)




Ouch!

Afterwards, he did not return.


We were right behind the Denver bench and had a great view of some of our favorite stars. So close that you could take pictures like the above.


This is one of the guys that was heckling us! He was very funny and jovial! He and his friend made the day go by much faster and we had a lot of fun with him. He actually started cheering for us on the few rare occasions when we actual got first downs. He felt bad for us. When Arwa told him that we watched away games all the time at Indy, Detroit and other locations, he started laughing and said, "So you're like a glutton for pain. Ok, I know what I am working with now. I am going really lay into you guys!"


That's the guy and his friend sitting next to Arwa.

The fans in Detroit were great. They kept their heckling to friendly and jovial. We had a great time with them.

The stadium was "sold out", but there were tons of empty seats. Not sure why. About 5-10% of the stadium was Denver fans from what we could tell. Most were wearing orange, but some were wearing blue. I was hoping they'd all wear orange to stand out.

Above are some Denver fans who were at the end of our section.

The Denver fans that were sitting behind us were really whiny and annoying. Every single play they were whining about the play calling, whining about players not catching the ball, whining about every little thing. It wasn't normal cheering or the occasional "Come on, catch the ball." It was a slow drone of whining, and complaining, and moaning. It was very painful to be around them. Thankfully, they were fair weather fans and left after the third quarter started (they came late too!)

Look, we all love the Denver Broncos, but when your team is getting pounded, try to make the most of it. Enjoy the atmosphere, enjoy the stadium, enjoy the fans around you, talk to people. Be happy. Whining is not going to change anything.

Another weird experience, a lot of fan not only did not show up, but came late and left early. I mean some fans came in the second quarter, and left after half time. Weird. I would love to be able to go to every Denver game and watch every second. If you have the privilege of being able to watch all your team's games at home, why would you leave early?

Below is the final kneel down after the 44-7 loss. (Proof we stayed till the bitter end)



In the back field is Calvin Johnson, one of the more amazing physical specimens. He is 6 foot 4 inches tall, weighs 240 and runs a 4.3 forty. Wow! I can't say I have ever watched a more athletic human being.

Some highlights, Shuan Rodgers running downfield and Selvin Young trying to tackle him. Like I always tell my team mates, tackle their legs. There is no way that a guy like Selvin is going to get the massive Rodgers down trying to tackle him that high.

Another highlight was watching Cutler warm up before the game. I saw what this guy can do. He has the strongest arm in the NFL by a huge margin. He is in an offense that still hasn't put his arm to use yet. During warmups, he was on the 25 yard line and launching he ball over 75 yards into the endzone, with minimal effort. It was pretty crazy!

Travis Henry and Dre Bly are really short dudes, Henry seemed really short. But he is built like a tank. It was hard to tell, but I think I am taller than both of them. Of course, I don't have Henry's legs or thickness, but I could probably give Dre a run for his money in the forty yard dash. He isn't very big, and didn't look too fast.

Ryan Harris and Hamza Abdullah are both Muslim, and I didn't see them take a prayer break. Hahaha. Just kiddig.

Sam Adams is an enormous human being. I don't know that I have ever seen anyone that big before. Watching him move around was painful.

My wife and I lucked out and got front row tickets to the Denver Broncos game in Detroit against the Lions on November 4th. Should be a lot of fun.

We will be in row 2 in section 124 right behind the Broncos bench. We plan on going early, making this a whole day event, getting autographs and hanging out with the Broncos players and staff.

Pretty exciting! I am not sure why Lions fans sell their tickets for cheap and don't go to the games.

Saturday night at 10PM I played football with a bunch of my good buddies. It was really special, we played on the shore of lake Michigan on Northwestern University's practice field. The field was a nice turf field with some very bright lights. It was a phenomenol atmosphere.

It's too hot in the summer to play football in the day time. It's also Ramadan, and when it's 90+ degrees out and you haven't eaten or drank all day, it's even tougher to play.

At night, the temperature drops a nice 10 degrees and it was a cool 76 degrees out. We were playing a rivalry game against a group of guys who challenged us. The past 2 weeks they have demolished us. It's not that our team was playing badly, it's just that they were getting lucky on broken plays. Our defense didn't allow much, but they got lucky off broken plays and would win 1-0. I did not play in the first two games due to scheduling conflits.

I made it this week and we won 7 TDs to nothing. Yup, 7-0! Our defense played lights out and did not allow them into the redzone all day. The one time they did make it, we intercepted them. The rest of their day was futile.

Our offense was on fire! Ali was John Elway sitting back and picking them apart. Our offense started out running up the middle. I was pounding away through the tackles and forcing them to respect the run. As soon as they stiffen up inside, we start passing all over. They tried to cover the pass, and we hit them with options and sweeps.

We demolished them on offense and put up touchdown after touchdown. It was a lot of fun.

Our defense hurried the QB on every play. Our front line was very high pressure. Over top we had Kaiser, Nick and Shazi shutting down everything overtop.

I gotta give those guys credit, they did hang in there and did not give up. They kept playing.

Although, we are down 2-1 in the series, our team has scored more than them, and hence we will just have to keep playing and see what happens.

Ahhhhhhhhh! Tackle football!!!!!!!! The greatest thing to ever happen to mankind!

Of course, I had the option of staying home and watching my beloved Ohio State play, but my rule is simple: If you are ever presented the option of playing versus watching football, always choose to play! Simple.

Did I say I love this game?

Football!!!!!!!!!!!!!!!!!

My largest fantasy footbll draft of the season is coming up on Friday August 31st. This is the meanest, scariest, smartest, wisest band of brothers ever assembled. Everyone in the group has an IQ score of 120 and higher. All of them are either doctors, lawyers, business owners, or PhDs. Very scary stuff.

For the past five years, this group of 12 has been meeting on labor day weekend at a conference room at O'Hare airport to conduct our draft. It's been pretty crazy!

The highest I have finished was 8th. I am always in the bottom quartile in this ferocious league. I usually am in the top half in my other leagues, but with these guys, it's really tough.

Wish me luck!

I love tackle football. I will play with any one at any time. I have lucked out that in Chicago, I have always found people to play.

My good friend Jalal after a nice game.

Football is one of the most intellectually challenging sports humanity has seen. Yes, most kids when they pick up a ball and play don't view it as mental exercise, but it truly is.

Yes, anyone can just play and have a good time. But truly playing football means scheming. You see what the other team is doing and adjust. You don't need superiour athletes, you need a superior plan. That's the beauty of the game.

You need leadership on your team that can analyze, scheme, and execute gameplans as the game is being played. It's harder at our level, because we don't use a coaching staff, we are the coaches and the players, while playing.

Last sunday, we went to a field near the city to play at night. The lights were on and it brought back memories of high school ball under the lights. It's cooler at night, so we prefer it. We picked teams. I ended up with my buddies Kaiser and Jalal. But the big monster of a human being ended up on the other team.

This guy was huge. 6 feet 3 inches tall, 245 pounds of rock solid muscle. He had a 32 inch waist that flared out to huge shoulders. This guy could be on the Under Armor commercials, ripped and cut. His team started laughing at us and saying they were gonna kill us. And that it was over.

Jalal and Kaiser told me that they are just gonna hand off to this dude and he is gonna run over us. I huddled up the defense, told them what our gameplan was, then we started hyping each other up and getting ready. We basically, put everyone in the box to cover the run and left to cornerbacks on each side to cover the entire field behind us.

We dared them to throw. We gobbled up the running back. He lost yards, got flipped, tore up his shirt.... had no where to go. We had our corners on an island covering the entire field.

They could not move the ball.

On offense, we gave them the same look on every down, but mixed in run and pass. We ran 90% of the time, because they could not stop us.

It was awesome! That's just one simple example of scheming and gameplanning.

Football is the greatest sport humanity has ever invented. I will continue to play every weekend.

Someday I will be a high school headcoach. I can't wait! My teams will always win! Superior gameplan, not superior athletes, but having both is great! Smart players!

So the Journal of the American Medical Association published a comparison of 4 diets, and Atkins diet won again.....

"A twelve month study of 311 women published in the Journal of the American Medical Association (JAMA. 2007;297:969-977) concluded that the Atkins diet was the best one studied. Those on the Atkins diet had the best blood pressure levels, the best cholesterol levels, and lost the most weight.

Those women on the Atkins Diet (very low carbohydrate) lost 4.7 Kg (10.4 pounds).

Those on the LEARN diet (high carbohydrate with low fat) lost 2.6 Kg (5.7 pounds).

Those on the Ornish diet (super high carbohydrate with super low fat) lost 2.17 Kg (4.8 pounds).

Those on the Zone diet (40% carbohydrate, 30% protein, 30% fat) lost 1.59 Kg (3.5 pounds).

The study showed that though certain basic vitamins and minerals were not at ideal levels for some people on the Atkins diet, but none of the severe health problems condemned by critics of the Atkins diet occurred. The study showed long and medium term benefits and did not compare the four diets with exercise. "

Download the PDF Now! Great read!