By the time I hit the 7th grade, I was pretty much listening to the small brown radio in my room every night. So when Bob Dylan's song, "The Times They Are A'Changin'' made the top 40, I was all about it. Of course, I had no idea what it all meant, but I knew it was a song I liked and so did lots of others. Bob Dylan wasn't known for his great voice but rather for his folk songs with a message and that song still has a message that is heard whenever we think the times need changing. When it comes to healthcare, it's clearly true that the times are changing and they have needed to change for quite a while. It's hard to find a doctor who's been around a while who isn't frustrated with the way we are treating patients. I can't think of any other professions where we schedule appointments 3 months down the road and then when they show up we make them wait again in the reception area! (It used to be called the waiting room until someone thought it needed a more politically correct name) We see patients but pay more [...]

I don't have many memories of being a 7 year old but one or two really stand out. Lincoln School was my elementary school and Mrs. Hansen was my teacher in the second grade where I used to sit near the back of the class (the place for the R's). I do remember thinking to myself, "how do the other kids see the stuff Mrs. Hansen is writing on the blackboard? Apparently, she picked up on my inability to see that far because not long after that, my mom and I were at the Ophthalmologist's office and I was told I would be getting glasses. Not really knowing what glasses would do for me, I don't remember being excited about it. Until the day came when we returned to the doctor's office for the delivery of the goods. That doc was shrewd, he took me over to the window of his office and asked me to look out there and tell him what I saw. His office was on the top floor of the Wing Building whose 4 stories made it one of the tallest building in our town! (Still is, I'm pretty sure). He stood behind me and then placed [...]

I have 3 friends from my college days and we have all remained close friends since those days more than 40 years ago. I doubt that many people could make that statement. It is the exception and not the rule to have friends like that. The other days I was laughing with one of them about those days at California Polytechnic State University, better known as Cal Poly. None of us has been exactly "usual" in the way we have gone about our lives and that was even present way back then... I applied to Cal Poly in1970 and, unlike most colleges, I had to declare a major before I was accepted. I honestly had no idea what to major in, I was just happy to be going to college! After trying to "declare" 3 majors (they were all full), I was finally accepted as an Ag Business major. If I could have chosen 2 things that I knew absolutely nothing about, it would have been agriculture and business. The rule would have been something I was remotely familiar with (like biology), the exception was ag business. BUT, I was in the door! I started taking general education classes, still trying to figure [...]

If you were around in the 1950's you might remember the beginnings of the Interstate Highway System under the leadership of President Eisenhower. It officially started in 1956 and the original system was proclaimed to be completed in 1992. With that freeway system came many other "industries" such as the motel (Arthur Heineman built the first motel in San Luis Obispo, California and wanted to call it the "Milestone Motor Hotel" but has to shorten to mo-tel after he could not fit the entire name on his rooftop). Motels reached their peak in the 1960's but were largely replaced by larger chain hotels at highway interchanges. With those motels and hotels came fast food restaurants. Again, springing up like weeds along the freeways and designed for people on the move who wanted a bite to eat but didn't want to spend a lot of time looking for a restaurant. And naturally, people moving along the freeway needed gas and car service so "service stations" evolved in these same areas. A family of 5 (like mine) could embark on a long trip from southern Oregon to southern California and save large amounts of time by stopping at a freeway exit that had food, gas [...]

I thoroughly enjoyed reading a blog on KevinMD.com by Dr. Linda Girgis entitled "These McDonald's practices should be avoided in health care". I agreed with her premise and her conclusions but I began to wonder if there are now ways that healthcare can learn from the way McDonald's does things and therefore we should advance them rather than avoid them. I am old enough to remember when McDonald's started as a fast food eatery in San Bernardino, California. The original brothers, Mac and Dick McDonald, had the idea of providing an efficient and clean "walk-up" restaurant that ran like an assembly line. Not everyone liked it. Some thought they were too hurried. They wanted to sit down, order, and eat their meal without the rush. But others found the pace to fit them and their situation. I see McDonald's as the "urgent care center" of restaurants. It's not an expensive restaurant, it's not a "hospital". It's a facility where you can go where a sore throat doesn't take 2 hours to figure out, where an earache in a toddler does not require an extended time to diagnose. I am not a frequenter of McDonald's but I occasionally stop in there especially when [...]