8 Tips for Success With Your New Doctor

Health insurance often changes with the new year and many patients find themselves searching for a new doctor. Here are some tips for making your first visit a success.

1- Come in for a reason. While it may seem courteous to want to meet your new doctor before you are ill or in need, these “getting to know you visits” aren’t always popular with doctors. Insurance companies require a diagnosis to bill and “establishing care” doesn’t count. If you want to become known by your doctor, schedule a visit for an annual wellness visit.

2- Don't come with too many reasons. There can be a lot of paperwork during the first viait and a lot of data to be entered. If you have more than 2 issues to address, ask for a longer appointment or be willing to come back for an additional visit.

3- Write out your health history in advance. Ask if the office has forms. Take the time to gather important data such as immunization history and dates of important screening tests such as colon cancer screens and mammograms. It really helps.

4- Bring a complete list of medications you are taking or better yet, bring the bottles themselves.

5- Know your insurance coverage. There are a lot of changes each year and it is impossible for office staff to keep up. They may have hundreds of different insurance plans to deal with, you have one.  Know what you need to pay each visit and be prepared to pay it when you arrive.

6- If you doctor offers the ability to communicate online, take advantage of it. I love it when patients who were unclear about my instructions gave me the chance to clarify later. 

7- Find out about office policies for someday visits and after hours calls. If your health plan requires you to use certain hospital facilities or urgent care centers it pays to know this in advance.

8- If you are unhappy, say something! If you have an unpleasant experience, let the doctor know before deciding to switch providers. Some of my greatest improvements were patient suggested. If you receive exceptional service share that too. Even doctors need an occasional “good job!”

- Bart

Thanks for reading. More thanks to those who take the time to click a share button and let know others know about the blog. It is the only way word spreads and it is a huge encouragement to me! Comments and questions are always welcome.

Leaving the Church

People leave churches. It just happens. In some circumstances it is due to a loss of faith but many times it is because something changed in the church. When a  place that once felt safe and once felt like “home” can sometimes become unfamiliar and uncomfortable. We have seen some of our friends reach this conclusion lately about churches they attend and move on to other congregations. It is sad. It is also increasingly common.

I don’t judge my friends in their decision because it is a decision I have struggled with at different times over the years. We never plan to leave a church, but it happens. In conversations with my friends and through personal experience I have learned some of the reasons that good people, godly people, move on.

1-      Bait and Switch. No one does this on purpose but the term describes how people feel when they think a church or a pastor is one way but then turns out to be another. We have experienced this a number of times. A pastor starts off as a solid bible teacher but then decides that they are not enough “new people” coming to the church. The pastor changes his approach to attract unchurched people. This can be expressed in many different. In milder forms it is songs, music styles and dress codes that change. When more drastic  sermons can get watered down and harsher biblical truth is avoided. Mature believers end up feeling left out or even ostracized. When this happens they often move on to a place where pleasing the world is not the primary goal.

2-      Doctrinal shifts. God never changes, but people do. There is a natural tendency to want to appeal to the culture around us. Doctrines that are unacceptable to the world get re-evaluated and revisited. Over time they can be rejected. I have seen this with issues such as same-sex marriage and women in the pulpit. Faced with the choice of setting aside firmly held beliefs and staying or moving on, many choose the latter.

3-      Seeing behind the curtain. Pastors are human and are fallible. Some faults are more dangerous than others. For a while I led the Children’s Ministry at a local church. As my time in leadership increased I saw that the pastor was not the man or the friend I thought he was. I attempted to speak with the pastor as a peer and was put “in my place.” Realizing that the man was not truly accountable, we decided that “our place” was in another church.

4-      The Glass Ceiling. Churches, especially large ones, are bureaucracies. As such they often rely on structure and hierarchy to maintain a sense of organizational order. Lay people with leadership gifts can easily find themselves at odds with leadership. Churches are much more comfortable with dedicated followers than they are with gifted leaders. When lay leaders realize there is no place for them and no opportunity to use their gifts, they move on.

5-      Lack of relationship. Churches are filled with people and people often only have room in their lives for a few meaningful relationships. This can make it hard to connect. When people are isolated it is easy to look for another place to fit in.

These are just a few of the reasons Godly people leave. I share them not to be critical, but to remind church leaders and church members that not everyone who moves on is “wrong”. Sometimes their reasons are valid and just. When people start leaving churches leaders need to take a close look at themselves.

I write also for those who do not feel at home in their current church, to remind them that as long as churches are filled with people, they will have problems. We need to remember that only God is perfect and that He, not the church, needs to be the center of our faith. If you decide to move on, consider taking the time to let someone know, as kindly as possible, of your reasons. If the leaders do not know they cannot grow.

-          Bart

The Absurdity of Christmas

The Christmas story doesn’t make sense. At all. This heretical thought that came to my mind as I watched our church’s Christmas program. The orchestra played the familiar carols beautifully, the choir was excellent, the soloists sang well and the tenor quartet performed their numbers wonderful harmony. Between the musical numbers my favorite pastor shared the story of Christmas simply, eloquently and with appropriate emotion. He spoke of the angel appearing to Mary, of the fear and wonder that must have gripped her as she was told that she, a virgin, was to give birth to the Messiah. He shared with us the Christian teaching that God became man in the person of Jesus, that from embryo to fetus to newborn baby to young child God existed in human flesh.

As he spoke I thought of how absurd this all sounded.

Seriously? Do we actually believe this? It makes no sense at all. It is difficult at times to believe there is a God at all, to believe that the all powerful creator of the universe would enter the human race via the womb of a virgin seems akin to believing in unicorns and pixie dust. The story sounds like a fantasy tale, the ridiculous creation of an unintelligent mind under the influence of an illegal substance.

And yet there we all were, over 2000 of us in this church alone, singing and clapping and celebrating this tale as undeniable truth. To these worshippers Christmas is not a fable or a myth, it is a timeless truth to be remembered and commemorated. The joyous celebration of which I was apart was and is not unique, nor is it novel or new. Similar celebrations have been held around the globe for hundreds of years. The natural question is, "How could so many believe so intensely in an event that seems so implausible?"

There are many reasons. The obvious reason is the person the baby in question grew up to be. His life, his teachings, his death and his resurrection are the evidence that supports the miraculous tale. Miraculous birth is more reasonable in the context of a miraculous life. The knowledge that this birth was foretold adds to its believability.  A review of the Hebrew scriptures written hundreds of years before the event leads to the discovery that this remarkable birth was not just anticipated, but predicted.

The Christmas story does not make sense. It defies human reasoning and is contrary to our understanding. Man's disbelief does not change the fact that it happened, just as the gospel writers described it. In a stable in a small town outside of Jerusalem, the Divine appeared in human flesh. Timeless God entered time, becoming the one man who would die for the sins of all mankind. It is miraculous, incredible and absurd, but it is true. Believe it or not.

-          Bart

Christmas for the Fatherless

Christmas is a wonderful family holiday, for those who have families. For those who come from broken homes it is an especially difficult time of year. I live in both of these realities, rejoicing in the time I have with my wife and children while at the same time dealing with the sadness that remains after many years of having no relationship with my parents.

I know I am not alone in this struggle, that there are thousands of others who similarly mourn. Every month in their search for understanding a few hundred of them find their way to my blog post “The Day My Dad Disowned Me.” Some of them are so wounded, so sad, that they pour out their hearts in the comments or in a private email. Their stories are heartbreaking.

One woman wrote,

“At 53 years old and being disowned as well, the pain never completely leaves. My father at 88 years old and dying still won't utter my name. I still carry a fantasy that as he is dying he will ask for me to come to him, tell me he loves me and we embrace, washing away the years of silence and pain. But this never happened. And still I search web pages "why a parent would not love one of his children" to help ease my broken heart and help me to understand.”

Another woman wrote of dealing with the death of the father she had lost years earlier-

My Dad just died yesterday.
I haven't seen him in 10 years....and 6 years ago he emailed me telling me to never contact him again.
He has been breaking my heart my entire life...and only in the past few years have I begun to make some progress in overcoming some of the heartache and not having it rule over and try to destroy my life.
Now it feels like I'm starting all over again in dealing with the pain, rejection, feelings of not being loved. If you have any books or sermons you can recommend I would greatly appreciate it.

A life spent fatherless led one woman to share these words-

I've grown up my entire life without a father. In high school when I found out, who (was told to me) was my father, I wanted a relationship. I spoke with him on phone, and asked for his help to attend college. As a naive 18 year old, I never imagined that it would cause such heartache for the rest of my life, as he denied me. To this day, I often wonder what it is like to grow up with a father.

There are many more similar stories of people hurting deeply, longing for a father’s love even as they enter middle age knowing it will never, ever come. I think of them at Christmas time and wonder what the holidays are like for them. Do they also stop and wonder if their fathers think of them? If there is any regret over casting aside their child? Have we been completely forgotten, are we nothing more than a bothersome memory they suppressed long ago?

Like me do they still wonder, “Why?”

For me, and for most of those like me, complete answers will never come. The only answer I have is that my father is a sick and damaged man who is incapable of love. The only choice I have is to be the best parent I can be and to love the family I have with all my heart, all year round, and to pray that God in His mercy will redeem the heart and soul of my father.

At Christmas I focus on another Father and another Son. I am grateful for the Father that sent His Son into my world so I could enter into relationship with Him. This Father will never leave me or forsake me for He loves me with an everlasting love.

-          Bart

Thanks for reading, and for taking a moment to pray for those who are hurting at Christmas. Thanks to all who have shared blog posts with others, it is the only way awareness of the blog grows. Your comments and questions are always welcome.

Merry Christmas

7 Minutes to save a Life- an Amazing Childbirth Story

Lots of things can go wrong in a delivery, but none are more frightening than stuck shoulders. When the shoulders are larger than the head they can wedge behind the pubic bone after the head emerges. The baby is truly stuck- unable to come out and nearly impossible to push back in. The umbilical cord is pinched and with it all of the baby's oxygen. If the baby is not freed within just seven minutes, brain damage occurs. It is truly a race against time.

In 17 years of delivering babies I encountered the problem less than twenty times. I remember many of them. The worst was about 15 years ago, and it was a surprise.

The mom was petite, only 4 feet 9 inches tall. Dad was over 6 feet tall but I was not concerned about the baby being too large as this was their second child and her previous delivery of a 6 pound baby had been uneventful. I was anticipating a perfect little 7 pounder. Nothing about her labor raised any concern, as dilation progressed at a normal rate and the baby's descent was smooth as well.

When the time came I prepared for the moment of delivery by going through my pre-delivery checklist. I arranged the instruments on the delivery table, making sure everything was in its proper place and readily accessible. While I did so I went through my mental checklist, rehearsing in my mind protocols for any emergencies that might arise. It did not matter that things were going well, I had been taught to prepare as if every delivery was an emergency waiting to happen.

As part of my routine I paused and gave my "just in case the shoulders get stuck" instructions to those in the room. I pointedly told the father and the nurse that if I said, "Legs up!" they were to put a hand behind the Mother's knees and pull them up to her arm pits. I then reminded the nurse that if the shoulders were stuck to be prepared to push down hard just behind the mom's pubic bone to try to free the shoulder. These instructions were typically unnecessary (I had no reason to think they were going to be needed this time) but it never hurt to be ready.

A few minutes later the head emerged, and then, it stopped, as if it had been partially sucked back in. I instantly recognized the sign- the shoulders were stuck, badly. I took a deep breath as I realized the seven minute clock had started.

In my calmest voice I spoke to the dad and nurse, "Legs up!" They quickly complied, sensing my urgency. I applied downward traction on the baby's head. It did not move. At least 30 seconds were gone.

"Suprapubic pressure!" I called to nurse. As the top shoulder was stuck behind the pubic bone, pushing down hard might help it slide under the bone and come free. The nurse literally climbed on the bed, balled her fist and pushed down with all her might while I continued to pull the head down toward the floor. I pulled as hard as I dared, for pulling too hard could tear the nerves in the neck and result in paralysis of the arm. Still no movement at all. About 90 seconds were gone. This was now the worst case of shoulder dystocia I had ever encountered. My remaining efforts to free the baby would be ones I had only read about or discussed, techniques I had never performed before. (gulp!)

Next up was the corkscrew maneuver, where the doctor inserts a hand into the vagina behind the baby's head, sliding it behind the upper shoulder. The doctor then pushes as hard as he can to try and turn the baby sideways in an effort to free the shoulder. If this failed I would need to take scissors and make the opening as large as I could, reach inside and try to deliver one of the baby's arms. If that didn't work, I would have to attempt to intentionally break the collarbone before trying the final step, which would be to try and shove the baby back inside until an emergency c-section could be performed, a desperate act that almost never worked.

I began the corkscrew maneuver, inserting my left hand in behind the baby's head, working it behind the shoulder. I pushed hard. Nothing. I repositioned my hand and pushed again, the baby did not turn at all. I took a breath and pushed as hard as I could...I felt movement! The top shoulder gave way suddenly, the baby turned and was free! It was out in seconds! I took the baby in my arms, cut and clamped the cord and handed him to the nurse. I looked at the clock- there were about 3 minutes to spare.

As the nurse examined the baby we saw why the shoulders had gotten stuck and how they had gotten free. The 4 foot 9 inch mom had just delivered a 9 pound 6 ounce baby! A baby who had also had a fracture of his left collarbone. We had gotten "lucky." The clavicle had snapped during the corkscrew maneuver, narrowing the shoulders just enough to free the baby.

When it was over, I sat and thought about the case, grateful for the training that had led me to diligently prepare for just that scenario, the training that caused me to review those techniques before every delivery. Although I ended up performing techniques I had never done, being prepared had saved the baby's life.

When I think about being prepared for a delivery, I think about all that Mary and Joseph had to face. They knew a baby was coming and they knew it would be difficult. People would talk about the circumstances of the conception, accuse them of immorality and question Jesus' heritage. I think that without preparation the task before them would have been nearly impossible. As it was it was surely very difficult to be young and under such scrutiny.

But God prepared them, giving them signs and dreams before the birth, and then allowing them to hear the stories of the shepherds, the blessings of Anna and Simeon when Jesus was presented at the temple, and later by the words of the wise men from the East. All of these events confirmed the promise of God, providing a foundation of faith and preparing them for what was to come. Preparation that made a difference.

- Bart

This is the fifth in a series of 6 Amazing Childbirth Stories, leading up to the most amazing childbirth story, the birth of Jesus. (for the other stories click here, here, here, or here). To get future posts and stories, sign up to receive blog posts via email via the button below my photo on the right. Finally-If you enjoyed this post or the blog, please share it with a friend!