Monday, May 28, 2012

Weekend wrap-up

I'm writing this from my porch on a warm Richmond evening, wrapping up a great holiday weekend with my wife. No clinical work for me this weekend, but did a lot of things--detailed my car, made a big batch of gazpacho, worked in the garden, played the piano, tried to figure out what to do about the yellow jacket nest in the yard, and went to the gym. You know, things that normal people do. It was a refreshing break from the hassles of arguing with insurance companies about why treating MAC pulmonary infection requires more than 5 days of clarithromycin, documenting,  documenting, and more documenting every fricking thing we do, and playing the regulatory compliance game (a game where no one tells you the rules but consultants remind you that what you did do was wrong).

To make the weekend even better, I received the following email from a patient with a 5-month history of relapsing C. difficile infection that I did a fecal transplant on several weeks ago (she graciously allowed me to share it):
Wanted to let you know that it has been a couple of weeks since the transplant and I am back to my old self. My energy is back and so far I'm feeling terrific. Thank you so much for everything you and your staff did to help me. Everyone was so friendly and competent. I want to especially thank your nurse who did a great job in getting me to relax during the (nasogastric) intubation, which was the most uncomfortable part. It feels wonderful not to have to take any more antibiotics. I wish for you and your staff the very best and I hope that this procedure continues to help more and more people who have been going through this debilitating disease. Words cannot express adequately how grateful I am.
Emails like this one serve as a great reminder of why I went to medical school. And it helps to put the bucket of broken into perspective.

As I sit here watching a great blue heron fly over the James River, I can only think that tonight it's all good. Tomorrow, back to the grind!

Graphic:  Anna DeStefano


  1. Awesome! I'm curious, will insurance pay for that? I get emails all the time from patients looking for local docs who will do the procedure, but rarely know who to contact in their area.

  2. At this point the procedure does not have a CPT code (number used by insurers for billing purposes), so I charge for an office visit only.