I have to get some things off of my chest.  A guilty conscience is something that can cause lots of problems, both emotional and physical.  As David said in Psalm 32:

For when I kept silent, my bones wasted away through my groaning all day long. For day and night your hand was heavy upon me; my strength was dried up as by the heat of summer.

Sounds like David lived in Georgia.

So here are my confessions:

I stole a bagel yesterday. I went to Pannera Bread Company yesterday and ordered a blueberry bagel (toasted and sliced).  I have a cup that allows me to get free coffee, so when the woman at the counter was slicing and toasting I went got myself some dark roast.  I chatted there with a woman about the fact that light roast actually has more caffeine than dark roast.  As I went to the counter I saw someone I recognized, said "hi," grabbed my bag and headed out the door.  It was half-way to work when I realized I was now a criminal.

This morning I went back and tried to pay for yesterday's bagel but she wouldn't let me.  I think she wanted me to live with my shame.  I put the appropriate change into a can collecting money for a kids cancer camp.

I watch American Idol. Yes, I watched most every episode this year.  Those who think I am all counter-culture can express their shock and disgust.  I enjoy hearing them perform - they were especially talented this year - and we watch as a family.  You must remember that I started college as a voice major, so I do like to hear good singing.

I was kind of pulling for Adam (his last name is almost the same as mine), but I thought Chris and Danny were worthy as well.

Sorry to those who now think less of me.

Our office allows drug reps to visit and give samples.  We even have them give us lunch. I know there are some who think that this is the hight of immorality, but I have found them to be quite valuable.  We have done our best to keep a limit on their access to us - they are not allowed to detail us in the hallway, only when they bring us lunch.  Only 1 rep at a time and no more than 6/day (never more than one from one company).

We have a person on staff who is dedicated to getting patients medications when they can't afford them.  She will work with the reps to find a program for them and will give samples when possible.

Why do we do lunch?  One main reason: for our staff.  I actually skip it often because I get fat if I eat too much at lunch.  Their finances are tight and so supplying them with lunch saves them money.  The docs will generally tell the flat truth to the reps ("I dont prescribe your drug very much").  I do find that they have brought me good information at times.

Our practice has always been a lower utilizer of brand drugs when we have been measured (mainly United Healthcare), so I don't think this has had an undue effect on us.  Still, the conscience nags when others feel that pharma is the spawn of satan.

I have checked my blog in a patient room. During the more acute compulsive blogging phases, I have checked traffic during a lul in the exam room.  I do actually feel guilty about this and have stopped doing it.  I have NEVER twittered in the exam room, however. 


There.  I hope my bones don't waste away now.

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