I've posed this question before - about whether your doctor has a right to fire you.

I've written articles about doctors who blackball their patients, but most blackballing is based on the fact that a patient becomes so difficult that the doctor no longer wants to tolerate him or her.  It's called "denial of care." Some of you have even shared your stories about being denied care by your doctor.

However -- this question actually comes from a magazine that is subscribed to by physicians - not patients.  And the question the doctor posed was, Can I fire a patient who refuses to pay his bill?"

Turns out that most states have a specific process doctors must take to dismiss you as their patient, no matter what the reason.

But the reason I ask the question today is this:  Suppose you work hard all week and at the end of the week, your boss decides not to pay you.  Is that fair? That's the effect on a doctor when he or she doesn't get paid for appointments.  It's not fair.  And honestly, I find it sad that a doctor would even need the question about whether he or she can legally dismiss a patient who doesn't pay his or her bill.

Yes, there are reasons bills don't get paid -- I understand that.  Of course there are just as many people who can afford to pay them, but choose to use their money in some other way (not staples or shelter, but video games or cell phone bills perhaps)...  but it seems only fair that if we ask for service from a professional, we expect to pay for that service.

Although, of course, this problem is uniquely American.  In another country, we wouldn't even ask the question.

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Photo © Arvind Balaraman - Fotolia.com

OK -- FUN might be a bit of a stretch -- but I've been sent links to some videos with some great messages for helping kids understand why hygiene is important and to help parents understand how to protect their kids from flu.

Here's a run down and links to the videos, which run for only 30 seconds to 1+ minutes each:

•  DocRoc Music Video -- Dr. Mache Seible's 5 Steps to Avoid Swine Flu

•  This one is called Moon Landing (actually looks like a Halloween Costume!)

•  The Gambler is a message for parents, as regards their kids.  (Note -- be careful if you are allergic to peanuts!)

•  The least entertaining, but with an important message, Spring Lockdown makes its point, too.

It makes no difference whether you're talking about H1N1 swine flu, or seasonal flu.  Good hygiene, and keeping our children protected is paramount.  These videos may be mildly entertaining, but I hope you'll take their messages seriously.

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Screenshot from the Moon Landing Video © National Foundation for Infectious Diseases

An article that turns the idea of medical opinions on its ear -- first opinions, second opinions and sometimes more - crossed my email. I share it with you, because I'm curious if you agree. I have a feeling that most, if not all of you, will concur wholeheartedly.

Penned (or is that keyboarded) by Lisa Gualtieri, PhD, a health communications professor at Tufts University, it suggests that many patients have turned opinion-seeking behavior upside down. We no longer seek a first opinion, then a second opinion from a physician. No -- now we seek a first opinion from the Internet -- then a second opinion from our physician. If we look for another physician opinion, it may be the third opinion we get.

Dr. Gualtieri also explores the fact that most of us don't own up to that fact to our physicians. Further, that physicians don't ask either. She provides some explanations for the lack of inquiry by the doctor -- not enough time, no training to do so, and so forth. But she also reveals why we patients don't tell our doctors. We are afraid we can't pronounce some of the more difficult words, or feel that we are being disrespectful.

There is much more to this article, which you can read here: The Doctor as the Second Opinion, and the Internet as the First.

But I'm curious. Is this how YOU access the medical information you need? When you experience symptoms do you make a bee line for the phone to make a doctor's appointment? Or do you sit down at your computer, do some Internet research first, then make your own diagnosis or assessment before you call your doctor?

Then - if you do scope out possibilities on the Internet, do you tell your doctor?

Let's see if our About.com Patient Empowerment family reflects Dr. Gualtieri's thoughts. Take this poll and let us know.

Then, if you need some help owning up, learn how to approach your doctor with what you have learned on the Internet.

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Photo © killerb10@istockphoto.com

In 1999, the Institute of Medicine, a highly respected public-private, non-political, research-based, health and healthcare think tank in Washington, DC issued a report on research it had done called, To Err is Human. The research had explored the numbers of medical errors that took place in the United States, and they reported that somewhere between 44,000 and 98,000 Americans DIE each year from mistakes made by their providers.

That's DIE. That doesn't even account for those people who are injured and possibly debilitated for life -- at the hands of the very people who have taken an oath, and whose job it is, to help improve their health, life and limb.

The idea behind the report was to bring awareness, so providers and provider-organizations would begin looking at ways to decrease those horrible numbers..... however.... Fast-forward these 10 years and the numbers have not decreased at all. In fact, today more than 100,000 people per year die from hospital-acquired infections alone. That doesn't even account for other ways people are hurt or killed by providers and the system, like surgical errors, or addicted doctors or even my own personal experience, misdiagnosis.

Put another way, since the original report, well more than one million, that's 1,000,000 people! have died, and tens of millions have been injured by the medical system in the United States. It's unfathomable, and it's unforgivable.

Consumer's Union's Safe Patient Project is holding a forum later this month, to review theses more horrible statistics, their causes, potential for improvement and more, and you are invited to attend. Although the forum will be held in Washington, DC, it will also be webcast so anyone who is interested may listen and watch the procedings. Called To Err Is Human, To Delay Is Deadly, it will be held November 17, 2009 from 10am-3:30pm EST.

The speaker list is like a who's who in the world of public safety. From professionals who deal with public safety issues daily, to the loved ones of people who have been lost to medical mistakes, they'll be there discussing the report, and the 10-year report card.

You'll need to register to attend the forum by web, or you can get more information about attending in person if you're so inclined. I'll be online with my ears open all that day. Won't you join us, too?

In the meantime, you can read more about the 10 year report To Delay is Deadly.

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