I am a registered nurse working at Sarasota Memorial Hospital in Sarasota FL. I have listened with much interest to the pass year’s campaign promises, particularly those concerning health care. Working in the hospital as an acute care nurse I get to see first -hand the needs of the uninsured and the underinsured and the financial strain that their needs are placing on the hospitals. This problem is only going to get worse as our economic problems worsen and the number of unemployed increases. This population usually does not have a primary care physician so they come to the emergency room for their health care needs, all too often they end up admitted to the hospital because lack of follow-up care has caused their condition to worsen. When they have to be admitted to the hospital their hospital stays turn into weeks, sometimes months to assure that they receive the full course of the antibiotic therapy required. Those patients covered by some form of health insurance are admitted, stabilized and then discharged with proper follow-up care; their discharge often takes place within three days.
I have been discussing this growing problem with other health care workers, nurses, doctors, etc. and I have developed a plan, which if implemented with as little red tape as possible, just might help the situation.
I propose that the government set up small health care clinics in residential neighborhoods, not unlike the old corner grocer. These neighborhood clinics should be able to provide basic medical care and minor emergency care. They would be able to triage the patients and send those in need of hospitalization on to the nearest emergency room, sending their paper work with them to streamline the admission process. These clinics should be within blocks, not miles from the population that they serve. They should be able to provide, child care for cold, flu, vaccinations

and well child check. Prenatal care, EKGs, basic x-ray and wound care as well as daily IV antibiotic therapy if indicated.
This sounds like a very lofty proposal and very expensive, but I propose that there are ways to contain the costs. First, the clinics can be small, housed in existing building, our banks are carrying many foreclosed houses on their books. They could be approached to sell some of these properties at a greatly reduced rate. Let’s face it, if one bank does not want to co- operate then perhaps the one down the block would be interested in taking advantage of the offer. Second the government would provide the equipment and medications needed to effectively run the clinics. Third it would become part of the licensure requirement, that if you are licensed to practice within the state, either as a doctor, nurse, respiratory therapist etc, then you are required to work free of charge at least one day each month in the clinic to which you have been assigned. These clinics need to be open 24 hours, and at least Monday thru Saturday, which is not difficult to accomplish, because health care professionals work days and nights, they would just be assigned their usual shift. Lastly, the people who live in the community that the clinic serves will be responsible for maintaining it, like keeping the interior clean, maintaining the landscaping so that the building does not become an eye-sore in the neighborhood. That way the community assumes ownership of their clinic and takes pride in it.
Perhaps this plan or something similar has been proposed in the past, and has fallen on deaf ears, but the time has come to put self serving greed behind us and reach out to our communities. Everyone who lives and works with in a community shares in this responsibility.

Theo

Don't Ignore Warnings From Your Doctor
On May 29th of 2008 I checked into the hospital to undergo a right radical nephrectomy, to remove a multi-cystic clear cell renal carcinoma which had lay hidden and growing in my right kidney. Days before surgery, I had to go in for pre-register and do a few pre-surgery tests. As I sat in front of an over educated nurse explaining the steps that I would be following I was as usual, not paying much attention to what she was saying, but more the expression on my wife’s face. Once again I caused undue distress to my darling wife.
But lets not jump ahead, lets go back a year when my doctor told me that that they had found microscopic blood in the urinary sample that I had given. He asked ask me to please follow it up with an urologist. Did I? No! I hate going to see doctors and one thing was for sure, I was not interested in meeting another. I ignored his warning telling myself that of course there was blood in my urine I had suffered with kidney stones for years so as far as I was concerned there was no problem.
The following year when I returned for my yearly checkup, my doctor who I have the greatest respect for, made an issue of the test I had a year prior. He demanded that I would go to see an urologist even though there was no blood in my urine at this time. Being more stubborn that I he talked me into promising him that I would go to the urologist that he recommended.
Stuck with the promise I had made, my appointment with the urologist became a reality. The news I received was not good. The urologist found a large growth in my right kidney and surgical removal of the kidney was the only option.
If I had waited longer to follow the recommendations of my doctor the growth within my kidney could have burst and metastasized throughout my body. So questions come to mind.

• Is it important to find a doctor that you trust totally for taking care of
your well being?
• Do we listen to our doctor without question?
• Do we need to follow our doctor’s advice out of fear or just common sense?
• How does one overcome the fear of finding more cancer?
• Is it possible to find enough support to get through the ordeal?

I would like to hear your comments on my experience. My next article will discuss the experimental drugs I am using in a clinical study.

Theo