Quality

I am seeing four new patients today that were sent from one physician - an orthopedic surgeon. Three of them are for nerve conduction tests, one for Restless Legs Syndrome. That is a lot of referrals from one person. I guess he thinks I'm taking good care of his patients. I used to have a lot of physicians who sent a lot of patients over here before the politics changed so dramatically. Now there are less. It was difficult to think that people wouldn't send the patients here over business reasons rather than who would take the best care of the patients.

I changed the practice to try to be able to get patients without relying on physician referrals, because I had no choice. Now I don't depend on them. I'm still working on practice building. It's hard, but it's good. It's good to do it on your own.

Now I find myself happy that this physician is loyal and lies sending people here. I feel "proud". This is something I have to watch. It isn't any better to think good things that depend on others than bad things. I have to be responsible for the determination of my quality. I have to know that I'm good at what I do because I'm good at what I do - not because someone else thinks so. Of course, some people have to know that they're right even when the whole world is against them. I don't think I have that sort of insight or that sort of strength. But history teaches us that this happens sometimes. Ghandi must have seemed ridiculous at the beginning, claiming that he could gain independence from Britain with non-violent protest. He changed the way the world thinks about non-violence, though. He somehow knew that he was right in the face of everyone thinking he was wrong.

There is still no reasonable way to measure physician quality. People try to do it all of the time. It's just about impossible.