Yet Another Motorcycle Thought….

WAIT! Before you move on to surfing Facebook or searching for that next internet purchase, give this article a few minutes. Even if you do not ride you will encounter a motorcycle on the road soon as the season is just getting underway, besides a peek into the psyche of motorcyclists is bound to be just a little entertaining!

Let’s start with an industry in decline. Motorcyclists exhibit nearly rabid brand loyalty. This industry produces motorcycles for nearly every conceivable application from cruising sedately down an interstate in relative luxury to flying off a mogul on a high winding dirt bike, executing a 360 before landing hundreds of feet from your departure point. Harley Davidson’s latest issue of their periodical aptly named H.O.G., (Harley Owners Group) printed the results of an informal poll where enthusiasts could choose their preference, breathlessly running through switchbacks and curves or the long straightaway. It was a virtual wash. Fortunately most bikes today permit traveling over both surfaces. Bikes are loosely classified in broad categories; Adventure, Cruisers, Dirt, Cafe Racers, Commuters, Choppers, Enduro, Moto Cross, Dual Sport and Naked. No, naked is not the obvious, rather referring to the lack of accessories on the machine. Google Triumph and look at their venerable 650 to get the idea. We can add electric to this line-up as there are two very fast electric bikes in production as I write. I am hard on millennials, admittedly likely because I am envious of their incredible array of ways to spend their discretionary time. A perusal of the current motorcycle market clearly indicates they are not entering the world of motorcycles. They would rather spend several thousand dollars on a carbon framed bicycle, another incredibly diversified market. Or technology.

Sorry for the digression…..

There are a good number of motorcycle manufacturers around the world. America does not have this market cornered and never really has. The Japanese and Europeans are building gorgeous, practical and inherently reliable machines, mirroring their experience in producing automobiles. Sales of motorcycles in Europe and Asia are sailing right along, perfect conveyances for the narrow road infrastructure in their homelands. Not so here. I stopped in an Indian motorcycle dealership one day last week. If you can’t ride one in this weather, you can still look at ’em. I noted they had a good number of holdover bikes of 2017 and 2018 vintage, many of them the same bikes on the floor during my last visit nearly a year ago. I ride a Harley, a big, heavy cruiser with all the amenities. Harley and Indian dominate the made in America segment in our part of the world. They are facing a rapidly shrinking demographic and are obviously perplexed as to how to deal with it. The generations these riders represent are rapidly parking their quickly depreciating asset as folks my age do not hold one of these 900 pound behemoths up at a stoplight as easily as we once did. My generation also doesn’t replace their bikes with any degree of frequency, the result of stickers easily ranging up into the 40s. You have to rack up a lot of miles to justify this many Benjamins.

When you venture out on a sun soaked spring afternoon and encounter a motorcycle, smile, wave and give him room. Notwithstanding the very occasional millennial on his new, Nippon pocket rocket, the rider you see is likely near the end. If he is astride a big bore trike, he has acknowledged his love for motorcycling and is attempting to get as much saddle time as he can before he backs it into the garage for the last time. Harley Davidson recently participated in a study of the brain waves of motorcyclists in an experiment coordinated with UCLA scientists. They were looking for the positive mental advantages and responses to the motorcycle experience. I wish them well as they crunch their data. I suspect that most of us that ride cannot account for the silly grin on our faces when we strap on our helmets and fire our steeds up.

I can help them, without the necessity to pee in a cup and wear an electrode bristled cap under my helmet. We ride because it is a hell of a lot of fun, something you have to do to understand. A thrill that our younger generations are choosing to take a pass on……

Weather, Meteorologists, And The Master…….

They are going to get the temperatures right this time, really most of the time, but they missed our snow storm today by a scant 4-8 inches, depending on the meteorologist you listen to. Call it climate change or not, these folks with their balloons and satellite imagery still have a hard time with forecasts these days. I am not bashing them. As a novice pilot I have spent a lot of time pouring over charts and data, but am careful to note the locations of various inviting airports along my flight path should their prognostications fall short. When in the air, it is all about wind and clouds for me, not really too complicated. When it doesn’t look good, I don’t fly. It is that simple. Fishing presents another, different weather challenge. The following story illustrates my point.

The exact date is of no consequence. Suffice to say it was sometime in the very late 90’s on an impossibly clear April morning that three good friends and I enjoyed a cup of coffee before launching our boats on Truman Lake. In those days, we were all still gainfully employed and when you took a few days off to fish, usually clustered around a weekend, you went. We were convinced that is why a fellow named W. L. Gore invented Gore-Tex back in 1969. This miracle fabric could repel liquid water and at the same time allow water vapor to pass through. It was during this time that cell phones were evolving with the ability to capture somewhat crude but useful radar images of storm fronts and such. One of our group, Mark Musso of Special Olympics fame, possessed such a phone and we gathered around to look at a loosely formed storm front that was some distance to the west of our location. These radar images were not as sharp as today and the accompanying script did not mention the speed of this squall line. It also failed to mention the expected intensity. With this information in our heads, we launched and began the ride from Berry Bend to one of my crappie haunts, Wright’s Creek. We were not alone, as the crappie were rumored to be biting, resulting in a line to launch our boats. Finally, we were underway, turning west on Truman Lake for the 25 minute boat ride. Being courteous, I throttled back my boat to provide guide service to the second, less powerful boat. I noted the “gathering” clouds to our west and made a mental note to immediately break out the rain suit when we reached our destination.

Wright’s Creek is a long tree filled creek and I was the lead boat, again coursing a route through the trees and such when our entourage gathered boat to boat to discuss the rapidly advancing squall line. Not being meteorologists, we quickly deduced this was not an ordinary spring thunderstorm and a decision was made to get back to the ramp and pull out until things settled down. Truman is filled with dead trees with limbs big enough to easily kill you when they become waterlogged and snap off. With unbelievable lightning just to our west and a freshening breeze kicking up, we retraced our route back to open water and made for the ramp. The front was catching us and I abandoned any gentlemanly instinct and ran, wide open, for the ramp, trusting that Ralph, the driver of the second boat could remember the way back. He told his partner, Mark, that when he saw the rooster tail come up behind my boat that it would be the last time they saw us until and if they made it back to Berry Bend. Our troubles were just beginning.

When we made the wake buoys at Berry Bend, we were one of easily 30 boats who had made the same decision to pull out. Lightning was striking both sides of the bank where the ramp was located, leaving the acrid smell of electricity lingering in the air. It was just a matter of time before one of the boats was struck. I have never seen such intensity in my life, with the issue complicated by driving rain and wind. I managed to get my brother-in-law, Dennis to the courtesy ramp and he ran for the truck, in a lot located straight up the side of steep hill. To suggest there was confusion on the ramp would be an understatement. Folks were panicking, backing into one another and up onto the courtesy dock, creating quite a show. Soon, Ralph heaved into sight, white knuckled, and worked his way to the dock sending Mark for his tow vehicle. He then hunkered down and drifted toward my location, with lightning still flashing all around us. When he came along side, I suggested he get his boat, made of aluminum, away from me as it was surely a lightning rod. We shared a laugh but understood the gravity of our predicament. It was at this point, in the height of the storm, that a fisherman came in, obviously panicked, and ran a beautiful Ranger boat up a rocky bank, before jumping out and running toward the lot. It was that bad.

Finally, the mess on the ramp abated and both of us managed to trailer our boats and make for a little cafe not far from the the launch point. We were wet, cold and still wide eyed from our experience that morning, and enjoyed a big breakfast and copious cups of coffee. The storm front passed, however, the radar indicated there were additional squall lines developing to our west and we put our recent experience to good use. We stopped in to visit our custom jig maker where we waited out the next storm. Later that afternoon, we did venture back out and all caught a number of nice fish. I have a healthy respect for thunderstorms, having lost an uncle many years ago to a lightning strike while standing on his porch after a storm had “passed”. My experience that morning enhanced that respect.

Today’s meteorologists, like Gore-Tex are pretty good, but they can’t stay ahead of Mother Nature, who serves at the hand of the Master. Mother Nature is just one of the tools the Master employs to send a message and on this day, I got the message!

Have You Got A Minute?

I ask, because apparently, these days, doctors and dentists do not. The way that medical care is delivered these days, from a patient’s perspective has either changed dramatically, or I have exceedingly bad luck in selecting caregivers to see me through the golden years. My recent experiences have led me to the inescapable conclusion that health care professionals are on the clock, leaving little time to know their patients beyond their name and the ailment or issue that has led you to them. If your current doctor or dentist knows something about you, don’t let them go as they are a rarity today. I am an observer, having made a good living through observing and addressing human behavior. The following musings reflect my observations of the changing landscape in healthcare.

We have relocated to Springfield, Mo. from the Lake of the Ozarks area. Springfield was our favorite stop during my years with the Patrol, a town just big enough but not too big. I would describe us as urbanites with a flair for the country. I enjoyed a long association with a terrific primary care physician in Jefferson City, Missouri, easily accessible from the Lake Ozark area. I had also established a great relationship with a dentist in the Lake Ozark area. Both of these providers knew me as a friend as well as patient and trips to their offices were something I looked forward to, assuming the trip was not as a result of something painful, needing immediate resolution. Reluctantly, I abandoned both of these practitioners and selected new doctors in the Springfield area. Springfield is big enough that making a selection should not be that difficult.

I selected a physician that is currently in our insurance network. He is a PCP, with just the right amount of experience, located within a large office complex close to where we live. My first experience with him was in the form of an annual physical, which was conducted in a matter of 15 minutes, start to finish, with most of this time spent with him typing away on a computer keyboard. I have a rebuilt heart which, as far as I know, functions perfectly, but that does require some degree of attention. This doc walks into and out of the exam room without a stethoscope and has no idea what is going on with my pump beyond the notes that I have provided him before the visit. He checked my current meds and if I asked about an issue (arthritis) he immediately referred me to a specialist, based only upon my raising the issue. I suspect this doctor is a very smart practitioner, but makes little eye contact and obviously needed to move on to the next patient in an expeditious manner. He stands in stark contrast to the doctor in Jefferson City who knew me very well, was always courteous and conversational, as well as genuinely interested in my state of health. Perhaps the attention from my Jefferson City doctor was the result of his considerable investment of professional expertise in my health over the years.

My first visit to my new dentist involved an initial exam and time with his hygienist for the normal 6 month cleaning. It was as expected, with the exception of his noting a very small cavity and a missing filling on top of a crown (covering an implant) that needed attention in a subsequent visit. The second visit was an exercise in rapid fire dentistry. The hygienist was tapped to make the numbing injections, one on each side of my mouth, one upper and one lower. She was very good with the needle, and I felt nothing. The single injection on the upper resulted in a very slight numbing, and when the drill touched the tooth, I immediately knew that sufficient numbing had not occurred. Three injections later, by the dentist, and the tooth was asleep and the filling placed. The dentist manned the drill leaving the rest of the work to his assistants. He then came in and smoothed the filling and I was out of there. Dentistry is evolving and I have no problem with the doctor’s staff doing things that only dentists did a few years ago, but his time behind my chair was exceedingly limited as he was busy going from chair to chair, almost running, to keep up with his patients. My Lake Ozark dentist was also a busy doctor but I was never rushed through his offices. He and I are also friends……

My point is this. Time is money and money is tightly regulated by insurance companies and group practice mandates, however, patients also matter. Studies have shown that, on average, doctors interrupt patients within 11 seconds of the patient’s attempt to explain what is wrong with them. Why? Time. The push to see as many patients as possible in a given time period is destroying the most sacred relationship that exists outside of marriage. In large multi-doctor practices, I expect to soon see time keepers in the hallways, computers in hand, carefully managing the time for each patient and knocking on an exam room door when time is up. If you are a doctor, do us a favor. Put the damned computer down and talk to us. Feel free to make an unsolicited observation or recommendation regarding our health and well being. Take a minute or two to listen to us. We are depending on you as if our life is at stake.

A visit to your doctor shouldn’t make you feel as if you are on Shark Tank. Even Shark Tank contestants get more than 11 seconds…..

What Is Happening To Harley Davidson…….

If you peruse the financial pages these days, you will see that iconic Harley Davidson is in the midst of a decline in sales and losing market share to it’s lifelong competitor, Indian Motorcycles. This observation is limited to that segment of heavy iron bikes, say 601cc’s and bigger. I am not a market analyst and am hesitant to jump on the bash Trump bandwagon and hold his tariffs responsible for the decline in sales. Rather, I take a more pragmatic approach to the issue of declining motorcycle sales in America. So it is with tongue in cheek that I make the following observations. I also proudly ride a Harley Davidson motorcycle.

Baby boomers are the sweet spot in motorcycle sales, and baby boomers are getting too damned tired and out of shape to hold a Harley up at a stoplight, much less back the beasts up a few feet in a parking lot. Did I mention the decline in baby boomer numbers? Next up are the generation X’ers, and they tend to struggle with their identities, lost in the confusion that exists between them and the boomers. Consider the choice between a motorcycle and the latest cell phone offering from Apple, with it’s plan costs that often exceed the payments on a Harley and you can appreciate their dilemma. I should mention that a Harley-Davidson motorcycle will last a hell of a lot longer than an I-Phone.

Enter the millennials. Millennials and heavy iron are just not compatible. When a millennial’s boomer father suddenly departs this world and leaves his big iron to the care of his millennial son, the trouble begins. If the son can pull his pants up far enough to straddle the motorcycle, he is sure to drop the bike in the garage as he struggles to get his cellphone to his ear. Assuming the bike doesn’t break his leg or pin him between the bike and a shelf full of helmets and riding gear, he is pretty well done. The bike will be sold to an aging boomer at a steep discount. Should the millennial survive the first attempt to straddle the Harley, he will immediately notice the absence of a joystick and touchscreen, thoroughly confusing him as to exactly how the thing works. He will instantly come to the realization that his 10 years in college, pursuing a degree in the Humanities, social Studies or Gender studies have not prepared him for actually operating a wheeled conveyance that is also equipped with a, gasp, clutch and manual transmission. The more adventurous millennial, who actually participates in an exercise related activity beyond clinging to a flag pole, shaking uncontrollably, will retrieve a helmet from the shelf and slip it on. This will end his heavy iron adventure immediately, as the helmet will have tugged at his nose and eyebrow rings, and, again, precluded him from answering his ever present cell phone. It is just as well, as the millennial that survives these initial trials and attempts to ride down the street, under power, will most certainly kill himself when he attempts his first selfie at 30 miles per hour.

Harley Davidson has probably not figured these things out and, frankly, I have nothing when it comes to solving their marketing problems. Their strategy is to attract thousands of new riders over the next few years and damn their bad luck in the form of Mr. Trump’s manipulation of the world economy. To this end, they are rolling our their first legitimate electric motorcycle, a “green” machine that will haul butt and appeal, perhaps, to the generations they are losing. It may appeal to the millennials, but has insufficient range for the open road guys that still exist. It may be perfect for the run from the flag pole to the coffee shop or “medical” marijuana dispensary, but has little appeal to the heavy iron guys that I am proud to associate with. The smell of exhaust and the feel of motor oil on our hands while we blast down the highway, destroying what little hearing we have left, is a thrill that will soon be extinct.

Maybe Harley-Davidson should consider a trophy for each millennial, you know, a participation award, to be conveyed at an elaborate ceremony to each millennial who buys a motorcycle, or an ornate bong, lending dignity to the medically necessary doobie…..

….or maybe, just maybe, the millennials are a hell of a lot smarter than we are.

The Deeper Meaning of Birthdays……

Today marks my 69th birthday. I don’t mention this to encourage the perfunctory birthday wishes, rather to talk a bit about the deeper meaning of birthdays, at least from my perspective. Birthdays, as you age, serve to remind us of good and bad fortune, as well as provide a kind of yardstick in life. At my age, the raucous parties of years past, way past actually, are nothing more than memories of a time when time really didn’t matter. Today’s occasion is a time of quiet reflection on the seriousness of time and mostly good fortune. Let’s have a look.

The photograph accompanying this piece is of a white coffee cup given to me by Sharon, my wife and a lady of extraordinary patience and uncanny perception. On the cup you see five Labrador Retrievers, with their names inscribed beneath them. There is Truman, Abe, Zeke, Micah and the current household CEO, Tazm. They are sitting easy, staring out across their favorite environment, water, thinking things that are known only to the minds of devoted retrievers. Four of these guys are now a part of the next life, leaving Tazm (named after the first four using the first letter of their names) to bring peace to the Johnson household. The cup is a priceless reminder that for dogs, birthdays are a very big deal indeed, as the Master has seen fit to seriously limit the number of these occasions on earth. I chose the late Charles Krauthammer’s last book, “The Point Of It All” to elevate the cup for the picture. The book seems particularly relevant to the point at hand. At some point, known only to God, I hope to spend time with these pups again…

Today’s birthday finds me incapable of accomplishing so many things taken for granted in the days when birthdays were not important. I spend more time with specialists than I would like to, attempting to preserve the function of arthritic hands and feet, with a grouchy back thrown in for good measure. The decline is palpable, easily measured over the course of this past year. A quick review of the impact of aging, just one year, reveals that I am without a bass-boat for the first time in many years, have suspended my flying career at least temporarily, and no longer have the urge to trample up and down the hills and fields in pursuit of deer and other game. My feet complain after a modest gym workout, much less working a climbing stand up a tall, straight oak on a hillside. Am I complaining? Nope, not at all. Instead of challenging physical feats, I am now enjoying America from the comfort of a RV, stopping in various previously unexplored places to dive into the local custom and culinary scene. Our adventures have shown me there is no need for dominance in a relationship, instead I have finally entered into a sort of partnership with Sharon in which decisions and plans are the result of true collusion. It is important to note that Sharon is a master of manipulation, allowing me the satisfaction of thinking that I am making decisions that she has carefully orchestrated beforehand. Simply put, she is smarter and thinks much quicker than I these days and is critical to my existence as time wears on. In addition, she does most of my remembering for me.

This birthday brings the jolting reality that I continue to lose friends and acquaintances at an accelerated rate. I have two dear friends who are here but are declining in terms of cognitive ability. These folks are living through the indignity of diminishing mental ability, a cruel chapter in lives so well lived. Is this me next year? Is my inability to remember where I placed my keys an indication that I am going to be in trouble next year? Is leaving my hat in a restaurant in Tallahassee another sign that I might be in trouble? Recall was perhaps my strongest suite, leaving me to wonder if my future is sitting on the dock with the pups, staring out over the water. I have lost, outright, several other friends who were permitted the grace of simply checking out without the drama of slow decline.

Through all of these self assessments, I remain optimistic. I will find a way to crappie fish from someone else’s boat. I love to trout fish, but have devoted little effort to becoming a trout fisherman. I love travel and relish the opportunity to settle into a dive or diner tucked away in some backroad locale to sample their culinary creativity. I still chill when I step onto a Civil War battlefield and contemplate the brutality of that Great War. I continue to enjoy casually dispensing sarcasm, usually directed at the current political clown show and choose to not be a hater, at least of people. I enjoy my friends and have moved on from the vitriol that accompanied betrayal in years past. I am enjoying watching my grandkids as they achieve and am determined to see them avoid the mistakes and traps that only experience can reveal.

As a final thought, birthdays, for me, serve as a reminder that not only am I a little older, but that I continue to be blessed with opportunities to learn, experience, and enjoy life. My good memories crush the bad and I am determined to stay challenged and enjoy life. I believe that if you are not gaining knowledge, you are losing knowledge. If I had a crystal ball, I would pitch it off the mile long bridge into the depths of Truman Lake. Not knowing is truly a beautiful part of life’s ride.

What a hoot!

The Interstate…..

Like a moth to a candle, I am drawn to Interstate Highways. My association with them began in 1966 when I received my first driver’s license in Pulaski County, Missouri. Pulaski County was traversed, east to west, by a crumbling, dangerous Interstate 44, much of it encompassing portions of the infamous Route 66 roadbed. I became a State Trooper in 1972, assigned to Lafayette County where Interstate 70 is the predominate highway feature. Like many troopers, I have countless hours of windshield time scanning four lanes of highway looking for any one of the hundreds of anomalies that occur on our roads. In my day there were few barriers to crossing the median to visit with folks who came to my attention as they travelled in the opposite direction. Troopers develop a special relationship with the Interstate, or any road for that matter, a consideration that has prompted this musing.

Tuesday morning, Sharon, Tazzy and I left Tupelo, Mississippi at 2:30 in the morning, headed for home in Springfield after a great winter break in the Florida panhandle. I was concerned with predicted deteriorating weather conditions in Missouri which prompted the early start on I-22 between Tupelo and Memphis, a road that I had no previous experience on. I can report this stretch of Interstate is in very good condition and traffic was light at this hour. My plan was to negotiate Memphis before the morning commute. Morning commutes, major metropolitan areas and 28 foot Airstreams make for a white knuckle experience that I was keen to avoid. For the most part, major metropolitan road systems are pretty well shot, and we try to avoid them when possible, unfortunately, Memphis was not easily avoided.

Tazzy was asleep and Sharon dozed a bit as my thoughts drifted back to those days on I-70 as a young officer. As I slipped back into an enforcement mode, I began scanning the traffic, mostly commercial trucking for potential problems or “good checks” as we referred to instances where intuition and experience focused our attention. We passed a passenger car, nosed into an embankment, that had not been there long, the likely result of inattention or slumber among other potential problems. There were the customary “high rollers”, folks taking advantage of light enforcement in the wee hours to cruise at speeds approaching triple digits. These days, with the cable crossing barriers, and electronic surveillance technology (fuzz busters in our day), these folks are really flying. They were among our most prized customers. I remember sitting on a ramp an hour or two after midnight and checking a tractor trailer from a major pipeline construction company, hauling a D-7 Caterpillar on a flatbed trailer at 91 MPH. The driver was a gentleman, wearing jeans that were perfectly creased, a western shirt and tooled leather boots. He was prepared to post a sizable cash bond and was pleased to be on his way after the delay caused by my intercession. I also recalled those terrible nights when everything went wrong and death was the result.

As we cruised along, I felt there was something not quite right about this trip down memory lane. In an Eureka moment, it occurred to me that I was missing the voice of our radio operators who were along for every tour in our cruisers. In my day, we had no Mobile Data Terminals to make quick inquiries, instead relying on voice communication with one of our superlative radio operators to make checks on the many things requiring further investigation. These folks were masters at cataloging the innumerable, additional resources needed to support the road officer and assisting with channeling those resources to any number of officers at one time. Their ability to respond to the needs of multiple officers, spread over a wide geographical expanse, often encompassing a major metropolitan area, was uncanny. In those days, radio logs were typed by hand, on paper, as they juggled their responsibilities and communicated with us. I smiled as I remembered that some officers were very busy initiating one check after another, nonstop, which had a predictable impact on the operator’s workload. It was a terrific partnership, resulting in invaluable assistance to the motoring public and long days in jail for many folks who thought their secrets were deeply buried. Lending dignity to the travels of folks on the Interstate was gratifying. I never left hungry or cold children on the Interstate….we always found a way.

Our Interstates are getting old. The wear and tear of millions of miles of vehicular traffic, some of it exceedingly heavy (trucks), is taking a toll. I believe the Interstate system, as envisioned by President Eisenhower, is an American treasure that has been taken for granted, as evidenced by the priority given to it by the very folks who rely upon it. I refuse to travel on I-70 in Indiana, preferring the secondary road system that is, surprisingly quite good. I-22, on the other hand, is an Interstate in it’s infancy. It is a pleasure to negotiate with superior engineering evident just about everywhere. I am a road warrior, and as such, have always been in tune with our highway system, particularly the Interstate system. Pulling a RV will serve to sharpen your sensitivity to our roads and highways. It seems we would rather complain than commit the resources necessary to maintaining our great treasure. Interstates have made millionaires out of folks in the orange barrel and cone business. We need to turn the barrel makers into multi-millionaires. We are losing ground every day we ignore the deterioration of our highway system.

Interstates never sleep. Virtually everyone in America relies upon them at some point, good guys and bad guys alike. In reality, an Interstate is a snapshot of America, rural, urban and alien alike. When I go to my reward, I would appreciate it if Sharon would see to it that part of my final journey on earth is on an Interstate. The sounds of a busy Interstate do not annoy me, rather I view the noise as America on the move.

Doctors, A Patients Perspective…..

It is getting harder to love your doctor these days. This cultural shift has nothing to do with the practitioners competence, rather with efficiency demanded by hospital affiliations and insurers. Americans still love the men and women we trust to keep us upright and taking nourishment, but the trust is becoming a blind trust as we don’t really know them and they know us only in a narrow clinical sort of way. I don’t know about you, but I miss the “old” days when you could look your doc in the eye and discuss the implication of his or her arched eyebrow while perusing your latest blood chemistry report. Various medical groups are very good about publishing the restrictions on and changes to the doctor-patient relationship from the doctor’s viewpoint. Let’s have a look from a patients perspective.

When I began my career as a rural highway patrolman, every trooper in the county knew, by name, every doctor in the county. As an example, my son was delivered by an obstetrician in the county seat, precisely two days after my last contact with this doctor in the emergency room of our local hospital where he was working feverishly to keep a young man alive who had been involved in a car accident. In those days, all of the doctors in the area took a turn in the emergency room, and were surprisingly adept at stabilizing patients for the helicopter ride to Kansas City where a specialist or trauma surgeon took over. There were three practicing physicians in my assigned town, all primary care doctors, two of which were married to each other. I can recall two specific instances of old style medicine that illustrate relationships long since relegated to the dustbin of medicine. On one occasion, having been stricken with some virulent, devastating bug causing me to vomit relentlessly, a phone call and two block drive found me bent over my doctors dining room table, in his home, awaiting the welcome relief of some powerful, injected potion that put me to sleep and dramatically slowed the wretching. On the second occasion, I was attempting to start a metal fence post into hard ground by standing on the “wings” of the post and jumping up and down. My boots were not up to the task, and one of the wings cut through a boot and into the sole of my foot. It was Saturday, and a call to the doctor resulted in his meeting me at his office downtown where he stitched up my foot and made sure my tetanus protection was up to snuff. The point is, doctors in those days practiced medicine, with few of the limitations that today’s highly specialized and efficient medicine requires. There was a personal touch….

This is not a political hit piece, however it should be noted that Barack Obama threw billions at a strategy involving the electronic health record system in use today. His EHR strategy would save billions he said, specifically 77 billion a year, create jobs and virtually wipe out Medicare fraud. Oops. This strategy actually greatly FACILITATED Medicare fraud and crushed many one horse medical practices as the costs of this equipment was prohibitively expensive. These doctors in small group or independent practices were forced into hospital affiliations or otherwise swallowed up by big practices. To us, the patient, evidence of this shift in the personal aspect of medicine is the appearance of your doctor, entering the room pecking away at his or her tablet, making little if any eye contact with you and leaving the room minutes later still pecking away at the computer. If your doctor didn’t adapt, there were instant penalties, on an annual basis, withholding a percentage of their Medicare payments…..already shamefully low. Efficiency? Perhaps, but at what price? It is estimated that ER doctors spend 43% of their time entering electronic records information and 28% actually with patients! Your average PCP now spends, on average, 48 minutes daily just entering clinical data. For us, the patient, the doctor spends considerably less time listening, and examining and more time pecking away.

Recently, I enlisted the services of a pain management doctor, a very nice young doctor, to help with chronic arthritic pain in my back. He spent 11 minutes with me and adjourned to the computer rack at the nurses station, making a record. Our conversation was exceedingly brief and his hurry was such that through an open door to my examining room, as I was putting my shirt on, he asked if I was suicidal or depressed! (He was entering a prescription for a med that I could not take as the FAA will not let you fly if you take it.) I told him no and walked out with a prescription that was useless to me. A few minutes of conversation would have cleared the air on this matter, but he was already in a room with his next patient. It is not about the patient, it is about the allotted time per patient and the necessity to see X number of patients per day to meet your quota.

As a final note. Doctors should know that we see the deteriorating relationship with them, on a personal basis, and don’t like it. There is little that we can do, however. Good medicine requires the sharing of deeply sensitive information with a member of a revered profession who we feel like we know well enough to be entirely candid. Today, with a single keystroke, the information you just shared populates fields in data systems virtually nationwide. For those of us fortunate enough to remember the old days when you could schedule time with a doctor who knew you by name, cherish the memory! Today, unless you are exceedingly fortunate, your name has been replaced by a numerical code, establishing the level of visit and a number indicating your time slot on a computer generated schedule. Do not dare to mention, during a visit to follow up on a sutured laceration, that you have been noticing a swelling on your arm. That is another time slot on another day.

Times have changed and we have to accept that, but we don’t have to like it!