Blogging Again

Returning Home
Leslie K. Price

It has been nearly a month since I last blogged and for the month prior to that, had found myself with less time to devote to this pursuit than I would like.  In the ebb and flow of life-between the challenges of work, family, and personal needs-somethings rise up and others fall to the back by necessity.  Once the pause happened, I felt that I would only return when I felt I could potentially return to regular entries.  I am hopeful that I now can.  How did I feel when I wasn't immersed in the blogosphere?  I missed the outlet for the "connections" I made while seeing patients and carried on my day to day clinical practice.  I dearly missed writing and the reward that comes from completing a creative endeavor.  I felt I had set aside some good friends, even though these are friends I know only from their writing and their "profiles".  On some levels, I felt unburdened of the "deadlines" I had set for myself for writing and I realized (AGAIN) that the blog is for me-an outlet, a connection- and not an obligation!
So I return.  Hopefully stronger than before, with renewed vigor and interest.  I hope you are still out there reading...

End of Life: Should we Mandate?

Recently I floated the idea that one requirement of Medicare enrollment should the completion of some type of "End of Life" document-at a minimum a Living Will and a Health Care proxy (with a regular renewal/update also required).  Everyone knows that too many health care dollars are spent in the last hours, days and months of life because (just a few of many reasons):

• No discussions have ever been had with the one who becomes critically ill (too depression, too sensitive, too...)
• Family members dislike the burden of decision making (are we killing Mom/Dad?)
• Physicians are ill-trained to confront the challenging issues
• The unexpected too often happens

The idea was largely either ignored or dismissed because:

• Promoting this will seem "cold", uncaring
• We can't impose this sort of thing, it is too individualized
• How could we enforce??

Recently, a California Study clearly demonstrated that using end of life documents that are carefully constructed does indeed save tons of money AND improve patient and family comfort with the end of life process. Has the time finally come for such a mandate?  I think the answer is YES.

Further reading:
Daily Finance: Costs Too High
Kaiser Health News
Cost of Death Video

Blogging for Fun

Have read a handful of posts lately apologizing for being "absent" from the blogosphere for one reason or another. Certainly there are individuals who blog for a living but otherwise I think our blogs should not bind us or add guilt to our lives (most of us already significantly juggle plenty of things to need that). It reminds me of all my friends and family who regularly swear they will start to keep a regular journal and start up very diligently (ofter just after January 1 or their birthday) only to see it fade away quickly because in the end, there were other things.
I have enjoyed my blog enormously and after a slow start did realize that making a commitment to regular entries was the only way to engender value and reward for me (and potentially my readers).  That strategy has worked well in providing both structure and limitation of guilt. But like the working mother who won't apologize to her children for working, I vow never to apologize for allowing other components of my life to take priority over blogging if that is necessary.
Hope you are all enjoying the remarkable spring that we are seeing here in New York (pictures to follow soon).