Bored?  Add procedures!

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Many of you have heard or read me discuss the many reasons to add procedures to your value proposition of your DPC clinic. In 2018 Dr. Tomsen and I did a talk about expanding your scope in DPC, and some of the reasons we cited were:

  • It’s the right thing to do
  • Adds value
  • If you want something done right…do it yourself.
  • Generates referrals and retention
  • Job satisfaction, lifelong learning
  • Adds potential additional revenue

But today I realized Nick I left one important bullet point out: It’s usually really FUN.

Today’s procedure was a reminder of that fact.

Three years ago our 31 year old patient put a homemade M-80 in a Pure Leaf Iced Tea bottle, lit the fuse, screwed the lid on and threw it. He did not throw it far enough. 

Of course I 100% support and regularly participate in such fun, wholesome explosive-related family activities. However, I also endorse employing some modicum of common sense safety precautions–an idea about which I believe this patient was somewhat less enthusiastic. 

Let me start by saying that the M-80 he made must have been LEGIT. This wasn’t one of those lame firecrackers where the bottle busts open and sure it’s loud, but the bottle still looks like a bottle that just kinda got violently ripped open, and nobody in the vicinity feels compelled to quickly self-assess to see if they need medical attention. On the contrary, this bottle turned into a thousand tiny parts in a nanosecond. RESPECT. 

Plastic shrapnel peppered our new patient, poking holes all over his clothes and only thanks to the providence of God not poking holes in his eyeballs. Multiple pieces broke the skin, but only one piece actually got through to the sub-q. And there it sat for 3 long years, presumably infusing his arm with a delightful chemical bouquet of sulfur and aluminum (assuming he makes his M-80s the way I was trained), microplastics, and maybe a couple of molecules of iced tea. 

Today, 3 years later, he says to me, and I quote: “This chunk of plastic in my arm always bothers me when I fish.” 

So after looking it over with the ultrasound today, I removed the foreign body from its 3 year resting place. Once I cleaned all the schmutz off of it, it was quite sharp and spiky–a 3-dimensionally stellate piece of plastic about 1cm in widest dimension. I was surprised he put up with it for that long, honestly. I don’t know, maybe he just wasn’t fishing that much.  

At any rate, he’s glad to be rid of it, has a souvenir with which to educate his son on homemade fireworks safety, and considering this excision was included with his membership, he 100% gets the value of DPC.

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About Vance Lassey, MD

Dr. Lassey earned his medical degree from the University of Kansas School of Medicine and completed his residency at the Smoky Hill Family Medicine Program, where he served as the chief resident. He went on to practice rural inpatient, outpatient, emergency room, and obstetric care, in Holton, Kansas. He found the calling he loved to have been hijacked by middlemen. Stuck in a broken system, mired in bureaucracy, clicking boxes, coding, not seeing his family, and hearing patients complain bitterly about medical costs he had no ability to control, Direct Primary Care (DPC) became the solution for him, his family, and his patients. He is passionate about restoring the physician-patient relationship, bringing transparency and sanity to medical costs, and advises physicians around the country on how to get out of the FFS system. He serves as an Assistant Clinical Professor at the University of Kansas School of Medicine, is the recipient of numerous clinical and teaching awards, and is a founding member and the past President of the Direct Primary Care Alliance.