10. See, Say and Do Something: The Doctor Is In ꟷ $0.00

T Michael White MD FACP
Oct 22
7 min read

Updated: Nov 2

ABC-STEEEP

Affordable Basic Compassionate

Safe Timely Efficient Effective Equitable

Patient-Centered Care

Letters to the File

T Michael White MD FACP

www.fixingushealthcare.com

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10. See, Say and Do Something: The Doctor Is In ꟷ $0.00

The WhiteHouse on the Belleair Bluff

Monday, October 22, 2025

Dr. Mike,

A letter to the file…

Reality is catching up with you doctor. All at once: 1) you have a critical, valid concern regarding United States (non) healthcare; 2) you can see a solution ꟷ health care as infrastructure; 3) you are earnestly endeavoring to sound the alarm; 4) few if any are listening; 5) as your concerns darken, you feel increasingly powerless ꟷ the futility thing; and 6) you are painfully aware: seeing something and saying something, you must do something.

And you know exactly what you must do. The moment this ABC-STEEEP ꟷ Letters to the File endeavor is in your rear-view mirror, you will…

Present daily to your community’s center ꟷ the Walmart parking lot;
Set up a shaded, clearly marked booth: The Doctor Is In ꟷ $0.00;
Hope Walmart Management will not call the Sheriff; and doubly hope Walmart Management will provide you with Wi-Fi access;
Post a sign that explains your raison d'être/modus operandi: Dr, Mike is an adult medicine specialist who is making himself available to assist you to organize your health care and position you to efficiently access health care. Dr. Mike will not be directly caring for you; and
To the best of your ability, do that thing you do ꟷ confidentially listen, professionally organize patients’ thoughts (what they are trying to say) and point them in a logical direction.
In this process, you will
- If desired, provide each individual with her/his vital signs: (temperature, pulse, blood pressure, pulse oxygen and height and weight);
- Create and print out for them to keep:
  - Her/his My (Unique and Very Personal) Medical Record (please see addendum #1 below).
  - Her/his My Chief Complaint ꟷ (my story ꟷ why I am here today) (please see addendum #2 below).

Note: these documents (that might take them weeks) will take you mere minutes to construct.

These addenda are from: Safer Medical Care for You and Yours - Six Tools for Safe, Effective, Compassionate Care (Hightower/White 2016)

When helpful, access a relevant Cleveland Clinic or Mayo Clinic site and provide them with the link for their future reference; and
Suggest logical next steps for them to consider (e.g., life-style habits, pharmacist consultation regarding self-care, urgent care, emergency care, 911, etc.)

To accomplish this, you will require a stand, sign, computer, printer, mobile phone, basic medical equipment and energy. Except for the latter, all will be readily available. As a bonus, it would be nice if you were accompanied by a professional partner (i.e., spouse Nurse Jackie) to assist with vital signs, crowd control, security and, most importantly, coffee and donuts.

Feeling better now, please soldier on with the understanding that when this ABC-STEEEP ꟷ Letters to the File endeavor has run its course The Doctor Will Be In ꟷ $0.00. (460 words)

Respectfully submitted with fondest personal regards,

Dr. Mike

www.fixingushealthcare.com

You may leave an anonymous comment without username and email ꟷ please do. Please share your wisdom, insights and perceptions (your reality) about what I have right, wrong and/or omitted. I will be delighted to hear from you as this draft and subsequent chapters will be significantly enhanced.

Dr. Mike

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Addendum #1: My (Unique and Very) Personal Medical Record

My Identification:

T (Thomas) Michael Example MD; DOB: 55/55/5555
The Belleair Bluff, Belleair, FL; 555-555-5555; tmikeexamplemd@gmail.com
Career: patriarch, physician (educator, executive, consultant), author, coach, musician, golfer, boater, LIOM-C (certified legend in own mind), PE (patriarch emeritus)
My Health Care Surrogates: Ms. Example (spouse; primary)/Belleair Bluff FL 555-555-5555 (M); Ms. Example Smith (daughter; alternate)/Scottsdale 555-555-5555 (M); Mr. Example (son; 2^nd alternate)/Pittsburgh 555-555-5555 (M)
My Preferred Hospital: Osler Medical Center
My Hospital Portal: Osler-Care Portal (UN/PW)

My Allergies/Implants/Prevention/TTD:

Lifetime history of allergic rhinitis
ACE inhibitors (for example, captopril) cause me to cough
Respiratory depression with procedural sedation and analgesia
No known allergies to medications or to latex
Titanium (MRI/TSA compatible) cervical spine implant and gel spacers
Prevention: Moderna X4 (04/2022); influenza (9/2022); Pneumovax (2011/2016); Pneumovax 13 (2015); Tdap (2020); Zoster (2009); Hepatitis B (1995); cardiac stress (2022); gastroscopy (2017); colonoscopy (2010); Cologuard (2020); AAA Ultrasound (2016); PSA (2022);
TTD: Shingrix?

My Chronological Problem List:

Active

1952 allergic rhinitis — active
1978 removal of multiple basal cell carcinomas, squamous cell carcinoma and actinic keratosis — active
1978 gastroesophogeal reflux disease (GERD) — active
1995 hypertension — active (09/2022: 120/70)
1995 intolerance to ACE Inhibitors (cough) — active
1998 rosacea — active
2003 benign prostatic hypertrophy/spastic bladder (partial prostatectomy 1998) — active
2005 low HDL cholesterol — active
2011 pre-diabetes — active (09/2022: 104/5.7)
2013 sleep apnea — active
2014 coronary artery disease — active
2020 osteoarthritis — active

Resolved

1961 appendectomy — resolved
2005 left inguinal hernia repair — resolved
2006 hemorrhoid surgery — resolved
2010 left sciatica (L5/S1) — resolved
2014 left trochanteric bursitis — resolved
2017 acute sinusitis ― resolved
2018 C3-C4, C4-C5 spinal stenosis cervical fusion with titanium plate (upper extremity weakness and spinal cord compression) — resolved
2022 COVID19 (August) — resolved
2022 posterior vitreous detachment (+/- retinal detachment) [laser] — resolved

My Medication and Therapies List:

Metronidazole topical cream; 0.75%; apply to face each morning (for rosacea)
Prilosec (omeprazole); 20 mg; by mouth; at bedtime (for GERD)
Lipitor (atorvastatin); 20mg; by mouth; at bedtime (for lipids)
Cozaar (losartan); 100 mg; by mouth; at bedtime (for hypertension)
Norvasc (amlodipine); 5 mg; by mouth; at bedtime (for coronary artery disease/hypertension)
Flomax (tamsulosin); 0.4.mg; by mouth; at bedtime (for BPH/spastic bladder)
Claritin (loratadine); 10 mg; by mouth; at bedtime (for allergic rhinitis)
Aspirin; 81mg; by mouth; at bedtime (for coronary artery disease)
Fluticasone nasal spray; 50 mcg; each nostril; each morning (for allergic rhinitis)
CPAP ResMed AirSense 10; nasal pillows (medium); 7cm water; 3.5% humidity (for sleep apnea)
Myrbetrig (mirabegron); 50mg XR; by mouth; at bedtime for spastic bladder (discontinued)

As needed and Over-The-Counter Medications:

Nitro 0.4 mg; under tongue; as necessary X 3; (for angina)
Augmentin (amoxicillin/clavulanate); 875 mg/125 mg; by mouth; as directed for sinusitis (rarely used)
Virtussin AC Syrup; 15cc; by mouth; as directed for severe cough (rarely used)
Advil (ibuprofen); 400-600 mg; by mouth for exercise induced discomfort (daily)
Tylenol (acetaminophen); 1000 mg; by mouth; if necessary for fever or pain (daily)

My Pertinent Family History

Paternal grandfather (87) late-life depression. Maternal grandfather (74) dementia. Maternal grandmother (85) renal cell carcinoma. Father (87) hypertension, hypothyroidism, minor strokes, retinal tears and anxiety/depression. Mother (98) breast cancer; atrial fib; hypertension; glaucoma; GERD and coronary artery disease. Spouse, siblings, children and grandchildren are alive and well.

My Personal Physicians

Cardiologist: Dr. Example/Clearwater/555-555-5555
Dentist: Dr. Example/Clearwater/555-555-5555
Dermatologist: Dr. Example/Clearwater/555-555-5555
General Surgeon: Dr. Example/Clearwater/555-555-5555
Neurosurgeon: Dr. Example/Clearwater/555-555-5555
Optometrist: Dr. Example/Clearwater/555-555-5555
Ophthalmologist (Retina): Dr. Example/Clearwater/555-555-5555
Personal Professional Patient Advocate (P3A): Dr. Example/Pennsylvania/555-555-5555
Pharmacy: Walgreens/Missouri Ave/Clearwater/727-586-4414
Primary Care/Geriatrics: Dr. Example/Seminole/555-555-5555
Urologist: Dr. Example/Clearwater/555-555-5555

My Significant HealthCare Attachments (available upon request):

My Chief Complaint (my story — why I am here today): for anticipated appointments, I will be prepared (in writing) to discuss the “O-P-Q-R2-S-T” of today’s encounter: onset (when it started); place (what part of body); quality (what it feels like); related symptoms; radiation (where it travels to); severity (scale of 1-10); and triggers (what causes it, makes it worse or makes it better)
My recent lab and radiology reports (2021); Cardiac cath report (2015); CT coronary angio report (2014); Cervical Spine MRI (2018); Nuclear stress report and EKG (2022);
2015-12-15 My (Unique and Very) Personal HealthCare Values, Desires and Wishes; 2014-01-04 My HealthCare Advanced Directives; 2019-12-19 My Designation of Health Care Surrogate and My Living Will

From: Safer Medical Care for You and Yours — Six Tools for Safe, Effective Compassionate Care

Stephen F Hightower MD FACP and T Michael White MD FACP

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Addendum #2: My Chief Complaint (my story — why I am here today)

Belleair Bluff

July 4th

Good Dr. Rusty Pipes Sir,

Hello.

Thank you for all you do daily so well for so many. Thank you for seeing me today.

At age 75, my health is basically good ꟷ cervical stenosis, coronary artery disease, skin cancer, hypertension, lipids, osteoarthritis and sleep apnea are all under control. Each day I am active (golf, swimming, walking and weights). I eat and sleep well.

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My only physical complaints of concern are urological. For years I have suffered from:

Nocturia X2;
Urinary frequency (q 2 hours);
Urinary urgency on occasion;
Slow to start (at times);
Poor stream (at times);
Incomplete voiding (at times);
Preoccupation with “pre-cautionary voiding;”
Fear of prostate carcinoma (minor);
Fear of anticholinergics (oxybutynin); and
Over familiarization with roadside rest stops (thank God for McDonalds)/10 Stands/aisle seats/etc.).

I believe that Flomax 0.4mg has mildly improved my stream (a recent three-day trial discontinuation seemed to result in slowing).

Annual PSAs have been stable (0.770 ng/ml)

I note that when I have had to delay voiding (for example, when awaking from sleep), voiding comes in waves and is incomplete (as if my bladder is in spasm).

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Thank you for your every consideration.

Best regards,

T (Thomas) Michael Example MD

555-555-5555

mikeexamplemd@gmail.com

From: Safer Medical Care for You and Yours — Six Tools for Safe, Effective Compassionate Care

Stephen F Hightower MD FACP T Michael White MD FACP

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Letters to the File