A Checklist for Doctors Moving Their Medical Practice

A friend is moving his Medical practice from one state to another. He was amazed at the requirements for making a move. He has to:

1. Notify his patients that he has seen in the past two years by letter that he is changing his practice
2. Notify the Texas Medical Board 
3. Publish a notice in the newspaper of the greatest general circulation in each county in which the physician practices
4. Place a written notice in his office
5. Notify the DEA
6. Notify the Texas Department of Public Safety
7. Notify Medicare
8. Notify Medicaid
9. Notify Champus
10. Provide medical records to physicians/and or the patient

 

No Water, No Electricity

Hurricane Ike felled three giant oaks in my 80-year-old uncle's yard. One oak punched a hole in his roof, right over his bedroom. With the wind blowing 50-70 knots and the rain falling, he climbed on the roof, cut the limb off the tree trunk, pushed the limb off the roof, and secured plastic over the hole. He let no one know he was having difficulty. When he couldn't be reached by phone, I drove out to his place. He had no electricity, two full one-liter water bottles , a gallon jug of potable water, and a barrel of water for flushing the commode. His meat, milk, and other refrigerated food were spoiled. He and his 85-year-old wife refused to come home with me. They will be out of electricity for a week or more, probably.

The Moon Shines on Everyone

On September 12, 2008 the moon was three days from being full. People somewhere would look up at the darkened sky and say "What a beautiful moon." Within a 500 mile radius of Galveston and Houston, no one saw the moon. A Hurricane cloud was in the way. Hurricane Ike made extensive damage to the Island and to Houston and west of the eye that passed through Madisonville, Huntsville, and Lufkin leaving very little damage in its wake in College Station, Texas. The wind blew hard enough to blow a portion of our fence down. A small 15' pine was felled. Four shingles blew off our ridge line. Electricity and our generator was down in our little hospital in Grimes county so our four patients were moved to the Rehab unit in Bryan, but that was the extent of our personal damage. Next time I will look at the moon with a different perspective: "What's happening to those people who live 500 miles away from me who are looking at the same moon?"

Hopeful Words

I think the American economy will recover and go on to another bubble of some kind BUT---maybe, just maybe, we can take a lesson from this particular bubble to try and reduce the severity of the next one.  We have GOT to do something to reduce Congressional meddling in the free markets.  Many on the left-leaning side of the aisle are attempting to lay this 'crisis' at the feet of George Bush (for obvious political reasons) while I would lay it at the feet of Congress. 

Howard Talley

The Insomniac Millionaire

Twenty years ago he couldn't sleep so he watched late night infomercials and bought some tapes for $39.95. He followed the plan, gradually buying property. Now he owns 30 houses in Colorado and 70 in South Carolina. He likes to sell his properties to people who had a few lucky years. When they are flush with cash, they buy a mountain villa or a seaside cottage. In a few years they can't make their payments. He gets his property back and sells it to another "lucky" person.

He says housing will continue to deflate for another 10-12 months. Lyle Fischer says to put an add in the classifieds--Want to Buy Land. There are, he says, hundreds of "lucky" people lying awake at night wondering how they are going to get rid of the property they purchased during the flush times. They will answer the call to that add (264-5383). 

TIME TO SAY GOODBYE

When I'm alone
 I dream of the horizon
 and words fail

I know there is no light in a room where the sun is absent, 


If you are not here with me. 


I'll go with you 
to countries I never
 saw and shared with you. 


I shall experience them. 


When you are far away 
I dream of the horizon 
and words fail. 


And, yes, I know 
that you are with me; 


You, my moon, are here with me

My sun, you are here with me


Time to say goodbye.

Children Get Older Too

With my love walked up valleys and down

Climbed a mountain and turned around

Saw my reflection in sun shining souls

The heart’s joy brought me down

Reflections in the eye

Where is love?

Can the child in my heart go with the ride?

Can I sail thru the changing ocean tide?

Can I handle the seasons rearranging?

Well, I’ve been afraid of changing

Cause I’ve built my life around you

But time makes you bolder

Children get older

I’m getting older too.

Take my love, send it around

Climb a mountain and turn back down

If you see my reflection in sun shining souls

May the new destinations make it shine on?

If you see my reflection in sun shining souls

May the new directions make it shine on?

Skip the Complaints

 The paper work this move requires has been incredible. First, I had reams of paperwork to complete and thousands of telephone calls to make to get my Virginia license.

 Then Carilion called to ask for the same material plus 584 more pages to complete for their credentialing. And they called back and wanted a fax number of every place I have ever worked including Internship and Air Force. They have another huge form for me to complete for physical illness and promotion material. And then they sent 18,999 documents for me to sign so they could get the insurance money I make for them.

 (Does working for someone take away incentive? ----not for me because I am in this business to help others, but I can see how giving the profits to someone else while you do all the work can be deflating, especially when a lot of unnecessary paperwork is required for each procedure.)

 They there are all of the changes in rules and regulations at Carilion and a huge staff and dozens of psychiatrist I will need to monitor and help. I'm afraid the new job will flood me with long, frustrating work with much less pay. When I was younger, I thrived on new challenges. Now I don't know if I have maintained the energy I once possessed.

 And most disconcerting, is loss of our church home, our many true, trustworthy, and fun friends, my mother, and Craig, my incredible staff.

 I’m developing stress symptoms---I’m not sleeping well. I am losing my temper over insignificant things, not reading my Bible, not praying daily, not reading books, not exercising.

 I wished I had invested my money more wisely. If I had taken the advise of just two people and if I had gradually added money to two of the investments they recommended and not sold them prematurely, I would be a multi, multi, multi millionaire so I wouldn’t have to work until I am 70₊.

 I’m having a pity party when there are billions in the world who are starving and being tortured with each passing minute. And just think--When I get to the pearly gates St. Peter can pull this information off the Internet and show me what an ingrate I have been.

 One thing that sustains me is you, Wende, --you are the darling of my heart and a special child of God---loving, loyal, understanding, forgiving, encouraging, consistent, a unique individual to whom God has given the full quotient of 10 talents. And then there is supporting, encouraging, consistent, loyal, and inside-and-out beautiful Vicki who has sustained me through good and bad times. And Lori and Lindsey, sweet little girls, and Greg who is just about becoming my best male friend. And Brad my amazingly talented, ebullient, and funny son...Andrea...Alex.... Annie...my mother...and of course Jesus and the Holy Spirit. When I think of all of you, the paper work and challenges of a new job become a little mosquito.

 I will say this, however: After Jesus had been in the desert for 40 days and the Devil had given Jesus 67,125 papers to complete before he could work with God, Jesus may have joined the Devil's team.

Defeated

Brad beat me in tennis today 7-5, 6-2, 7-6. He was playing exceptionally well. He kept me off balance all day with a powerful serve, aggressiveness at the net, and hitting winners on all but two overheads, most of which were difficult to return. He also played with patience and then used powerful ground strokes to throw off my timing. His drop shot had me on the defensive. Yet, I had my chances and used the most abominable strategy of playing not to lose instead of playing to win. This defensive approach was forced by Brad's aggressiveness and my poor serving day. Nonetheless, Brad won fairly and squarely dominating me more than the score would indicate. The alarming question that arises with each new day is this: Will I ever beat Brad again. He is strong, fast, quick, and physically fit. Biology indicates that I can expect to lose strength, quickness, and speed with each passing day. I hope that for a few more months, I can at least keep our matches competitive.

In the afternoon made a few phone calls regarding land in Virginia. I also called a home builder to get some ideas on square footage cost.

Alex and Annie the First Generation Under the Tyranny of Socialism

Alex is all boy and Annie and beautiful girl. Had fun holding Annie and reading to Alex and playing tennis, getting his hand-held motor shooter in the mud. Against Brad, I won the first set 6-4 and he won the second 6-4. 

Watched a movie filled with debauchery, The Dewey Cox Story, but James T. Riley can certainly sing. The movie would have been much better if they just let him sing. 

Later Brad and I watched Governor Palin. We were both impressed.

Then we watched Obama's video and his speech. I did well telling Brad all the things I liked about Obama and leaving out the he is a socialist and possibly communist with hatred for the American Independent way of life. He wants the government to do everything for each American as he has no faith in the common man because he was mentored by anarchists.  But, of course, I said nothing about this. Instead I occasional yelled "I back Barrack" and "Mamma's for Obamas." You can't win an argument, so why not have a little fun.

Despite Governor Palin's strong showing, I fear that the Democrats will entice us into their web of socialism. This year is the last of America as I have known it. I will not have to suffer socialism.  I will die in the next decade or two and by the time clear thinking American's wake up it will be too late. Oh well, the law of entropy and greed eventually causes all empires to fail.

As an aside I heard a woman Democrat radio host compare Palin the the porno movie star who comes to the door with her glasses on and after letting the Fuller Brush salesman in the house, unties her hair, takes off her glasses, and shows the salesmen creative uses for the Fuller Brush.

The Drive to Wilmington.

The drive from Blacksburg to Wilmington is 564 miles, but it is freeway all the way and takes a tad under six hours. fabulous 4-5 lanes in most of North Carolina. Beat Brad 6-4 and 6-3 in tennis as he attempted to slug his way to victory.

Family and Land

Looked for land with Nancy. Found a beautiful 6.99 acre lot close to Blacksburg owned by Mr. Jack Chin Juang, but cost is prohibitive. Lunch with family and then a drive Cascade Falls before the kids left for Charlotte.

Finding a Church, Visiting with Family

Attended the Blacksburg United Methodist Church. I liked it. Not certain that Vicki did. She wants to look around more which I will do with her to maintain harmony. After there church Wende and family came down for the rest of labor day weekend. Ate out, walked around the Virginia Tech campus, played Rummicube, and read to the kids.

On Our Own

Looking for land by ourselves while realtors and others take off for the Labor Day Weekend. Found some beautiful property in Deercroft, but will probably be too expensive and may not be for sale. Steep drive way, rock that is difficult to penetrate, lack of city water and sewage make the price of the land escalate beyond our means, but the view is terrific. Looked a numerous other lots that made us think of a poor man's college station priced for a prince. Dejected, but not discouraged and more determined to find the land God has picked for us. I will pray more specifically for him to take us directly to the land. God is faithful if one takes the time to develop and relationship with him and stores his ego in an impenetrable cave.

Land That Appears to Avoid Depreciating

Looking for more land with nancy Phillips. Later went to Coal Ridge Hollow where there exists beautiful land that appears to be bought up for investment opportunities. About a dozen or so homes have been built, but there is a vast forest land of 2-3 acre lots that have been untouched for several years. Later Nancy confirmed that people buy land for investment here and so for the bubble has failed to pop.

We Meet Nancy Phillips

Jim Wesel, manager of Oak Tree Town Homes who leased our house to us and who is quickly becoming a good friend and a source of information (The book, The Tipping Point, would designate him a Mensch.), gave us the name of Jim McAlister, President of First Bank and Trust, who gave us the name of Phi Beta Kappa graduate from Randolph Macon University, Nancy Phillips who is a desigener and builder as well as real estate agent. She will take Vicki through the entire building progress, going as far as taking her to pick out kitchen and bathroom fixtures. We immediately took a liking to this practical, honest, and knowledgeable builder. Vicki talked design with her and then we went traipsing around lots.

Later, met with Jim Wesel to finalise our lease. Called Atmos to have our gas turned on on the 27th of September and went by Christiansburg Municipal Building to sign up for water and sewage.

Met with Eric Roethlisberger, another builder to look at one of his homes and talk about land. After talking with Andrea's sister Nici and her husband Jason who told us of sealing and chinking required for log home maintenance we decided once and for all against the log house. Called Diane Boon and told her of our decision. She was very pleasant and in retrospect the least "pushy" realtor with which we have ever met.  

We Have Dinner with a Natural Leader who is a Christian.

Drove all over the New River Valley looking for land on which to build then a fabulous dinner and Frankie Roland's Steak House in Roanoke with the Medical Director ofthe Carilion psychiatric unit in Roanoke and New River Valley psychiatric unit in New River where I am section chief. He is a Christian and a medical visionary who seeks outstanding quality of care and innovation. He is eager to help make the physician owned Carilion the standard for all physician owned hospitals around the country. He also wants to develop a first class research program, and medical student and, and psychiatric  resident training programs within a spiritually based program. He is a devoted Christian who prays before eating in a fancy restaurant and abstains from hard drink. He is unashamed to speak of Jesus Christ and is a natural and kind leader who has the courage of his convictions with the assertiveness to pursue what he wants.

Some Important Future Associates

Had a long lunch with Dennis Means, MD, Vice President for Medical Affairs,  and Don Holliwell Administrator, Carilion New River Valley, Virginia at which time we discussed goals for the psychiatric unit and an informal partnership to improve the quality of care at Carilion. Also met briefly with Charlotte Ramsey, Chief Nursing Officer, Carilion New River Valley Medical Center and Elizabeth Wade LCSW, Director of Clinical Programs, Psychiatric Unit.

In between looked for land for building and the Preston Forest log cabin. Too expensive and too many problems--master bedroom on third floor along with a guest room that shares a bath with the master bedroom; unheated laundry in the basement; log burning fireplace instead of gas burning fireplace. Log burning fireplace creates messes when bringing to logs in the house and temperature inversions can cause smoke to drift back into the house.  

New Friends and New Temptations

Had breakfast with Rhonda Creger, recruiting coordinator for Carilion Hospitals and her husband, Wayman, Senior Pastor of God's House, A Church for all Generations in Pembroke, Virginia. They are both terrific people who add to the conviction that we did the correct thing in taking this new job.

Looked at a fabulous log cabin with realtor Diane Boon that was too expensive for us. You can look it up on Realtor.com by entering 4560 Chowning Trail in Preston Forest Blacksburg, Virginia. What do you think? The price is prohibitive, but the reduction in cost is tempting. The cabin has been reduced frmo $690,000 to $545,000.

A Friend and a Rental Home Found

Victoria and I drove all over the New River Valley in Virginia looking for property. We checked out a small house in Radford, Virginia that had been purchased by a realtor for her daughter to live in while the daughter attended Radford University. After the daughter graduated from college the 1500 square foot cottage was put on the market as a property to lease. It was a cute little home from the outside, but way to small for us on the inside. You can check out the property at 116 Hammet Drive, Radford, Virginia online at Realtor.com. It could be just right for you.

We then looked at a Victorian home on Tuckahoe Drive in Riner that looked great on the internet except that the Master BR was upstairs and all the ceilings were 8 feet. In person the place was a wreck--at least it looked like a wreck to us. You can't always trust the Internet when looking for homes. You might like it though. Check it out on Realtor.com

When I was looking for Tuckahoe Drive I pulled into a Shell Service Station at the corner of Highway 8 and Tuckahoe. I didn't realize that Tuckahoe bordered the Shell Station at the time. I asked two employees at the Shell Station if they knew where Tuckahoe was. They both said they had never heard of it. 

In small towns the post mistress at the post office is always a good source for gossip and real estate deals. This nugget proved true in Riner were the post mistress gave me details on all the real estate properties in the county. If I had bought something, I would have paid her a commission.

We drove all over the Riner area. Our initial impression was that the land was too wide open. There are beautifully green rolling hills with endless vistas. Sadly that means that on ridges you can see much more than you want to like house trailors, junk yards, and Interstates. Nothing is hidden when the land is cleared that the elevation high.

I showed Vicki the New River Hospital where I will begin working October 1, 2008. She liked it.

While we were driving all over Radford County, Vickie noticed an add in a real estate magazine for rent homes. We called Jim Wesel who met at this office in Christiansburg with some house keys. The first home he showed us we took. It was built in 2005. It had a nice yard with trees in the back and was clean and neat. The lease price was gracious and the house is seven miles from the hospital. You can check it out on Realtor.com by entering 215 Barkwood St., Christiansburg, VA.

Jim Wesel, a Methodist, was also a fount of information and stories such as the tale about the lady who flushed her potted plant down the commode and wondered why it kept stopping up and the women who kept 10 dogs in the house. The dogs lack of training left the walls and carpets malodorous and mildewed. When cleanup costs ran to over $10,000 she told Jim, "Go ahead and sue me. I don't have any money, so a law suit won't bother me."