Why Being Good is a Bad Thing

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by Dr. Michael Miller

For those of you following me on LinkedIn, you have seen me post time and again that I am looking for patients with non-healing wounds and related conditions because "I've healed all the ones I had"!  Though I have more often than not been accused of being an egotist, there is a paucity of arguments about my and my associates' abilities to heal all manner of wounds in an expeditious and cost-effective manner.  For better or worse, we are (in Indianapolis) where the difficult wounds that no one else seems to heal, come to do so.

The problem is that we go from receiving a plethora of new consults from our devoted home health care agency partners to a barren wasteland of house calls within a few weeks, and the problem is...we are very good at what we do.  We have offered our services (at no cost to the facility) to numerous skilled facilities and AL's, all of whom express feigned enthusiasm but turn and relate tales of in-house expertise either from their stalwart medical director (who's wound care vocabulary consists of Keflex, Silvdene and Dakin's Solution), to the wound care DME company who's pseudo-medically credentialed and equivalently untrained salesperson seduces the powers that be using lurid tales of undocumented miracles of healing using the many wound care products she has at their fingertips.  Of course, there is always the in-house nursing lackey or therapy department who "has been doing wound care for years" so there is really no need for someone with 21 years full time expertise.  I mean, why have someone who is trained to make a diagnosis when their staff get almost everything healed or the infamous, "We really have no in-house wounds right now." 

Of course, I call your attention to the most powerful testament to wound care expertise via the recent statistics for facility developed Stage 3 and 4 pressure based tissue injuries in Indiana for 2014 and 2015.  These now provide the newest definitions of  Mercurial...and confabulation.

It is not so much sour grapes and a bruised ego at being passed over for what is universally much poorer, more expensive and considerably less successful care, but rather the simple fact that when these people eventually leave these facilities, they do so with histories of care that far too often borders on the wound care version of paella made by a two-year-old on Mountain Dew.

And so, what befalls those of us cursed with the ability to do it better, faster, and cheaper; who offer facilities, patients and what's more, the health care system, the multidimensional opportunities to benefit from our expertise combined with our desire to do it better than anyone else?

We blithely sit on our over inflated egos like a Roho cushion and await one of two things.  The opportunity to be invited to help those facilities and entities who have patients in need receive the care and assistance they deserve (and that is but a simple fax or phone call away); or the chance to experience our expertise as we provide it in an educationally antagonistic manner on the opposite side of an attorney's letter.

If being good at what one does is a universally acceptable stigma, then when the choice can be made, why should anyone choose purposefully to be bad?

Join me each month on my blog "Ramblings of an Itinerant Wound Care Guy" at woundcareadvisor.com.


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Dr. Michael Miller is Board Certified in General Surgery by the American Osteopathic Association and initially received his 10-year certification in wound care by the American Academy of Wound Management in 2000 and the American Professional Wound Care Association in 2005.

His practice has been devoted exclusively to wound care and related issues since 1998. He is one of very few full-time physician wound care specialists in the State of Indiana, as well as the U.S. He has published numerous articles in peer-reviewed journals, written chapters in wound care texts, and presented poster exhibits and podium presentations at numerous domestic and international conferences.
Dr. Miller is also a consultant to numerous companies in the wound care industry and provides expert consultations to professionals in the investment and legal industries. In addition to his clinical practice, he owns several patents on wound care devices. Dr. Miller was named the American Osteopathic Foundation's 2010 Physician of the Year.