RE: Intro

March 3, 2004

Dear Tim Rowe,

Sounds as if we have followed a similar path to what appears to be

this place in what appears to be this time.

Blessings, Steve D.

> Hi,

>

> I've been lurking here for a few weeks now and wanted to introduce

> myself.

>

> I've been doing The Work more intensively of late, although I first

> came across it about 4 years ago.

>

> It was actually Steve's comments about 'A Course In Miracles' that

> prompted me to post this.

>

> I studied (and possibly practiced) ACIM for about 8 years. I finally

> decided that I wasn't getting anywhere and that the lessons didn't

> 'work'.

>

> It was really only when I started to do 'The Work' that the

> ideas found in ACIM started to become incredibly clear to me -

really

> for the first time.

>

> Anyhow, thanks all for being here.

>

> --

> Love,

> Tim (another one)

June 6, 2004

Change,

Welcome. As someone wise on this board told me....take what you can

from the posts, you don't have a responsibility to reply to

anything. No need to apologize. This is for you. Glad to hear from

you, and post when you want to!

I have had some similar experiences. I hermit a lot. It is a flea I

picked up from nada. I was doing very well in getting over it 2

years ago, but because of the events of the last 2 years, I have

reverted back to that behavior. I am dealing with is as best as I

can right now, with the confidence that I am making progress, and not

critizing myself for not being 'perfect' in this or any other area.

I have two adult children, 29 and 26. I have learned that some of my

behavior with them has its roots in codependency and the flea of fear

of abandonment. I have had success in overcoming this, however. The

most recent is my son, 26, who is living at home right now. He had

made the mistake of getting into credit card debt, was laid off from

a very high paying job, and with $700/ month in child support, just

couldn't handle it all and maintain his own apartment. It will be 2

years this August, and he has not contributed financially. I need to

clarify that for most of this time, his possessions were here, but he

was only here on the weekends. During the week he would stay at his

girlfriend's. He would stay at my house during the weekend when he

had visitation with his son. And my codependency would come into

play with wanting to make everone happy, even if it meant I was not.

Now he and girlfriend have ended their relationship, and son is here

full time. Although I can financially cover these additional

expenses, I am not doing him or me a service by allowing that to

happen. So I sat down with him and expressed my concerns. We are

now tracking expenses to determine what would be a fair and realistic

contribution from him. Whenever I do this kind of thing, there is

anxiety on my part. But I know that my children love and respect me,

and so I know that if I continue dealing with them in a loving and

respectful way, that we will be able to work out our problems. I have

to think it through, cause it does not come naturally. I also feel

that I am doing what I need to do to take care of myself, also. And

when I realize that I am starting to feel sorry for my self....poor

Sylvia.....I use that as a red flag signal that something is wrong in

my life....and accept that I have to take action to change the

situation.

Regarding the issue of your pet. I have had two pets euthanized. In

one case, the cat could have lived for many more years, but he

required such special care to do so, and I had been dealing with this

situation for 2 years. Continued care would have required daily

uncomfortable/painful intervention as well a frequent veterinary

visits. There were also some other issues that was making life with

and for this pet difficult. I decided to have him euthanized. The

other pet was suffering from a disease and in a great deal of pain.

I felt that in both cases, I was dealing humanely with these

animals. As their owner, I had the responsibility for providing them

with a comfortable quality of life, and that was no longer

possible....with no type of change for the better in their futures. I

was with each pet during the process. I am sure you have done the

best you could with your pet. Try to avoid feeling guilty about this.

Best of luck in dealing with your fleas and the KIDS!

Sylvia

> Okay this is a rather belated intro because I've been reading the

> posts for at least 6 months. (yeah trust issues...)

>

> .....................................>

> I have spend the majority of my life trying to distance myself from

> my family thinking the problem was there and not realizing the

> severity of the effects I carry. I was emotionally & physically

> abused most probably from 2 years onward.

>

> I have one 20+ daughter who is living with me as well as her 20+

> boyfriend. Several pets, a couple of good friends and a regular

coda

> meeting. ..................> I really want to focus on me but have

numerous issues/flea's and am

> in nead of support.

>

> I am trying to " fix " my own life and it is really hard. I have

> always been somewhat of a neat freak & minimalist with my house

(for

> one) and the not really KIDS living here I enable badly. They are

> reminscent of my mom very sloppy. After 2 1/2 years of being back

> here they don't know what days garbage is picked up...

>

> I stopped doing all & resent the fact that my house is a diaster.

Am

> having a lot of trouble setting this boundary. Spent the afternoon

> on a friends of hoarders sight but decided to post here instead.

>

> I know most my issues stem from my childhood. Have done some

painful

> inner child work but really need a supportive environment I can

trust

> for back-up.

>

...............................>

> Will probably have grief/guilt issues soon as a goal is to soon

> euthanize an animal that I have had over 10 years (health problems).

>

> Thanks all for now.

>

> Change

February 1, 2008

Hi Gloria, It sounds like you have a lot to deal with, so I can understand the overwhelming feeling of too much all at once. I'm not a smoker, but I have heard that when you try to quit, you need to replace it with something each time you have the craving. Have you tried any of the patches or anything similar ? If not, try that. If you still feel overwhelmed, give it a couple of weeks, then try again. I'm glad you are trying to quit. It can be really hard on you physically. Getting away from abuse of any kind is right. People don't have the right to do that to you. I'm the receiver of anger, hostility and it's been causing too much stress. I am on bp medication, but hope to be off it soon. All that abuse can heap a lot of stress on you for sure. Take care of yourself first. Life is short. P.S. Montana is great place to reduce

stress....take up fly fishing or painting ;-) Best wishes.....Kenny Gloria wrote: Hi, I'm Gloria from Big Sky Country Montana. I have had a problem with stress in my life for such a long time that I am not able to relate it in numbers. I grew up in a very positive home. My mother had polio when she was 6 and at about the same age I became her care-giver. I was her feet, I had to do all

the running errands, shopping etc. The one thing she and my Grandfather taught me is that; "There is no such word as can't, you can do anything you want to as long as you try hard enough, and if you don't know how, learn." That has been my philosophy all my life. The word "can't" does not exist in my vocabulary. On the other hand, my Grandmother was extremely domineering and verbally abusive. I eneded up in an abusive marriage for 21 yrs. until I found the resources and strength to break the vicious circle. Last July, my husband of the last 20 years, passed away suddenly and unexpected and my whole life has changed. Four days ago, I decided that I was going to quit smoking. Today would have been my 4th day without tobacco and I'm feeling a little overwhelmed right now. Like maybe I was trying to take on too much at one time? Gloria

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February 1, 2008

Hi Kenny' I have quit smoking "cold Turkey" once and it lasted a year and a half and then for some reason my husband started and of course I followed. He died in July of Emphazema and smoking related heart disease. We had tried several times over the past few years using the patches, which were unsuccessful so I have quite a few left, but they are sort of old and I'm wondering if they have lost some of their effect. I'm going to get right back on that wagon tomorrow. I have gotten rid of all the triggers and am really wanting this to be successful. I was married to Terry for going on 20 yrs when he passed away this last summer. Terry knew about my ex-husband and about all the abuse I had been through during my life and really tried hard to help me with the stress that has become a part of my life - I don't what it would be like to be stress free. I am on several

anti-depressants, anti-stress and anti-anxiety meds and still sometimes the stress is just too much. I have used music and self-hypnosis to help me with my stress when I go to bed at night. I also suffer from chronic pain due to a degenerated disk in my lower back and I do believe that my left hip is starting to disintegrate also. I rest every afternoon on a vibrating heating pad that is full length and listen to my music and de-stressing subconscious therapy. GloriaKenny Skeet wrote: Hi Gloria, It sounds like you have a lot to deal with, so I can understand the overwhelming feeling of too much all at once. I'm not a smoker, but I have heard that when you try to quit, you need to replace it with something each time you have the craving. Have you tried any of the patches or anything similar ? If not, try that. If you still feel overwhelmed, give it a couple of weeks, then try again. I'm glad you are trying to quit. It can be really hard on you physically. Getting away from abuse of any kind is right. People don't have the right to do that to you. I'm the receiver of anger, hostility and it's been causing too much stress. I am on bp medication, but hope to be off it soon. All that abuse can heap a lot of stress on you for sure. Take care of yourself

first. Life is short. P.S. Montana is great place to reduce stress....take up fly fishing or painting ;-) Best wishes.....Kenny Gloria <montanamorningglory> wrote: Hi, I'm Gloria from Big Sky Country Montana. I have had a problem with stress in my life for such a long time that I am not able to relate it in numbers. I grew up in a very positive home. My mother had polio when she was 6 and at about the same age I became her care-giver. I was her feet, I had to do all the running errands, shopping etc. The one thing she and my Grandfather taught me is that; "There is no such word as can't, you can do anything you want to as long as you try hard enough, and if you don't know

how, learn." That has been my philosophy all my life. The word "can't" does not exist in my vocabulary. On the other hand, my Grandmother was extremely domineering and verbally abusive. I eneded up in an abusive marriage for 21 yrs. until I found the resources and strength to break the vicious circle. Last July, my husband of the last 20 years, passed away suddenly and unexpected and my whole life has changed. Four days ago, I decided that I was going to quit smoking. Today would have been my 4th day without tobacco and I'm feeling a little overwhelmed right now. Like maybe I was trying to take on too much at one time? Gloria Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now.

Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now.

November 29, 2008

Welcome. I am about 3 months ahead of you. I am not going to take medicare initially, have not opted in or out. Will not see senoirs because i can't bill medicare and can't charge the pts either. Nutty system. Will wait and see how I do w/o medicare, see what happens w the new president. I think you can charge a retainer fee for Meidcare pts but also not sure. Does it say anywhere in medicare regulations that that can't be done? What about HMO co pays for seniors? The amounts seem to vary from pt to pt at the last HMO I worked at- some paid $5, some paid $20. Who decided how much these medicare pts pay? Does anyone out there know for sure? Is anyone doing that out there?

Hello to everyone in this group; I am a new member of it. I expect to be pestering everyone with a bunch of questions over the next several months so I figured I'd do a little introduction.

I am 5+ years out of a primary care IM residency, living and working in Denver, Colorado. I had the great pleasure of starting my own practice up anew 5 years ago as an employee of a large hospital corp that is prominent in Denver. My original plan was to build up to 3-4 physicians then divest from the hospital as a group, which actually I think would have worked well. Unfortunately, the hospital essentially refused to add anything more than a part-time physician and for a variety of reasons that I'm sure many of you are familiar, working for a corporation clearly isn't something I can do for my career.

Over the last couple months, I've decided I need to just go off on my own to have the type of practice and career that my patients and I deserve. I was referred to this group by an endocrinology colleague that started up last year via the IMP model.

I certainly have some things in my favor as far as going off on my own. Foremost is I have a pretty strong patient base after starting with nothing 5 years ago. I've seen in total about 2400 unique patients in the 5+ years and about 1000-1200 in the last 24 months and see on average 14-16 patients daily. I've generated on average about $270,000 in yearly revenue. Additionally, I have an EMR (Allscripts) in which I'm fully embedded and have been using for 4 years.

Despite the positives above, I still feel I need to move on. I cannot work with my current company any longer; they are just way to malignant and have such little interest in either physician or patient satisfaction. While I have an already low volume practice, I feel the need to cut my patient volume back to provide the level of service I want.

I am in the process now of exploring different practice models and am hoping to finalize my blueprint over the next 2-3 months. I can then start looking for specific space in my area and planning the definitive transition.

I plan to continue traditional insurance billing I plan to use a 3rd party billing service that already uses Allscripts so they essentially would use my own software to do our billing and charge about 6.5% I'd like to additional have a very low cost retainer/yearly fee for patients. I was think of about $100. I was hoping this would add back some of the revenue I would lose by decreasing patient volume. Additionally, I'm hoping this helps to wean my patient base only to those patients that really want to be with ME as opposed to any doc. I feel that 1) the quality of care I provide is worth that yearly retainer, and 2) its small enough that it should be a financial restriction to probably 95% of my patients. I would likely allow my current medicare patients to come over though I assume I cannot charge them the retainer (is that correct?) With the Allscripts software there is an online patient portal that allows scheduling, physician correspondence and lab/study result viewing by patients that I plan to use (we're not currently using it). I don't foresee myself trying to do this with a partner though I wouldn't mind renting some space from another physician office as opposed to just finding a small space myself. I do have a colleague that does acupuncture and chiropractic work that I was considering sharing space with as that fits with my practice where I utilize a lot of non-traditional treatment modalities.

Those are some of the specifics that I've formulated most in my head at this point. Of course, none of those are mandatory if another model seems as if it will work best. As above, I'll likely be asking a slew of more specific questions but thought I've give this little intro. If anyone has some general thoughts or specific black holes to avoid, it is much appreciated. I've already enjoyed reading the board over the last week. Thank you all.

Dave Gordon

Denver, CO

-- M.D.www.elainemd.com

Office: Go in the directions of your dreams and live the life you've imagined.

November 29, 2008