Thursday, March 8, 2018

To go public, or not?




I was more than delighted to receive an email recently from one of my readers.  I am posting it here hoping to enlighten more doctors, specially the young ones who are finding themselves at a crossroad in their career path.

********


Good day po, doc.  I have read your blogs regarding residency and I just want to ask you questions lang sana if it's okay.  I just passed the board exam last march 2017. I've been moonlighting na ever since. I plan to go on residency by Jan2019. I'm planning sana to take IM. I wanted to try applying in private hospitals in Manila but medyo takot ako na baka di ko masustain ang mga needs ko with only limited salary. I cannot depend on my family naman. Kaya option ko n rin magpublic hospital para at least bigger ang pay. May I know what residency did you go into? And if private or public hospital ba pinili mo? I just want sana to at least have an idea. Thank you, doc! - Nicole


********




Hello Nicole!

Thank you for taking time to visit my blog and read my entries. At least, in my own little way, I can be of help specially to budding physicians like you.

I had my residency training in Internal Medicine in Cebu Velez General Hospital in Cebu City. It is actually the base or mother hospital of my alma later, Cebu Institute of Medicine. It is a private hospital, and I admit, the pay is a bit meager compared to that of public medical institutions, therefore I had to make a few adjustments particularly with regards to my expenses.



Actually, my pathway to residency, and to finally completing it, was quite unique in the sense that I went into residency twice.


The first time I went into residency, I was a total newbie, fresh from passing the boards, with barely any savings at all. 


The year was 2006. Still high after nailing the licensure exam and oozing with desire to be independent and to take a load off my parents’ back, I moved out of the apartment I rented when I was a medical student. I knew that my monthly salary of... (drumroll please).....
Php. 12,000.00,  would not be able to support my simple lifestyle (yes, simple, no kidding!) so I chose to avail of the free board and lodging offered by the hospital.


Free lodging meant we had our own rooms at the upper floor of the hospital, free water and electricity - not a bad offer at all, except that the upper floor above ours, was where the owners of the hospital live, and when we went down one level, it was already our workplace, our battle grounds - the wards. Still not bad. No transportation expenses at all in going to the workplace. Those were minor, almost negligible hurdles compared to the challenge called residency. 


Free board meant free food from the hospital dietary - still not bad because we would occasionally have lechon kawali, pork barbecue, freshly-squeezed kalamansi juice (yes, healthy!), and I am a fan of a number of the dishes they serve even if I have been their customer for half a decade. At least I could brag and say, there is such a thing as free lunch.


I finished the first year in residency but decided not to continue to the next level since I decided to try my luck with the USMLE. I spent four years working for my American Dream and during that span of time, I moonlighted in another private hospital in Tagbilaran City in the beautiful island of Bohol. 


It was during my moonlighting stint that I was able to get hold of a relatively large amount of money that I did not encounter in my life - not really in the million levels but pay was never better than I have known since I started my career then. I was able to afford stuff that I wanted, on top of my needs. It was also during that time when I brought for myself my very first investment, a life insurance from Sun Life. I am proud of that achievement and I consider that as one of my remembrance purchases during moonlighting - something that will outlast that gig of mine. When the time came that I had to go back to residency, I had to face the fact that adjustments had to be made once again.


Presently, I am an employee of the Philippine government, since I am affiliated with a DOH-retained hospital in Mindanao. I can say compensation is quite satisfactory.


For you, Nicole and for budding doctors like you, I have enumerated the following points, which I believe are major issues that need to be considered in choosing which hospital to train
-- private or government-owned. "To go public, or not?" -- that is the question that we all hope to answer.


1. Work load -- To establish a baseline idea,residency is like a vampire that only desires to suck out all the life and blood out of you. Do not get me wrong here. I favor residency training as long as your circumstances would allow.  I am not trying to scare you or discourage you from going into training but at least I want to give you an idea of what you will soon be getting into. In my own humble opinion, work load is a little bit - just a teeeeeeeeeeeny weeeeeeny bit - forgiving in the private hospitals. In the government hospitals, aside from your designated job description as resident, you might find yourself also doing a lot of scut work, like pushing wheelchairs, extracting blood specimens yourself, sending specimens to the laboratory, and other stuff like that. I even hear testimonies from fellow physicians that they go as far as buying stuff like IV catheters for their patients using money from their own pockets. Government hospitals, specially the referral centers, are always flooded with patients, it's like there is a party at the Emergency Room every single day. You have to prepare yourself for that reality in case you go for the government hospitals.


2. Compensation -- Dito naman bumabawi ang mga pampublikong ospital. A lot of doctors nowadays are finding themselves in government hospitals because of the very attractive compensation. The government gives 13th and 14th month pay, that's one month of your salary that is tax-free. There is what we also call Philhealth sharing among the hospital
employees, wherein we receive our share of the Philhealth earnings of the hospital. Sharing could be at least Php 5,000.00 every month, that is on top of your monthly salary, monthly laundry allowances, uniform allowances, hazard pay, and many others. I knew all about this when I started working for a government hospital. In this case, all your efforts and sleepless nights actually pay off as you find yourself laughing as you pay a visit to the ATM machine to check on your salary. In the private hospital where I trained we only had the 13th month pay
to look forward to, and a modest love gift from consultants, which both come in December, that's all.


3.  Conducive learning environment -- Now this would not depend on the hospital but this one last issue depends on you, the main player of the game. Just ask yourself, in which environment will you find yourself at the peak of your learning. In which environment would you feel more motivated to work and learn at the same time. Remember that residency is all about learning the ropes before we go into the real world. It is all about learning skills, developing good habits and clinical practices, and sharpening our clinical eye. Which environment will bring out the best in you?


To come up with a decision, consider each issue carefully and just be honest with what you feel about it. Remember, you are at the receiving end of the outcome of this major decision you are going to make. Be kind to yourself first, so that this kindness will radiate on to your patients, whether they find you in a private or a public hospital.


 I wish you all the best and I hope that somehow this has shed some light to your queries.


********

Keep the e-mails coming, dear readers.

Thank you.






Friday, November 3, 2017

Why doctors are a special bunch when it comes to building financial wealth






It is a well known fact that we physicians only start to earn in the later stage of our lives, compared to the general population. This is primarily because we spend around ten years of our lives in school trying to earn our medical degrees, that does not yet include the years spent in specialty and subspecialty training.


          When we come to think of it, most physicians actually get to start or embark in most milestones in life rather late  - we earn our medical licenses at about 25 or 26 years old (I for one, earned my license when I was 26 years old), some start to build their families and have kids at around 28 years old to 30 years old, and most importantly, we start building our financial future around this age also, or maybe even later than that, like me.


            So why are doctors a special bunch when it comes to building financial wealth?





1. We bury ourselves in our medical books while our counterparts start earning. After graduating from college at around 20 years old, we are in for the journey of our lives, as we jump from the pot to the fire by the time we enroll ourselves in medical school. 

          
          I remember the first week of class in medical school when our biochemistry professor then told us that in order to survive medicine, we have to live, breathe, eat, and sleep medicine. It was short of saying that in order to earn our medical degrees, focus and determination are on the topmost list of the requirements. Grit would be an appropriate word. One has to have grit in medical school, to withstand all the challenges that the course encompasses. Of course there were sunny days, there were eureka moments that instantly reminded us of our reasons of why we were where we were back then. (I think I just created a tongue twister right there.)


          Back to our topic of building financial wealth, while our high school batch mates were already starting to earn, we were still beginning to achieve our dreams of becoming doctors. 


          By the way, since our educational system has recently implemented the K-12 system, this only means that the incoming batches of medical students will come in two years later - or older - than we did during our time. 


2. Even when we have earned our medical licenses, we continue to bleed ourselves dry as we slave ourselves away while on training for our chosen specialty.  We almost jumped over the roof when we knew we passed the board exams. It was such a nice feeling, knowing that from that time on, we will be addressed as "Doc" and all our efforts in medical school have finally paid off. 


         However, passing the boards is just the start of another rollercoaster ride since our journey does not stop there. Residency is next in line, as we choose and decide whether we want to be pediatricians, internists, obstetricians, or surgeons. Read more about entering residency training here


          By the time we step into slavery -  I mean residency - our counterparts have already established  their niches in their careers. We earn our first salaries when we go into residency but compensation is only about 20,000.00 (at least during my time of training and maybe that has increased a bit now) in Philippine currency, still exclusive of taxes. 


        In this day and age, imagine what life a monthly compensation of Php. 20,000.00 would give. That does not include taxes, and contributions to PhilHealth and SSS. 


          A single physician-in-training who is self-supporting and living alone and far away from home, has to do some tight budgeting with that amount, and try to make it sufficient to pay for rent, gas, decent clothes, laundry, food, and yes - coffee. During our time, books would have to be included in the list but with the advent of e-books that would not be much of a problem. 

             In my case, I availed of the free board and lodging offered by the hospital during my (first) stint in residency.  


           There are some resident doctors who are blessed enough to have their lifeline still active, with continuous financial support from their parents. However a vast majority of the resident doctors' population are striving - or may be starving - to make ends meet. This is actually a challenge because the prevailing notion is that once an individual has passed the phyisician licensure exam, it is almost always equated to having a lot of money, almost instantly, like magic! But hell, no, I am sorry to disappoint you guys, it is not always the case.


               At this stage the new physician is at last and at least earning but he or she is either under-compensated or the cash-on-hand is just enough for the rookie doctor's basic needs. The common priority therefore at this time is to make ends meet, rather than setting aside a certain amount for savings.



3. Others who chose not to go into training start earning a lot of bucks but... Moonlighting is the term coined for physicians who are working as doctors in certain hospitals but are not under a specialty training program. Moonlighting is a very attractive option for new doctors specially that it offers a good take-home pay, sans the psychological, emotional, and physical battery that goes with residency training. 


           However, for someone who has just started earning and has a lot of wants, saving might still be on the last part of the list. 


          The newly adapted ideologies of the young generation today, particularly YOLO and FOMO, can also, in a way hamper  these young individuals from starting their journey to financial freedom.
           
          You cannot blame someone who has just held in his or hands a 5-digit salary that is at least amounting to 30,000 pesosesoses, to finally buy the latest mobile phone he or she has been eyeing, or that G-shock watch of his favorite color, or to finally go to that dream destination whether that is inside or outside the country.


         It is a fact that there is a lot of money in moonlighting. Those moonlighters are the rich bunch in the line of rookie physicians. Yes, they are already starting to earn big time but building financial wealth or maybe even thinking of retirement are among the least of their priority.

         To moonlight, or not to moonlight? Read more here.







4. Even when we are done training in our specialty and subspecialty, we realize even more that it is a dog-eat-dog world that has been waiting for us at the finish line. A doctor who has just graduated specialty and subspecialty training will finally take a breath of exhilaration. He or she is about to start the rest of his or her life as a medical practitioner. 


           Another biting reality will reveal itself during this stage. The physician who has just started practicing realizes that money does not come easy. This is at least for the majority of new physicians who have not inherited a practice from their relatives. There will always be exceptions to the rule you know and these lucky ones are that. Good for them.


          One has to spend and count hours, and even days, sitting patiently and painstakingly at the clinic to wait for patients. While I do this at the clinic, I keep reminding myself,  "This is a waiting game." Repeat three to four times a minute.


          I am going to tell you a secret. You know what I do inside my clinic while I wait for patients? I organize my tasks. I am really into To-Do Lists and so while waiting I check my progress, and tick off the items in my list that I have already accomplished or completed, or in the case of my monthly bills, those that I have already paid. There is still one thing that I love to do though while waiting for patients -- of course this one will just place a close second to sleeping while waiting.


         I cut a lot of paper. I cut old magazines and recycle them into envelopes. Actually I have made a lot of recycled envelopes already, that I am thinking of donating them to the church so they can be used as offertory envelopes. Their recycled lives would at least be spent for the greater glory of God. So can you imagine now how many hours I have spent inside the clinic waiting for patients? 

          However, whether you like it or not, the waiting will soon be over. To put it in another light, there are days that are not spent waiting.


          There are always firsts, like the day when your first patient walks into the clinic. Then you get to earn your first professional fee.  Oh, what a joyful moment that was! I felt like dancing round and round, and at the same time jumping, while holding my secretary's hands. 



5. Financial management is never taught in medical school. This is very true. Maybe medical school administrators can invite resource speakers who will speak to us about financial management. It would also help if resource speakers on taxation would also be allowed to speak to medical students, or if not to those newly-minted physicians, so it would not come as a shock to them, how much they have to pay for taxes, how to get a TIN, and if they really need to employ the services of a book keeper or accountant.



         
         If you are like most physicians (or any other individual regardless of profession) who have not yet started building your financial wealth, do not be disheartened. It is not too late to start. I tell you, I have been there – got into a credit card mess, brought all the gadgets that I want during my moonlighting stint, and there was a time when I barely had savings – but I was able to rise above all that, and I believe that you can, too.


        Hoping to share more to you soon so that you will be inspired to start building your financial wealth and secure your future. Together let us all aim for financial independence and eventually, aim to achieve financial freedom wherein we would not have to work for the money at all, but our money will be working for us.


          I tell you, that is very possible.

          Love and light!



 





Saturday, August 5, 2017

Clever ways to spend the money you earned in moonlighting (Last of 2 Parts)



To continue...


Second unsolicited advice would be, spend your money wisely. You did not earn your money sleeping. In fact, you had to lose a lot of sleep and grow heavy eyebags beneath your eyes to earn those bucks. 


It is only right to be clever and wise in spending the money you earned in moonlighting.


Your hard-earned money should at least be distributed into five categories: 


(1) Tithes. God will give you back according to what you gave and even more. As written in the Bible, in Malachi 3:10, "Bring the whole tithe into the storehouse that there may be food in my house. Test me in this, says the Lord Almighty, and see if I will not throw open the floodgates of heaven and pour out so much blessings that there will not be room enough to store it. 


(2) Parents. Give back to your parents (even if they do not ask for it), as a way of thanking them for everything they went through during your medical education. They were with you during your journey in medical school - they too were stressed when you were stressed with your duties at the hospital, and they cried and laughed with you through it all. The value of utang na loob (debt of gratitude) is deeply ingrained in the Filipino culture, and it would not hurt us if we give back to those who supported us all the way.  


(3) Savings. Save whenever you can and when you can. Every peso counts. There will come a time when you will be tired of moonlighting and you will eventually decide to go up the next level which is residency training. Learn a lesson from the ant who works hard to save for the rainy days. Residency is most of the time not sunny (in terms of the pocket) and so you should prepare for those days.  


(4) Investments. Investing your money will always be a good idea. They say, the best time to invest was yesterday - but you were not yet earning then - so the next best time to invest is today - I mean now, that you have your own money. There are quite a lot of investment tools that are available at present - mutual funds, UITFs, traditional and variable life insurances, and there's the stock market too. I availed of a traditional life insurance during my moonlighting stint. I consider that as my achievement, as well as a remembrance of my career in moonlighting. The gadgets I bought during those days had been outdated, some have even grown useless, but my insurance still lingers  - in a way because I am still paying for it until now because it is up for 30 years payment - most importantly, it continues to be an assurance that I am protected and my family won't be left hanging if ever something unexpected happens to me. 


(5) Things and Travel. Buy the things that you need and some of the things that you want. Travel to places that you have always wished to explore. Go out on an adventure. Unwind. The millenials have a word for this - YOLO, which means You Only Live once - which is quite true. You deserve a reward once in a while for all your efforts. Getting that latest phone model would probably inspire you to work harder. As for me, I bought myself a DSLR camera and a laptop when I was moonlighting. The former, a want, because photography is one of my hobbies, and the latter, a need, because when I bought the laptop, I already decided to go back to residency the following year. Reward yourself after a day's work like pigging out with friends in your favorite restaurant, watching a movie, or visiting a recreational theme park in your area. 


If you decide to choose the moonlighting path, I have no objection to that. Whatever makes you happy. "Kung saan ka masaya," as they say in Filipino.


Follow your heart. Just make sure that you have your career plans in check all the time and you know where you are headed to.




Tuesday, May 2, 2017

Comforting words from Liz Gilbert, and more...





Elizabeth Gilbert, the famous author of the bestseller,  Eat, Pray, Love,  wrote something beautiful on her Facebook Page. 


I am sharing her post right here, because it is too precious not to be shared, specially that I know it will make a difference in your life, the way it did in mine. 


Wherever we are in our lives right now, whether we are smiling with the sun, or weeping under gray clouds, Liz's words will give us an idea, where to run to when we feel we are treading a downhill course, when we feel that the climb is too steep for us that taking just one small step feels like carrying iron balls tied to our feet through chains, and how to heal ourselves, when we are deeply wounded. 


 "Go to the Water"
by Elizabeth Gilbert


Years ago, when I was going through a really hard time, a friend of mine who was a naturalist gave me some beautiful advice about how to best take care of myself.

He told me, "When an animal in the wild is injured, it has only two strategies for how to heal itself: It can rest or it can go to the water. Right now, try to do as much of both as possible."

Rest.

And then go to the water.

Drink the water. Submerge yourself in the water. Touch the water. Look at the water.

Then go back to sleep.

Repeat as necessary, until healing occurs.

Sometimes, I forget these two magical principals, how to rest, and how to go to the water.

Then I get overwhelmed by life's challenges, and I trick myself into believing that I need a much more complicated cure than your average wounded animal. And sometimes I do need a more complicated cure, I guess.

But not usually.

Usually sleep and water will do the trick.

It always reminds me of that Isak Dinesen quote: "The cure for everything is salt water: tears,sweat, or the sea."

This morning - after a good night's sleep - I went to the water. Here is a photo I took this morning of my feet dipping into my old friend, the Atlantic Ocean. She has never let me down yet, and she didn't let me down this morning either.

(That said, when the ocean is not available, a long hot bath will work. Or a cold shower. Or standing naked under the garden sprinkler, which has been known to change the energy of a day as well! As a final resort: Just drink 8 ounces of the stuff...whatever it takes. Get thee to the water, people.)

Just rest, and go to the water.

It's all gonna be alright.

That's what the water always tells me, anyhow.
And I believe in the water.

:)

ONWARD, and be good to you,
LG





On the other hand, I believe we should also go to the water when we are at our happiest. Personally, the beach for me represents a treasure trove of memories. There, in the beach, I was at my happiest, and in those moments, I was surrounded by family and friends, people I love and who love me back at the same time, no matter what. 



Mama took this photo while I was testing the cold waters of Miami Beach in Florida.



A realization dawns on me that "water" will always have a role in both our happiest and saddest moments. 


We shed tears when we are sad, yet we drink and try to drown ourselves in our merriment when we celebrate. Well-wishers applaud a newly married couple who drinks wine together during a wedding reception. In a gathering or celebration, there will always be someone who would lead and want to make a toast.


The situation may be different for others who cry and drink at the same time during moments of despair. 


We go out of our way, brave distances, in order to bask in scenic beaches.  While others visit the beach to reminisce memories of a lost love, or to simply forget the cruelty of the world,  and yes, to heal. 

We are even forced to drink bitter concoctions or syrups or suspension, to achieve cure and freedom from illness. 


Athletes and athlete-wannabes sweat hours of training, not minding the sacrifices they have to make, and the indescribable discipline they have to maintain and adhere to. Yet, when they sweat in the very day of the race, their sweat couldn't be more sweet. It is in fact the sweetest of all especially when they reach the finish line. 


Water, therefore, is not only essential in maintaining life. It plays an intrumental role in every aspect of it. 


Get thee, therefore, to the water. 



Frolicking at Patong Beach in Phuket.






Tuesday, April 18, 2017

Reflections 101



Have you ever led someone by the hand and guided him or her to enter through the gates that guard the boundaries that define the person that you really are?


It seemed then that you were under a mystic spell that made you reveal yourself so easily to that person, not worrying a bit about the reality of rejection, and most of all, not worrying about  the reality - and the risk it accompanies - that opening yourself to him or her is actually exposing your vulnerability - the softest part  of you where he or she can easily stab with a dagger anytime he or she decides  to,  and be sure that hitting that spot will instantly drain all the life that is left in you.


As for me, I did.  I’ve been there.


And it hurt a lot.  It hurt too much that I could not even begin to figuratively describe the pain of betrayal. 


I have picked up the pieces from the experience though. 



I have learned not really to regret but instead, to be cautious the next time I decide to open up to someone.  Moreso, I have learned to really choose the right person to open myself to and reveal the feelings I have deep within.  That is the harder part, though.  The act of opening up to someone is like giving that someone a present, a gift.  That present is a part of yourself, a vulnerable part of you that that someone could break.  It could also be like handing that person a gun, and allowing him or her to aim it at your heart, but trusting that person that he will never pull the trigger. I think Spongebob said that. 


When one opens up, it is like giving up a part of yourself to someone.  That is why choosing the person to reveal yourself to is actually the hardest part because, it is easy to give up something, but it is not easy to find the person worth giving it up for.  




Saturday, April 1, 2017

Things to consider when travelling with senior citizens



When we were young, my mother took my sister and I to a tour in some of the tourist spots here in the Philippines. She even would multi-task as mother and office worker when she took us to her out-of-town business trips.

I could not really say those instances awakened in me the love for traveling, however it sparked a desire in me and in my sister to give back to her by bringing her also to places she had never been.

Now in her senior years, my mother had visited a few countries other than the Philippines, and she also visited new tourist destinations in our country, as well. During our trips with her, I have realized that traveling with a senior citizen is something out of the ordinary - an adventure on its own, aside from the destination itself. 


Striking a pose at the Ngong Ping 360 Cable Car and Village in Hongkong. 


Unlike us young adults and millenials, senior citizens may not be as agile as before and mood swings might also be a challenge for some. That thought was a light bulb moment for me and so I decided to come up with this article.


1. Comfort should be king. This should be first and foremost in travelling with our folks. Comfort should be on top of the list when planning for trips, from accomodation to travel time, and mode of transportation to take. In the planning process, they should be asked whether it would be comfortable for them to take a 4 to 5-hour bus ride to a certain destination, like travelling from Puerto Princesa in Palawan to El Nido for instance, or would it be fine with them when going to a certain destination entails transfers from plane to bus to boat, such as in Boracay.

This reminds me of my latest trip to Boracay with my mother. It was ages since I last went to that paradise and while I was on the plane, I was trying to recount where to go next and what ride to take once we land on Caticlan Airport.

Good thing the flight attendants were selling these tickets for bus and boat transfers to the island. I admit it was quite pricey (Php 800.00 for a ticket per way per person), but I could not be more thankful and relieved that I bought tickets for us. Travelling was a breeze and we did not need to line up. The guide just told us where to go next and which van to hop into. I could line up for hours to save some bucks but I could not allow my mother to stand for long hours because she has problems with her knees on prolonged standing and in walking long distances. 

Comfort could come at an exorbitant price but that is nothing if that comfort is for our folks, right?


Obligatory inflight photo with Mama taken when we were on our way to Boracay.


2. Safety is a close second.  Once you enter your hotel room,  take time to survey the place and warn your folks whether, for instance,  they need to watch their steps in getting inside the comfort room, or whether they need to keep their head low when passing through the door that leads to the balcony.  Safety considerations may also include avoiding places that may have issues with insurgencies or security,  and the like. You might want to schedule your travel to those places some other time. Nobody would want to be caught in a crossfire, you know. 




3. Make use of privileges of senior citizens. These privileges include being prioritized to board first on the plane, or having seats specially designated for them, or being allowed to skip a que, or simply having the comfort of being transported on a wheelchair by airport personnel. 





4. Make sure to pack and bring their maintenance medications, blood pressure apparatus, and glucometers. Going on a vacation does not mean that they also have to take a break from taking their medications and from monitoring their blood pressure and blood sugar levels. 




5. As much as possible,  meals should be on time. Always bear in mind that our folks do not have iron stomachs like ours which could endure ultra-delayed meals. Sometimes some folks might be too shy to say that they are hungry so sometimes the best indicator is they become quiet, or worse, they become grumpy. Spare yourself from their "wrath," and avoid reaching that point where the signs are flashing in neon lights right in front of your face.




6. Simply lounging at the beachfront is happiness.  For these bunch who are in the prime time of their lives, travel may not necessarily equate to adrenaline-pumping experiences. They are quite past that. Join them as they simply enjoy watching the sunset, or watching the waves as they kiss the beach over and over again.

Mama and Me simply sitting on the powdery white sand beach of Boracay


7. They might not be able to do a lot of walking. Most trips usually entail walking. Ask your folks in a nice way if they want to bring along a portable wheelchair.  I say that with emphasis on nicely because they might be in denial that they are not as agile as before and you might strike a sensitive chord when you ask them that. An alternative would be to buy them those pricey slippers called FitFlops or Crocs. My mother's rheumatologist actually advised her to have those for her osteoarthritic knees. 





8.Ask them what places they want to visit. Lastly, ask them what places they want to visit. In that way, you will be making their dreams come true, all expense paid by you of course. Now you might want to start working and saving for that like, right now (?) 😀 Good luck! 


Going wacky with Mama at the Upside Down House in Phuket. 



To go public, or not?

I was more than delighted to receive an email recently from one of my readers.  I am posting it here hoping to enlighten more doctors, sp...