When’s the last time you felt euphorically hopeful?

When I inspire citizens to design ideal clinics and hospitals I feel exhilarated and, honestly, a bit manic. There’s something extremely energizing about helping people live their dreams. And the excitement is contagious.

Last weekend NPR aired my segment on creating dream hospitals. Before the interview was over I began receiving e-mails from listeners in Wisconsin and West Virginia.

Then Dave from North Carolina offered me a recommendation: Take a few pinches of whatever “IT” is that you have, put it in a an empty jar, stick on a simple label, and repeat a thousand times. Then carry the whole lot to flea markets across the country and sell each jar for a fair price. You will make a fortune AND you will leave a trail of happy, healthy, and energized ‘patients.’

Samuel Coleridge, an English poet and philosopher, once said, “He is the best physician who is the most ingenious inspirer of hope.”

Amid recession, depression and unemployment, patients seek more than another bottle of pills. They want a jar of hope.

Here’s my prescription:

1) Remember your dreams, your passion, your reason for being.

2) Every day inspire as many people as possible with your dream.

3) List everything that brings you joy. Do more of that stuff every day.

4) And don’t forget to smile!

“I’m a gastroenterologist in practice for four years and frustrated, hopelessly unfulfilled with modern health care. I’ve even contemplated leaving practice. I love medicine and treating patients but I’m sick of the headaches of running a business and worrying about what insurance, if any, people may have. Thanks for your advice.”

Another day. Another urgent plea from a doctor.

I was once a discouraged doctor. I dreamed of returning to my college waitressing job just so I could be nice to people again. It is the patient relationship that is the greatest source of professional satisfaction for most physicians. So it is no surprise that assembly-line medicine fails us. Production-driven health care is an oxymoron.

The good news for my frustrated colleague is that we live in an era of transparency. Disintermediation or “cutting out the middleman” allows modern businesses such as eBay and Amazon to build direct relationships with clients. Even in medicine removing intermediaries saves money and renews patient-physician relationships.

Gandhi advises: “You must be the change you wish to see in the world.” Now is the time for innovation.

If you are sick of the headaches of running a business, remember medicine is a calling. Revision your practice. Align with your values. Simplify and find meaning.

Here’s my advice for the top five physician morale-busters:

1) Low reimbursement? Drop bad payors and provide cash discounts. Lower overhead; you’ll need less revenue: Expensive building? Downsize. High staff-physician ratio? Consider part-time employees; streamline tasks with technology.

2) Loss of autonomy? Limit bureaucracy. Scrutinize third party contracts and terminate burdensome relationships. Say goodbye to middlemen who undermine your ability to care for patients. It may be difficult–like leaving an abusive marriage–but I promise you’ll never look back.

3) Patient overload? Take care of yourself. Every stewardess warns: Put your oxygen mask on first then help your child. Empathy burnout and physician fatigue have real consequences. I recently read 20% more polyps are identified on colonoscopies performed before eleven in the morning.

4) Loss of respect? Safeguard patient relationships and enjoy renewed respect and appreciation.

5) Malpractice worries? The sacred patient-physician covenant is your best protection. Patients don’t sue doctors they like.

Some heroes are not invited to the White House. Their opinions are not sought by Washington think tanks. There is no national holiday to recognize their contributions.

Welcome to IMCHeadline News! Here we celebrate the people who are living the dream and leading the way to ideal medical care for all.

Nominate your healthcare hero today!

George Lundberg, MD–the once Editor-in-Chief of the Journal of The American Medical Association–reports on MedPage Today “How to Ration Rationally, the Oregon Way.”

His brief video highlights the pioneering work of Dr. John Kitzhaber’s Oregon Health Plan and Dr. Pamela Wible’s grassroots–new & improved–version of the Oregon Health Plan.

Congratulations to the citizens of Lane County for believing in ideal medical care–the sensible and sane model for patients and physicians.

You ALL are my inspiration. Thank you!

Over the years I’ve been asked about the proper care and cleaning of the vagina. Women often want to know how to douche and what preparations to use.

But the vagina is like a self-cleaning oven.

Cleaning with water externally during bathing is quite adequate. Use a small amount of mild unscented soap if you must. Soap dries out your mucous membranes which are already more likely to absorb toxins.

Now new research just out this week suggests a link between use of talc and ovarian cancer. Women reporting long-term frequent application of talc powder to the genital area have a two-to-threefold increased risk of ovarian cancer.

So please refrain from special preparations, perfumes, and potions. Your vagina knows how to take care of itself.

Please forward this to anyone you know who has a vagina or loves someone with one. Thank you!