Vitals Plus Assessment about Rimal Babulal Bera MD by Keith Torkelson MS and MSG-EQR Study for Brand New Day
Brand New Day HMO
A-1 Abstract
This report is a product of
Mentalation Solutions Group (MSG). The
primary character or subject in this report is Keith “Buster” Torkelson
MS. Buster is MSG’s principal. I am Avey C Asus and I do many different
things around here at MSG. Buster is
treated by Doctor Rimal B Bera for anxiety and a sleep disorder. His medical records say it is bi-polar
disorder yet Dr. Bera has done nothing to prove Buster is Bi-polar. Here are some of the numbers on deck with
this report.
A-2 Frequency
Years ago in 1989 Buster
purchased 24 services hours with doctor Arnold P Deutsch over the course of six
(6) months. Typically, doctor Rimal B
Bera (RBB) gives 15 minutes of service time to Buster over the course of six
(6) months. Since Buster fell gravely
ill in 1989 Buster has partnered with pretty close to fifteen (15) Behavioral
Health Doctors (Psychiatrists). Back
around 2009 Buster was trained by the Orange County Health Care Agency (OCHCA)
to act in the role as a Para-professional Mental Health Worker. The training which Buster completed was 160 in-class
hours. Since Buster partnered with doctor RBB in 2018 they have had
approximately 16 appointments together.
Buster’s “dosage” of services is rather high. We call this dosage his Health Related Engagements
or HREs. Buster’s high frequency with
services is due in part to the fact that he is prescribed Clozapine. Clozapine management is relatively
intensive.
A-3 Doctor Numbers
For many of MSG’s reports we
reference on-line rating services. One
of these services is Vitals dot com (Vitals).
Vitals tabulated that in 2017 RBB earned 4.0 stars (VitalsStars) and in
2021 he earned 3.1 VitalsStars. RBB’s
WebMDStars have demonstrated improvement.
On October 7, 2018 we pooled RBB’s online Stars Scores and our
calculations yielded for RBB 2.9 PooledStars.
For Practice Management we give RBB 2.2 Star Equivalents. We compared some of Buster’s Behavioral
Health Doctors (BHDs). They score from
1.0 Star Equivalents (SEs) to 4.7 SEs.
Doctor Dobos one of Buster’s legacy doctors earned the 4.7 SEs. When we query our database for documents
related to doctor RBB get over 200 hits.
Buster scored RBB using the Healthgrades (HG) method. For RBB’s subjective score Buster gave RBB
3.2 SEs. We have collected time series
data on doctor Bera from WebMD. Doctor
Bera’s WebMD maximum score is 3.2 Stars.
From WebMD doctor RBB earned himself an Office Feature Score (OFS) of
4.0 Stars.
A-4 Consumer Numbers
Now we re-direct to Buster. After reaching low values several times with
his Global Assessment of Functioning (GAF) Score we are pleased to share that
Buster may be as high as 70 now.
Buster’s Psychiatric Pathological Burden Score (PPBS) is 45.0%. Back to Buster’s doctors. We compared RBB with his colleague and Buster’s
BHD prior to RBB. Buster’s prior doctor
was Bum Soo Lee. We gave BSL 4.0 Stars
as compared to the 3.7 Stars we calculated for RBB. In the end we more often than not score
doctor Rimal B Bera MD higher than others do online. Yet, we really do not expect doctor Bera to
improve much over the next five years.
Themes
APD Prediction
Assessments and Evaluations
History - Appointment Dates
Method – Structured Temporal Reconciliation
- Table - Service Details – Provider – Rimal Babulal Bera MD (RBB) - BHD
- Results - Objective Ratings for Doctor Bera
- Special Topic - Does the Venue matter?
- Practice Management Scheme
- Compare Behavioral Health Doctors (BHDs) (*)
- How is it Pre-shopping?
Errors – Costs may be fatal
Healthgrades Approach
Forgiveness Approach
Table – Vitals for Doctor Bera – Last Scored: 20160829-M
WebMD Approach
Feature – Keith “Buster” Torkelson’s Functioning
- Table – Sample Buster’s GAF scores
- Feature – Keith “Buster” Torkelson’s Symptom Severity
- Rigorous Condition Evaluation (RCE)
- Bera Safety Net
- With Care Coordination & Care Management - Not
- Specialty or Expertise
- BHD Helpfulness – Performance Earned Value (PEV)
A Day in the Life – Phlebotomy
A Situational Awareness Slideshow
Comparative - Vitals Brief Method (7 Items)
Service Year 2021
Summary
APD Prediction
When we consider the level of
service (LOS) that doctor Arnold P Deutsch (APD) offered Buster DBA Keith
Torkelson BS as compared with quality of time spent with doctor Rimal B Bera RBB)
we see disparity. RBB is Buster’s
current Behavioral Health Doctor (BHD). In
six-months’ time APD spent 50 minutes once per week with Buster. With rounding up to an hour that equates to 4
hours by six months or twenty-four service hours. When Buster visits with RBB he now gets ten
minutes every four months. This year
Buster will have three total visits with RBB.
Ten minutes by 3 visits is thirty minutes per year or 15 minutes for six
months. Back around 1990 APD projected
that psychiatrists may eventually phase themselves out of the picture. Time spent is only one service aspect where
psychiatrists are cutting corners. Just
like most everyone else in the age 55-65 bracket what they really care about is
having enough resources and time in retirement.
There are some BHDs that have published books. These few may actually leave a legacy. Most of the some odd fifteen (15) psychiatrists
that Buster has paid to serve him are basically illiterate. Instead of seeing a psychiatrist for
medication management Buster would prefer he contract with a toxicologist.
Assessments and Evaluations
Rating Behavioral Health Doctors
(Psychiatrists)
We are Mentalation Solutions
Group (MSG) and Keith “Buster” Torkelson MS is our principal. Buster holds a graduate degree in
Pathology. Every once in a while we get
the opportunity to ask one doctor about another doctor that the first doctor is
familiar with. We hope that the first
doctor had used some structured means to evaluate the competition. If they do not have that information it would
be nice if they knew the others online scores.
Online scores such as those offered on Vitals dot com. The best we usually get is: “Oh! She is a
good doctor”. High on our list of those
positioned best to evaluate other doctors would be doctors specializing in the
same field. They call Oranges with
Oranges Evaluation. At one point we did
get BHDs Chandler and Vu to weigh in on doctor Amen’s SPECT driven
approach. Both indicated that doctor Amen
was just out to make money rather than offer authentic psychiatric
services. Last time we checked Amen was
considered one of the wealthiest and most prominent psychiatrists in the United
States. Amen is a good example of a BHD
leaving a legacy.
Rules of Engagement
We piece together our Rules of
Engagement based upon Keith “Buster” Torkelson’s lived experience retaining
psychiatrists AKA BHDs. At last count
Buster has worked with fifteen (15) psychiatrists. From each Buster took away at least one
lesson learned. The following is a
foreshortened list of what Buster feels is necessary to address in productive
partnerships.
10_Profile_18010403_List_Psychiatrists_First V2021
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Practice Feature |
Example |
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- |
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History |
Dobos |
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Causation |
None |
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Presenting Problems |
More than 3 |
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Situational Awareness |
Dobos |
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Sleep |
None |
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Housing |
None |
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Association(s) |
Chau |
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Standardized Methods |
Inglis |
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Best Practices |
Chau |
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Assessment |
Chau |
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Medication Management |
More than 3 |
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- |
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Last Reviewed: 20211003-SUN:
Inception of Association
Buster’s unilateral relationship with Rimal B Bera MD (RBB) formally began on January 3, 2018. In 2018 Buster had been aware of the means and methods about the Mental Health Services Act (MHSA) for near about eight years. The act described bi-directional partnerships. In practice the associations are still unilateral. The nature of Buster’s first appointment with RBB was referral and linkage. We expected some form of baseline assessment or assessments. In another context RBB discussed some of the assessment tools that he was interested in. So when Buster came away without any assessment scores he continued with his own assessment agenda.
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Date of Service |
# |
Provider |
Nature |
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- |
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20180103 |
1 |
Rimal B Bera. MD |
Referral & Linkage |
Last Reviewed: 20211003-SUN:
RBB Legacy Reports
We keep telling Buster he has done enough sharing about Dr.
Rimal B Bera. That the association is
good enough move on to new material. We
have published several reports that address RBB.
Method – Structured Temporal Reconciliation
For some reason when Buster
generates a timeline he finds it easier finalizing issues. He also discovers issues that are resistant
to solution (RTS). What follows are
records of Buster’s visitations with his current (2018-present) Behavioral
Health Doctor (BHD) Rimal B Bera MD. In
order to assemble an Structured Temporal Reconciliation (STR) we reference
Buster’s wall calendars, his at-a-glance planners, provider records such as
visit summaries, and patient portals. We
call this documentation running in the background. Quite a while back (2009) Buster was enrolled
in a Mental Health Services Act (MHSA) funded course to make paraprofessional
mental health workers (PMHWs). The
course was 160 hours and called the Consumer Training Program (CTP). The money was administered by the Orange
County Health Care Agency (OCHCA).
Mental Status Exams (MSEs)
For Buster’s CTP case study
Buster decided to access his medical records circa 2007 while being treated by
the Orange County Health Care Agency (OCHCA).
He went to the Records Department and paid for everything they had on
him. He didn’t see this coming! The OCHCA had amassed about 100 pages on
him. One of his treating physicians, Dr.
Andrew Inglis, was generating a Mental Status Examination (MSE) for each
encounter. Buster was being stabilized
on Clozapine in an out-patient setting. So
Buster says to himself: “Well that is what behavioral health specialists do – MSEs”.
“I can and will work with this.” So when
he partnered with Rimal B. Bera back in 2018 he expected at least MSEs to work
with – not. There is a second purpose
for our STR method. Our STRs help with
submitting a complete formal complaint to: Central City Community Health Center
(CCCHC), Brand New Day Buster’s insurer or Medicare. In 2018 we were interested in our CCCHC
records. Yet, they told us it was all or
none. For Buster’s CCCHC records a flat
fee buys us all of Buster’s records.
That policy deterred us. We had
hoped to see some select case notes.
09_Record_Request_18072702_Supplement Form
Register of Appointments – 2018 to 2021
BHD_RBB_Bera_Driven_Appointment_21020206_Register
Skips details on the Crash and Burn Appointment
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Date of Service |
# |
Provider |
Nature |
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- |
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20180103-W |
1 |
RBB MD |
Referral & Linkage Assessment |
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20180411-W |
2 |
RBB MD |
Adjustment |
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20180718-W |
3 |
RBB MD |
Confidence Building |
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20180731-TU |
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Beatrice (Clerical) |
Records Request Error Checking |
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20181010-W |
4 |
RBB MD |
Medication Management |
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- |
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Last Reviewed: 20211003-SUN:-
Table - Service Details –
Provider – Rimal Babulal Bera MD (RBB) - BHD
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Date of Service |
# |
Provider |
Nature |
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- |
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20190116-W |
1 |
RBB MD |
Begin Easy Money Let than 10 minutes per appointment |
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20190403-W |
2 |
RBB MD |
Return on starts to deteriorate |
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20190703-W |
3 |
RBB MD |
Begin to realize why he bills for Medication Managment |
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20190925-W |
4 |
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20191218-W |
5 |
RBB MD |
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- |
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Last Reviewed: 20211003-SUN:
Table - Service Details – Provider – Rimal Babulal Bera MD (RBB) - BHD
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Date of Service |
# |
Provider |
Nature |
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- |
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20200318-W |
1 |
RBB MD |
Billed as Medication Management |
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20200715-W |
2 |
RBB MD |
Medication Management |
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20200925-W |
3 |
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Medication Management |
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20201007-W |
4 |
RBB MD |
Medication Management |
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- |
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Last Reviewed: 20211003-SUN:
Table - Service Details –
Provider – Rimal Babulal Bera MD (RBB) - BHD
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Date of Service |
# |
Provider |
Nature |
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- |
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20210103-W |
1 |
RBB MD |
Medication Management |
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20210602-W |
2 |
RBB MD |
Medication Management |
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20211006-W |
3 |
RBB MD |
Medication Management |
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- |
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Last Reviewed: 20211003-SUN:
Measurement
Rate Your Doctor – Online Data
& Vitals Plus (MSG)
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Instrument |
Priority |
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- |
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Google |
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Healthgrades |
Secondary |
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Vitals |
Primary |
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Vitals Plus MSG Extended Tool |
Tertiary |
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WebMD |
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Yelp |
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- |
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Last Reviewed: 20211008-F:
Standard Features per VITALS
There is an online rating service
or site for practicing doctors called Vitals dot com. In our reports we use several formats for
rating doctors: Vitals, Healthgrades, WebMD, etc. Of these methods Vitals is the simplest. From these services we collect our objective
rating information. We here at
Mentalation Solutions Group expanded on the Vitals method to created our Vitals
Plus tool.
Matrix – Online Rate Your Doctor
Summary View for Dr. Rimal B Bera MD
Vitals Approach
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Time Stamp |
DOW |
Service Rating System |
Rating |
Reviews |
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20160714 |
TH |
Vitals |
4.0 |
3 |
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20180319 |
TU |
Vitals |
3.3 |
11 |
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20181007 |
SUN |
Vitals |
3.3 |
11 |
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20210202 |
TU |
Vitals |
3.1 |
12 |
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Last Update: 20210202-TU:
Matrix – Online Rate Your Doctor
Summary View for Dr. Rimal B Bera MD
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Time Stamp |
DOW |
Service Rating System |
Rating |
Reviews |
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20170926 |
TU |
Healthgrades (HG) |
2 |
4 |
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20180104 |
TH |
HG |
2 |
4 |
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20180310 |
SAT |
HG |
2 |
4 |
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20181007 |
SUN |
HG |
2 |
4 |
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20210202 |
TU |
HG |
1.7 |
6 |
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Last Update: 20210202-TU:
Matrix – Online Rate Your Doctor
Summary View for Dr. Rimal B Bera MD
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Time Stamp |
DOW |
Service Rating System |
Rating |
Reviews |
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20170926 |
TU |
WebMD |
2.4 |
5 |
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20180104 |
TH |
WebMD |
2.4 |
5 |
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20180319 |
TU |
WebMD |
N/A |
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20181007 |
SU |
WebMD (*) |
3.0 |
16 |
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20210202 |
TU |
WebMD (**) |
3.5 (sh) |
17 |
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Last Update: 20210202-TU:
(*) Buster has a niece that is a
double doctor plus (MD, PhD). When he
and his neice discussed online ratings she indicated that the doctors could pad
their reviews. We have checked a bit
finding that the old timers of fifty (50) years of plus are unlikely to pad
their ratings with falsified information.
(**) On February 2, 2021 (TU) we
discovered a reporting glitch with WebMD.
It is hard to determine the exact Star value from their data.
Special Topic - Does the Venue matter?
The Orange County Health Care
Agency (OCHCA) raves over collocated services such as having the Primary Care
Physician (PCP) in the same facility as is the Behavioral Health Doctor
(BHD). Buster’s current PCP and BHD are
collocated. Buster has yet to find much
benefit in this arrangement. Unlike PCPs
BHDs can collect what they need over a distance. This is called Telepsychiatry and
telemedicine. Furthermore, in the new
age of Electronic Health Records the doctors can review the other’s
documentation at a distance. It is not
the physical collocation that matters much for consumers such as Buster it is
the collocated immediate access to each other’s records.
Vitals for Rimal Bera MD
http://www.vitals.com/doctors/Dr_Rimal_Bera/reviews
ASKAhnika Position
A bit more on Buster’s niece’s online rating position. Either Thanksgiving 2016 or 2017 Buster and Ahnika S Kline (ASK) MD PhD were discussing Online Rate Your Doctor sites. He calls these transactions ASKAhnika. ASK’s position was to argue against them. She indicated that they could be padded or falsified. To determine the validity of this supposition we focussed on the WebMD ratings. We found the number of Rimal Bera ratings shot up from a flat five (20170926 and 20180104) to sixteen in less than one year. We wonder! So we apply our Pure and Utter Falsification Check. Our conclusion was that the new 11 data points were not Pure and Utterly Falsified [See CALC Below].
Practitioner = Rimal B Bera MD
Consumer and Rater = Keith “Buster” Torkelson MS
Associated Document
06_Practice_Management_RBB_CDM_19090401_Operations V2021
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I# |
Aspect |
Note |
2021 1005 (TU) |
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01 |
Accountability |
SoSo |
0.50 |
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02 |
All money from medication |
SoSo |
0.50 |
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03 |
Bedside Manner |
Pass |
1.00 |
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04 |
Billing |
Secret |
0.50 |
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05 |
Diagnostics |
SoSo |
0.50 |
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06 |
Efficiency with Experiments |
SoSo |
0.50 |
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07 |
Health Related Engagement |
Pass |
1.00 |
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08 |
History |
Weak |
0.25 |
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09 |
Housing Help |
Poor |
0.25 |
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10 |
Housing Impact |
SoSo |
0.50 |
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11 |
Invoicing |
Absent |
0.00 |
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12 |
Medication Management |
SoSo |
0.50 |
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13 |
Minutes Spent |
Poor |
0.25 |
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14 |
No Fraud |
Pass |
1.00 |
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15 |
Patient Operations Manual |
Absent |
0.00 |
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16 |
Pedagogy |
Weak |
0.25 |
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17 |
Practice Management |
SoSo |
0.50 |
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18 |
Selling Profession |
Weak |
0.25 |
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19 |
Situational Awareness |
Poor |
0.25 |
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20 |
Teckno-psychiatry |
SoSo |
0.50 |
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21 |
Time Spent |
Poor |
0.25 |
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22 |
Transparency |
SoSo |
0.50 |
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- |
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CALC |
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=9.75/22 |
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Practice Management
Score (PMS) = |
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44.3% |
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Star Equivalents = |
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2.2 |
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- |
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Last Reviewed: 20211005-TU:
Parity with Medication Management quick score
0.50 V 0.443
Medication Management is a complex issue [STAYED]
In Buster’s case the primary role of his current Behavioral
Health Doctor (BHD) is Medication Management.
Like housing for the disadvantaged Med Mgmt. is a complex issue. We could not due the topic justice by rushing
through it. We hold Med Mgmt. over for
another report.
Roughly Chronological
MSG’s Quick Star Method (Q*M)
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Practitioner |
2021 1001 (F) Q*M |
Forte |
Note |
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1Deutsch |
4.0 |
Tandem work |
Position on over-medication and over-medicating |
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2Dobos |
4.7 |
Psychiatric-social problem solving |
Help with Buster’s progress about CSUF secondary teacher
education program |
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3Chandler |
2.5 |
Population Level Administration |
Cold turkeys “Buster” off Ambien Associated with a hospitalization |
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4Singh |
4.2 |
Medication Management |
Introduced us to Clozapine |
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5Inglis |
4.5 |
Medical Records |
Helped us get off LPS Conservatorship Source of medical records for school report |
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6Daniels |
1.0 |
Lying |
Convinced us to try something other than Clozapine Associated with a hospitalization |
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7BSL |
4.0 |
He is a Nice Guy because he said Buster is a nice guy |
Continuity of Care Only doctor that served Buster in both in-patient and
out-patient settings |
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8RBB |
4.0 |
Can’t determine |
We are really liberal with on Quick Score about him |
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- |
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We omitted several doctors such as Dr. Himasiri [K] De Silva, MD.
15_MDOC_Profile_16051605_DeSilva V2021
-
Initializing the Relationship
Keith “Buster” Torkelson MS and Rimal Babulal Bera MD (RBB)
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Date of Service |
# |
Provider |
Nature |
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20180103 |
1 |
Rimal B Bera. MD |
Referral & Linkage Assessment |
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How is it Pre-shopping?
In 2012 Buster signed on with Brand New Day (BND) as his health insurance provider. BND is collocated with Central City Community Health Center (CCCHC). CCCHC houses some of the BND associated Behavioral Health Doctors (BHDs). In 2012 their where four BHD’s working out of CCCHC: Unknown, Bum Soo Lee (BSL), Rimal B Bera (RBB), and Dr. Waknine. Buster had met and was served by doctor BSL in the hospital. Buster’s BND associated intake paperwork indicated his doctor was BSL yet he was assigned to Waknine. About the first appointment Buster could tell that doctor Waknine wasn’t a good fit. Within about two months Buster managed to get BSL back. Buster and BSL’s best achievement was to get Buster going again with Clozapine. After five (5) or so years Buster could tell that BSL was getting physically tuckered out. BSL didn’t want to admit he needed retirement yet Buster did not want to get caught in-between doctors. Late in 2017 Buster asked BSL for a referral to doctor Bera. We had been observing doctor Bera since 2016. Within a year or so after referring Buster to RBB BSL retired.
Dr David M Dobos, MD Kaiser Psychiatrist in Aliso Viejo, CA
Doctor On Call - Stats by TheDAG and Keith E Torkelson, MS
http://the-torkel-saga-2059.blogspot.com/2016/05/dr-david-m-dobos-md-kaiser-psychiatrist.html
Time
Stamping
For us here at Mentalation Solutions Group (MSG) we work with two type of time stamps: Absolute and Best. Absolute times are those that for sure the date reported is the date reported. Best are close yet not exact. An example of a best conflict are those assocated with lab results. You get to chose from: Draw date, test date and report date. When it comes down to formatting dates we prefer YYYYMMDD. If a format is provided let us say in a lab report then sometimes we use their format. When writing text we sometime use the month day, year format. We also include the day of the week associated with a date.
See that 26,000 plus documents! That is why we had to develop our MSGBase. TRCBase is directory driven whereas our new and improved MSGBase for years 2015 and after is filename driven. In TRCBase we had directories some fifteen levels deep. Our MSGBase queries deliver from both our TRCBase and MSGBase. Mentalation Solutions Group base (MSGBase). For the most part intelligence about doctor Bera is in our MSGBase. The majority of database his are by far *.doc format. The next most frequent are *.xls format.
External
Quality Review (EQR)
Reference
to Doctor Rimal B Bera (RBB) first appears in our database, MSGBase, on May 13,
2016. Again, we knew that Doctor Bum Soo
Lee MD (BSL) was getting old and may retire soon. “Buster” had already worked a bit with Doctor
Waknine. The association was a weak
one. Waknine and “Buster” differed
greatly on how to pursue recovery. Most
importantly doctor Waknine was not on track to get Buster stablized on
Clozapine. Buster’s Brand New Day (BND) contract
indicated that BSL was to be “Buster’s” Behavioral Health Doctor. BND’s director at the time Diana approved a
referral to Dr. Lee. Diana also approved
that Buster be moved from Invega back to Clozapine. From 2012-2017 BSL served “Buster” well. BSL only made one mistake. We wrote him up and shared it with BND
corporate. This complaint help us
develop our External Quality Review (EQR) function with Brand New Day.
Errors
– Costs may be fatal
In
the above metadata you may find reference to “Daniels”. Due to an medication error Doctor Daniels propelled
“Buster” into the hospital. Doctor
Daniels was a female. We have tried to
find online information about her and the program with which she associated no
avail. We think that even though the
program called her “Doctor Daniels” that she was probably an Registered Nurse
(RN) or some other non MD that can prescribe medication. On her program’s website they make no
reference to a Doctor Daniels. This
little Daniels fiasco increase Buster’s risk for pre-mature death.
https://www.healthgrades.com/physician/dr-rimal-bera-2xn5c
Control Reference: 20210202-TU: 1.7 Stars with 6 Ratings
Buster scores Dr. Bera
Service & Office Related
|
|
- |
|
|
|
|
I# |
Aspect |
Note |
2021 1006 (W) QUANT |
|
|
|
- |
|
|
|
|
1 |
Appointment scheduling |
Improved |
0.75 |
|
|
2 |
Office environment |
Improved |
0.75 |
|
|
3 |
Wait times |
OK Same |
0.50 |
|
|
4 |
Appointment wasn't rushed |
Not Last improved |
0.75 |
|
|
5 |
Explained conditions well |
Not |
0.25 |
|
|
6 |
Listened & answered questions |
SoSo |
0.75 |
|
|
7 |
Trusted the provider's decisions |
SoSo |
0.75 |
|
|
|
- |
|
|
|
|
|
CALC |
|
=4.50/7 |
|
|
|
Session Favorability Value = |
|
64% |
|
|
|
Star Equivalents = |
|
3.2 |
|
|
|
|
|
|
|
Last Reviewed: 20211008-F:
Forgiveness Approach
Our last appointment for the year
(2021) with RBB our BHD was October 6, 2021 (W). One of the reasons our BHD reports vary in
format and content is that we try to move past shortcoming and capture the most
up to date picture. During our
appointment doctor Bera and his team performed rather well. We found a marked improvement. What follows is Healthgrades evaluation for
deficits.
Deficits Assessment
Service & Office Related
|
- |
- |
|
|
|
|
I# |
Aspect |
Note |
2021 1006 (W) QUANT |
|
|
- |
- |
|
|
|
|
1 |
Didn't listen or answer questions |
Valid |
0.50 |
|
|
2 |
Didn't trust the provider's decisions |
Valid |
0.50 |
|
|
3 |
Appointment was rushed |
Valid |
0.25 |
|
|
4 |
Didn't explain conditions well |
Valid |
0.75 |
|
|
5 |
Difficult to schedule appointment |
SoSo |
0.25 |
|
|
6 |
[Substandard] Office environment |
Fail |
0.25 |
|
|
- |
- |
|
|
|
|
|
CALC |
|
=2.50/6 |
|
|
|
Session Deficit Score
= |
|
42% |
|
|
- |
- |
|
|
|
Table – Vitals for Doctor Bera – Last Scored: 20160829-M
Shopping Phase – Pre-Linkage Evaluation
Standard Features per VITALS (Expectation)
Modified Stars Scoring Method
|
- |
|
|
|
|
|
I# |
Patient Ratings |
Knowledge |
2016 |
2016 |
|
|
- |
|
|
|
|
|
|
1 |
Ease of Appointment |
No Evidence (NE) |
ND |
4.0 |
|
|
2 |
Promptness |
No Evidence |
ND |
3.5 |
|
|
3 |
Courteous Staff |
Same staff and I have now |
4.0 |
3.0 |
|
|
4 |
Accurate Diagnosis |
Not on record that he will inherit |
0.5 |
4.0 |
|
|
5 |
Bedside Manner |
Appears so 3.0 |
3.0 |
3.5 |
|
|
6 |
Spends Time w Me |
In Community Setting has spent more that 2.0 hours with us |
4.0 |
4.0 |
|
|
7 |
Follows Up After Visit |
No Evidence |
ND |
4.0 |
|
|
- |
|
|
|
|
|
|
|
|
CALC |
=11.50/4 |
=26.00/7 |
|
|
|
|
Vitals Stars = |
2.9 |
3.7 |
|
|
- |
|
|
|
|
|
NE or No Evidence Method
ND=Not Demonstrated
Vital Obj = Objective using scores from existing data reported by others
-
Service Year – 2018
Star Method Scoring
Table – Vitals for Doctor Bera – Last Scored: 20181010-W
Last for 2018 – Maintenance and Planning Phase
Baseline for a Year of Service
Standard Features per VITALS (Observations Results)
Modified Stars Scoring Method
Buster Scores Doctor Bera
|
- |
- |
|
|
|
I# |
Patient Ratings Service Element |
2018 1010 (W) |
|
|
- |
- |
|
|
|
1 |
Ease of Appointment |
5.0 |
|
|
2 |
Promptness |
2.5 |
|
|
3 |
Courteous Staff |
2.5 |
|
|
4 |
Accurate Diagnosis |
0.5 |
|
|
5 |
Bedside Manner |
4.0 |
|
|
6 |
Spends Time w Me |
4.0 |
|
|
7 |
Follows Up After Visit |
0.0 |
|
|
- |
- |
|
|
|
|
CALC Number Scored = 7 Score MAX = 35.0 |
=18.50/35.0 |
|
|
|
Percent Satisfied = |
53% |
|
|
|
Stars (*) = |
2.6 |
|
|
- |
|
|
|
Profiling Rimal B Bera MD
FYI
http://doctor.webmd.com/doctor/rimal-bera-md-f76af2b5-1424-42f4-b975-ddd16a3867e5-appointments
Dr. Rimal B Bera MD
-WebMD
|
- |
|
|
|
|
|
Time Stamp |
DOW |
Reviews & Ratings |
WebMD |
|
|
- |
|
|
|
|
|
|
|
|
|
|
|
20170926 |
TU |
5 |
2.4 |
|
|
20180104 |
TH |
5 |
2.4 |
|
|
20181007 |
SU |
16 |
3.0 |
|
|
20200130 |
SA |
17 |
+/- 3.5 |
|
|
- |
|
|
|
|
Rimal Bera MD - WebMD Physician Directory
https://doctor.webmd.com/doctor/rimal-bera-md-f76af2b5-1424-42f4-b975-ddd16a3867e5-overview
WebMD Method
http://doctor.webmd.com/doctor/rimal-bera-md-f76af2b5-1424-42f4-b975-ddd16a3867e5-appointments
Modified: 20211006-W:
WebMD - Overall Rating Physician Rating
|
- |
|
|
|
Element |
2021 1006 (W) Score |
|
|
- |
|
|
|
Explains conditions and treatments |
0.50 |
|
|
Takes time to answer my questions |
0.50 |
|
|
Provides follow-up as needed |
0.50 |
|
|
How was your visit with Bera? (Select a rating) |
0.75 |
|
|
|
|
|
|
CALC |
=2.25/4 |
|
|
Overall Physician
Rating = |
56% |
|
|
Star Equivalents = |
2.8 |
|
|
|
|
|
WebMD Method
http://doctor.webmd.com/doctor/rimal-bera-md-f76af2b5-1424-42f4-b975-ddd16a3867e5-appointments
Office Features Rating
|
- |
|
|
|
Element |
2021 1006 (W) Score |
|
|
- |
|
|
|
Office location |
1.00 |
|
|
Average office wait time |
0.50 |
|
|
Office cleanliness |
1.00 |
|
|
Courteous staff |
1.00 |
|
|
Scheduling flexibility |
0.50 |
|
|
- |
|
|
|
CALC |
=4.00/5 |
|
|
Office Management
Score = |
80% |
|
|
Star Equivalents = |
4.0 |
|
|
- |
|
|
Last Reviewed: 20211006-W:
Healthgrades Approach
All we can say is that the
Healthgrades raters hammered Dr. Bera.
It is going to take many positive reviews to climb out of this Healthgrades
hole. For the most part Buster rates Dr.
Bera much better than he score here with Healthgrades.
Dr. Rimal B Bera, MD - Garden Grove, CA - Psychiatry - Healthgrades
https://www.healthgrades.com/physician/dr-rimal-b-bera-2xn5c
Dr. Bera is now accepting new patients.
Dr. Rimal B Bera MD -
Healthgrades
|
- |
|
|
|
|
|
Time Stamp |
DOW |
Reviews & Ratings |
Healthgrades Stars |
|
|
- |
|
|
|
|
|
20170926 |
TU |
4 |
2.0 |
|
|
20180104 |
TH |
4 |
2.0 |
|
|
20181007 |
SU |
4 |
2.0 |
|
|
20200130 |
SA |
6 |
1.0 |
|
|
- |
|
|
|
|
Last Reviewed 20210131-SUN:
Aside – Visual Disturbances
Unless Buster is hallucinating again Dr. Bera exists. Actually Buster reports to never have had a visual hallucination. That is not to say he doesn’t see things that others typically do not see. An example would be water molecules and their variations and activities in liquid form versus solid forms. Typical people are clueless into water molecule molecular configurative variation and kinetics. As we mentioned we rely on a few online rating services to collect information about doctors. From Healthgrades we found that doctor Bera “is now accepting new patients”. In addition, doctor Bera experience matched with Buster’s needs came out at 100%. We have no idea how they came up with their matching Intel. This is a good place to share that Buster suffers from anxiety complicated with a sleep disorder.
Dr. Rimal B Bera, MD - Garden Grove, CA - Psychiatry - Healthgrades
https://www.healthgrades.com/physician/dr-rimal-b-bera-2xn5c
Feature – Keith “Buster”
Torkelson’s Functioning
Statistical Remediation
Time has flown since the elegant Global Assessment of Functioning (GAF) method went by the wayside. The problem is the there is an enormous volume of records that documented GAF scores. The last time Buster fell down was 2012. During 2012 about three (3) practitioners reported GAFs on Buster.
Table – Sample Buster’s GAF
scores
|
|
|
|
|
|
Record Time Stamp |
GAF |
Practitioner Reporting |
|
|
|
|
|
|
|
20120319 |
40 |
HCA: Wilfert, MFT II |
|
|
20120420 |
30 |
Ravinder P Singh, MD |
|
|
20120425 |
Unreported |
Ravinder P Singh, MD |
|
|
20120518 |
Unreported |
Thymes, MD ER Doctor |
|
|
20120607 |
35/45 |
Bum-Soo Lee, MD |
|
|
|
|
|
|
Last Reviewed: 20211006-W:
Improvement – As Measured By…
Since 2012 Buster’s assessment (evaluation) scores have improved. Yet due to his sleep problems he is always at risk for hospitalization. In 1989 he was diagnosed three times with three (3) different diagnoses. Since 1989, Buster has pulled himself up many times by the boot straps. Until 2013 he really did not know the core problems that he needed to address. So he kept episodically falling down. We now know that Buster is truly Serious and Persistently Mentally Ill (SPMI). He will not get better as Measured by (AMB) workability. Relative to both his Rent a Shared Room cohort and his Brand New Day cohort Buster is highly functional. Yet he is still a SPMI person. We figure that if GAFs still mattered his current GAF is between 30 and 70.
SPMI V GAF 80 Plus
|
- |
|
|
|
|
Criterion |
Note |
QUNT 2021 1006 (W) |
|
|
- |
|
|
|
|
Good functioning in all areas |
SoSo |
0.50 |
|
|
Interested in a wide range of activities |
Yes |
1.00 |
|
|
Involved in a wide range of activities |
Yes |
1.00 |
|
|
Socially effective |
Yes |
1.00 |
|
|
Superior functioning in a wide range of activities |
SoSo |
0.50 |
|
|
Life’s problems never seem to get out of hand. |
No (*) |
0.00 |
|
|
I sought out by others because of his or her many positive
qualities |
Yes |
1.00 |
|
|
- |
|
|
|
|
CALC |
|
=5.00/7 |
|
|
GAF 80 Mirror Score
(GAF-MS) = |
|
71 or 71% |
|
|
- |
|
|
|
Higher Scores are favorable indicating assets
(*) Biggest recurrent problem is reliable rejuvenating sleep
Rigorous Condition Evaluation (RCE)
Even if Buster’s GAF related scores are improving we still have to address the Severity of his Symptoms. For tracking progress managing his symptoms we created a Rigorous Condition Evaluation or RCE. We also describe this tool as A Conditional Containment Assessment (ACCA). Our beta version has 30 items. The assessment yields a Psychiatric Pathological Burden Score or PPBS.
|
- |
|
|
|
|
Time Stamp |
Part |
SUM/Items |
|
|
- |
|
|
|
|
2021_0130 (SAT) |
Part B |
=7.00/15 |
|
|
2021_0130 (SAT) |
Part A |
=8.50/15 |
|
|
|
|
|
|
|
CALC |
|
=13.50/30 |
|
|
Psychiatric Pathological
Burden Score (PPBS) = |
|
45.0% |
|
|
|
|
|
|
The full assessment is in the following document
Data found in Assess_VITALS_RBB_21100401_Bera
We find that doctor Bera has other engagements in addition to his hours at Central City Community Health Center (CCCHC). He appears to be associated with the University of California @ Irvine. He acts as both a practicing doctor and an educator. He also appears to be associated with a local behavioral health operation called the John Henry Foundation (JHF). Conflict Of Interest (COI): There is evidence that doctor Bera has accepted money from one or more pharmaceutical companies. We here at Mentalation Solutions Group are hoping to get an open-ended referral for housing at the John Henry Foundation Residential Treatment Center (RTC). It would appear that doctor Bera is accepting new patients about the JHF office. FYI – Phone (714) 456-8978 – Address 403 N Susan Street, Santa Ana, CA 92703-3433. This open-ended referral would constitute by doctor Bera an act of Prevention & Early Intervention (PEI). It could prevent Buster from falling hard again. What Buster would like to know is: When the times comes and he is at risk for falling again that his doctor Bera has for him a safe and humane place for Buster to sleep. We have examined the JHF a bit and it appears to be a humane place to go.
20211004-M: Bera Safety Net
Back in 2015 we were interested
in assembling a Safety Net for Buster.
Safety Nets can save money and make BHDs such as doctor Bera (RBB) look
good by keeping consumers such as Buster out of institutions such as the Psych
Ward. We found that one of the key
features with Buster’s Safety Net(s) is housing. The element about housing that is most
important is sleep and anything that promotes nightly rejuvenating sleep. During appointments on and off Buster and his
BHD talk a bit about housing. RBB
thanked Buster for his “advocacy work with housing”. Since sleep is so important: It would be
prudent if RBB offered Buster a housing and sleep evaluation with each
appointment. Thinking back to when
Buster partnered with Kaiser for Behavioral Health Services (BHSs) his
coordinator/therapist Joyce Alessi had Buster fill out her worksheet before
each face-to-face.
With
Care Coordination & Care Management - Not
Back in 2012 when Buster signed on with his new insurer Brand New Day (BND) he needed help coordinating his care. He gradually took over areas such as scheduling and transportation. BND provides Buster a Behavioral Health Care Manager or BHCM. Yet in reality both his BHCM and Behavioral Health Doctor are not very helpful. Buster is very rarely asked to bridge the gap between his Primary Care Physician and his Behavioral Health Doctor (BHD). Yet, if bridging is necessary Buster acts as his own Case Manager. Obviously Buster has little to do with financials except co-pays. Buster routinely solves problems associated with his: Pharmacy, lab work, housing, and finances. Last, he manages efforts with his specialists such as his Dermatologist, Ophthalmologist, and Dentist. He has often been asked to make manual Health Information Transfers (HITs).
Rimal B. Bera, MD - Psychiatrist
in Santa Ana, CA | MD.com
https://www.md.com/doctor/rimal-bera-md
Going to have to go back to this site because it looks to contain some helpful information and numbers.
VITALS Ratings – Ancillary
Information
Many of the online rating
services in addition to Stars Scoring share information about the doctor’s
specialties or expertise. We are not
sure how the lists are generated. We
cannot tell for sure if the doctor had any input. We are going to assume the Dr. Bera’s expertise
as listed are accurate.
Vitals Method
Dr. _________ has been reviewed: By ___ patients who have provided ___ comments the rating is ____ out of 5 stars.
Name: Rimal Bera
http://www.vitals.com/doctors/Dr_Rimal_Bera/profile
20181007-SUN: 3.3 via 11 Reviews
20211007-TH: 3.1 via 12 Reviews
Uncertain of Source
Dr. Rimal B Bera has the following 13 expertise
|
- |
|
|
|
|
Expertise |
Buster’s |
RBB |
|
|
- |
|
|
|
|
Attention Deficit Disorder (ADD) |
Nothing |
|
|
|
Attention Deficit Hyperactivity Disorder (ADHD) |
Persistence |
|
|
|
Bipolar Disorder |
Treat Anxiety (Bourne) |
Yes |
|
|
Clinical Depression |
CBT (Burns) |
|
|
|
Depression |
CBT (Burns) |
|
|
|
Depressive Disorder |
CBT (Burns) |
|
|
|
Insomnia |
Clozapine (Singh) |
Yes |
|
|
Manic Depressive Disorder |
Treat Anxiety (Bourne) |
|
|
|
Mental Illness |
Mixed methods |
Yes |
|
|
Mood Disorders |
Clozapine (Singh) |
Yes |
|
|
Personality Disorder |
Awareness and socializing |
|
|
|
Schizophrenia |
Sleep (Singh) |
Yes |
|
|
Sleep Disorders |
Clozapine & address environment |
Yes |
|
|
- |
|
|
|
Last Reviewed: 20211006-W: CBT = Cognitive Behavioral Therapy (Bibliotherapy)
BHD Helpfulness – Performance
Earned Value (PEV)
We here at Mentalation Solutions Group (MSG) classify conditions as up, down, in and out. Conditions such as depression are down. Anxiety is up. Activated psychosis is out. And in-activation is in. We find that many dying old men (DOMs) are in-activated. We feel that the BHD might best only treat one coordinate with medication. To resolve any other co-morbid condition the doctor should use non-pharmacological approaches. These approaches may or may not be Promising Practices. To be an expert the doctor needs to report some outcome measures reflecting statistical proof of their practices. Buster can say he is an expert with car tire changing. In his lifetime he has successfully changed about ten (10) tires. In this time he only made one error. From 2012-2016 Buster’s car was in keeping with his oldest sister up in Los Altos California. In 2016 when he earned the car back it did not occur to him to check the air pressure in the spare tire. When one of his tires went flat he goes to get the spare just to find no air. He resolved the new hurdles that made a routine unusually complicated. BHDs need to quantitatively earn value in their expertise. It is their job to know how helpful they are and have been in practice.
Google Chrome Query > “keith torkelson mdoc”
About our Google Blogger publications we get six (6) Google hits for the query above. From 2016 to 2018 we worked on our Medical Doctor on Call Project (MDOC-P). One of the rewards is we had the opportunity to discover Buster’s best doctors and why we felt the way we do about them. One peripheral benefit was that we improved the Digital Presence of our target doctors. Page for page about Buster’s doctors we have published more positives than shortfalls. When it comes to psychiatry Dr. David Dobos is our standard for excellence. We have rated Dr. Clayton Lon Chau on and off as being good yet Buster never saw him in the core capacity of Medication Management.
Assess_VITALS_RBB_21100401_Bera
Rate Your Doctor – Graphics
The online rating services such as Vitals include graphic presentations of data. We decided to leave them out with this report.
Longitudinal Vitals Stars Method (LVSM) Data
|
- |
|
|
|
|
|
Time Stamp |
DOW |
Reviews/Ratings |
Vitals Stars |
|
|
- |
|
|
|
|
|
2016_0714 |
TH |
3 |
3.0 |
|
|
2018_1007 |
SUN |
11 |
3.3 |
|
|
2020_0130 |
SAT |
12 |
3.1 |
|
|
- |
|
|
|
|
Last Reviewed: 20211008-F:
Does it matter what your client thinks about your service?
Some evidence indicates that healthcare compensation levels may be influenced by consumer satisfaction. Buster’s insurer lingers about 3.5 Medicare (CMS) stars. Medicare indicates that it rewards healthcare systems earning higher CMS scores. We assume Brand New Day (BND) gets reimbursed for the services they provide and oversee. So far BND has kept reimbursement and such a secret. Thus, if BND gets less money than it makes sense they have less to give their contractors such as doctor Bera. So in reality everyone benefits from measuring the quality of service.
On Record Lability
The way online ratings are managed is that they only report the latest findings. If you don’t capture past ratings then for all practical purposes they are un-accessible. Additionally, at times we have found some of the links are broken.
What your client said about you!
20170207 – Vitals Commentary - Deficits
https://www.vitals.com/doctors/Dr_Rimal_Bera/reviews
“Do not see this man he is a waste of time fraud. Not nice at all rude and doesn't care. He will see you for 5-10 minutes and not even ask how I feel.”
MSG’s Evaluation
We ran a fraud evaluation on
doctor Bera. We found he has a low Fraud
Trap Score (FTS). He is not very
rude. He cares a bit. Buster’s current appointments are just less
than ten (10) minutes. Lastly he doesn’t
solicit much input from Buster. Yet,
Buster would rather not distract him while he takes care of his Medication
Management business due to increasing the risk for error.
A Day in the Life - Phlebotomy
Buster is in the waiting room
right now for his doctor Bera associated Complete Blood Count (CBC) lab. His appointment was at 1015am. The time right now is 1030am. We just noticed that there are seven people
in the waiting room. That is a high
since the Corona Virus Affair (CVA) began back in early 2020. Buster has been very fortunate that Corona
has not substantially interfered with his healthcare. When he checked in the counter person took
his temperature. We always wonder what
has occurred to clients that fail the temperature check. Buster is highly dependent on his monthly
CBC. For this visit Buster let his guard
down a bit. He did not get either of his
routine phlebotomists. During the blood
draw, he notices the phlebotomist stuck the wrong area and was poking to and
fro to hit the vessel. She indicated
that Buster had not consumed enough water this morning. His water consumption was in par with every other
CBC day. She gave Buster some very cold
water to drink. In the meantime she
tracked down good ole Beatrice. Beatrice
had trouble also. She seemed a bit angry
as she poked to and fro. Finally while
applying the cross his finger luck method Beatrice delivered on the blood
draw. Buster was thinking if she doesn’t
get it soon he might need a drop everything referral to Quest Diagnostic. Buster needs the monthly CBC in order to get
his primary prescription Clozapine.
All Tore Up
Today is October 5, 2021 (TU) and
Buster is all tore up. He is getting
over back pain about his lower left back quadrant. Last Tuesday he had MOHS surgery on his lower
lip to remove a Squamous Cell Carcinoma.
On and off his lip hurts and causes difficulty while eating. Earlier in September his dentist diagnosed a
problematic tooth in need of a crown. He
may also need a root canal (RC).
On-and-off Buster’s bad tooth aches.
He made an appointment for next Thursday. In the meantime his dentist says use Oral gel. Buster was reserved about the dental work
because he did want any complications about the lip and stitches. He has been fortunate that he is getting
adequate rejuvenating sleep.
A Situational Awareness Slideshow
What follows are excerpts from
some of the situations that Keith “Buster” Torkelson MS is facing for the Fall
Term 2021
|
- |
|
|
|
|
Area |
Note |
Detail |
|
|
- |
|
|
|
|
Dermatology |
Squamous Cell Carcinoma surgery |
Lower Lip CBC lap correlation |
|
|
Death in the House |
Wounded Warrior Rochester Cannon |
Chance he was underserved and inappropriately served |
|
|
Dental (Approval) |
Root Canal potential co-pay |
Could complicate lip healing process |
|
|
Most Significant Other Ever |
Joan Zhorne |
Uncertain fate |
|
|
Death in the family |
Aunt Joyce Maxine Brown |
Family succession trial with step down two generations |
|
|
Financial Succession |
Generational step-down process |
Oldest sister to nephew |
|
|
Old housemate dies |
Mark Allen |
Brand New Day client dies too young |
|
|
- |
|
|
|
Last Reviewed: 20211008-F:
Oct 12th, 2015 regarding Rimal B Bera MD
User Friendliness – Objective Narrative
“Going to these appointments is
difficult enough. Not being made to feel like an idiot prior to coming in would
be really great. The staff answering the calls should take some awareness
training. The interaction that I just
had has sparked something that is making it difficult for me to view myself
walking in that office comfortably.”
The above blurb was written in 2015. Even though Buster did not hook up with Dr. Bera until 2018 he has been going to the “Office” since 2012. Since 2012 clerical has vastly improved.
Comparative - Vitals Brief Method (7 Items)
http://www.vitals.com/doctors/Dr_Rimal_Bera/reviews#ixzz4EPLUiCpc
Typically the Vitals Stars Method
(VSM) is a seven (7) item online survey.
The rater here is Keith “Buster” Torkelson MS. Of the seven items we find that “Bedside
Manner” carries the highest weight. In
the outcome matrix below we compare two Behavioral Health Doctors (BHDs). Both work/worked out of the Central City
Community Health Center’s (CCCHC) Garden Grove location. The BHDs are: Bum Soo Lee (BSL) and Rimal
Babulal Bera (RBB). We picked 2016 as
the reference year for BSL and 2020 as the reference year for RBB. We scored BSL on 20160507 a Saturday. Higher scores are better. The maximum score for any item is 5.0 Star
Equivalents.
|
|
- |
|
|
|
## |
Service Element |
2016 |
2021 |
|
|
- |
|
|
|
01 |
Ease of Appointment |
4.5 |
4.5 |
|
02 |
Promptness |
4.5 |
4.5 |
|
03 |
Courteous Staff |
4.5 |
4.5 |
|
04 |
Accurate Diagnosis |
3.5 |
3.5 |
|
05 |
Bedside Manner |
4.0 |
3.5 |
|
06 |
Spends Time with Me |
4.0 |
2.5 |
|
07 |
Follows Up After Visit |
3.0 |
3.0 |
|
- |
|
|
|
|
|
CALC |
=28.0/7 |
=26.0/7 |
|
|
Q*M Average Star
Equivalents = |
4.0 |
3.7 |
|
- |
|
|
|
Last Reviewed: 20211006-W: FY = For Year
Service
Year 2021
What
a Difference a Day can Makes
On
20210131 a Sunday we decided to score Rimal Babulal Bera (RBB) again a
day later. We score him for service year
2020. Again we used the Vitals Stars Method (VSM-Brief). We added “Wait Time”. The rater is Keith
“Buster” Torkelson MS. On 20210130 a
Saturday we checked RBB’s online vitals score.
He earned himself a 3.1 across 12 ratings.
FYI
Vitals Online
https://www.vitals.com/doctors/Dr_Rimal_Bera/reviews
Buster Rates Bera
|
- |
|
|
|
I# |
Requirement |
RBB 2021 0131 (SUN) |
|
- |
|
|
|
1 |
Wait Time (*) |
3.0 |
|
|
|
|
|
2 |
Easy Appointments |
4.0 |
|
3 |
Promptness |
3.0 |
|
4 |
Friendly Staff |
4.0 |
|
5 |
Accurate Diagnosis |
3.0 |
|
6 |
Bedside Manner |
3.0 |
|
7 |
Spends Time With Patients |
2.5 |
|
8 |
Appropriate Followup |
3.5 |
|
- |
|
|
|
|
|
RBB for 2020 |
|
|
CALC |
=26.0/8 |
|
|
Vitals Brief
Performance Score = |
3.3 (**) |
|
- |
|
|
Last Reviewed: 20211006-W:
(**) Our score is higher than objective: Vitals 20210130-SAT = 3.1
How is it 2016?
How is it that we picked 2016 to
review Dr. Bum Soo Lee (BSL)? Doctor BSL
has been Keith “Buster” Torkelson’s Behavioral Health Doctor (BHD) since
2012. Together they overcame a few
challenges and hurdles such as working about the nuances of Clozapine.
S-1 Summary
We provide this information in
that the next generation that prescribes psychotropic medication(s) gets it
right. The doctors might best provide
Performance numbers about their practices and interventions. We foresee in the future ever better
medications ones’ that are lighter about side effects. We first ran into a psychiatrist for Buster
DBA Keith Edward Torkelson BS back in 1989.
His name was Dr. Arnold P Deutsch (APD).
APD taught Buster some of his lessons learned about the practice of
psychiatry. APD predicted that one type
of doctor will go when the Primary Care Physicians (PCP) start taking over
psychotropic medication management. The
lesson we have learned with Behavioral Health is that each doctor should have
structure in the form of a consumer workbook including evaluation challenges. For the most part almost all of Buster’s
BHD’s are week on writing. In other words
they might be considered relatively illiterate.
S-2 For New BHDs
We have done much work: Profiling,
describing, and publishing the affairs of Buster’s psychiatrists. In the last ten years Buster has studied Best
Practices in Behavioral Health. If all
the doctor actually does is medication management then the doctor should pen and
share their lessons learned and performance measures. This might help them with future consumer buy
in and improve their online Quality Assurance scores including Stars. We feel that if they shared their practice
management findings with “NewBee” and upcoming doctors it would most likely
drive burgeoning Behavioral Health Doctors (BHDs) away.
S-3 Increase in Diagnoses
Even before the advent of Corona
many sources indicated that there would be an increase in diagnoses for
Behavioral Health Disorders. This will surpass
the increase due to growth in population.
Now the Health Care Agency (HCA) is documenting growth of let us say
depression in “The OC”. If business as
usual continues these “NewBees” face dissolution with little substantial hope
to set things right or more right.
S-4 Selling the Profession
Before Buster fell permanently
ill in 1993 he was attending his second year of veterinary school at UC
Davis. Historically private practice
came before professional schools. Overall
operation of the school of veterinary medicine is a scaled up version of
practice management. There are four main
teams: Administration (Dean), Curriculum (Assistant Dean), Funding (Assistant
Dean), and Student Services (Assistant Dean).
Buster’s current BHD is weak in Curriculum and Services. Davis’ strength as a medical school is that the
majority of its’ professors and their teams created their own programs to educate
(practice). The outcome measures are the
number passing the module (formative) and the number passing the licensing
exams (summative).
S-5 Special Topic - Succession
“According to the U.S. Department
of Health and Human Services, the current workforce of about 45,580
psychiatrists must increase by 2,800 to meet today's demands for psychiatric
care. This works out to a 6.4 percent shortage. By 2025, that shortage could be
as high as 6,090 psychiatrists, or 12 percent.”
FYI
Why there is a Psychiatrist Shortage - and What to Do About
It
https://adaptivemedicalpartners.com/why-there-is-a-psychiatrist-shortage-and-what-to-do-about-it/
Closing Arguments
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- |
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Dimension |
Note |
|
|
- |
|
|
|
Recovery |
Chances decrease as consumer get older |
|
|
Righting |
Possible throughout life |
|
|
Resilience |
Assumes operational prior state |
|
|
Sleep |
Key to resilience and righting |
|
|
Serious & Persistent Mental Illness (SPMI) |
Permanent condition |
|
|
Triple Diagnosis |
Behavioral Health + Substance Use Disorders + Criminality |
|
|
Crime |
Assume for most it is an illness |
|
|
- |
|
|
Last Reviewed: 20211005-TU:
While at Central City (CCCHC):
Saw Steve: Consider including photograph (Not)
