CONTACTS 
0201 - Kaiser Permanente                                                                                                                                                  O-00000718 0201
020101 - Ms. Sylvia Connolly, M.D.; Physician                                                                                                                             O-00000718 0201
020102 - Medicine Urgent Care                                                                                                                                             O-00000718 0201
0202 - Kaiser Permanente - Shadelands                                                                                                                                     O-00000718 0301
020201 - Walnut Creek, CA                                                                                                                                                 O-00000718 0301
020202 - Dr. Syed E. Naqvi, M.D.; Physician                                                                                                                               O-00000718 0301
020203 - Primary Care
0203 - Kaiser Permanente - Shadelands                                                                                                                                     O-00000718 0107
020301 - Walnut Creek                                                                                                                                                     O-00000718 0107
020302 - Ms. Sue Juelis; Administrative Assistant                                                                                                                         O-00000718 0107
020303 - Physician in Chief

SUBJECTS
Medical, Kaiser
Exam 990625 Knee, Physical, Prostrate Cancer
Exam 990628 Physical, Prostrate Cancer
Communication
Medical History

0707 -
0707 -    ..
0708 - Summary/Objective
0709 -
070901 - Follow up ref SDS 14 0000, ref SDS 7 0000.
070902 -
070903 - Submitted medical history for meeting on 990625 to Sue Jeulis.  She
070904 - had difficulty opening the record on the web. ref SDS 0 2262  Sue is
070905 - investigating. ref SDS 0 1026  Doctor Syed Naqvi performed a physical
070906 - examination. ref SDS 0 0977  Blood tests and an EKG was accomplished.
070907 - ref SDS 0 0874  Syed indicated better communication with patients
070908 - using the Internet could be helpful. ref SDS 0 2223
070909 -
070910 -     [On 990701 Sylvia had not received letter, and is checking with
070911 -     Sue. ref SDS 15 2295]
070913 -      ..
070914 -     [On 990706 Jeanne trying to transmit letter for Sylvia on work
070915 -     performed 990625. ref SDS 16 0001]
070916 -
070917 -
070918 -
070920 -  ..
0710 -
0711 -
0712 - Progress
0713 -
071301 - In the morning, I called Kaiser and got an email address for...
071302 -
071303 -                Sue Juelis
071304 -                Administrative Assistant of Physician in Chief
071306 -  ..
071307 - I talked to Sue.
071309 -  ..
071310 - Explained submission via ref DIP 2 of medical history on kee problems,
071311 - ref SDS 14 5152, and information on new therapies which Dr. Sylvia
071312 - Connoly requested when we met on 990628. ref SDS 14 5400  The letter
071313 - has background on prior physical, and prostate exams from work by
071314 - Kaiser on 940625. ref SDS 14 2061  This can help Dr. Syed Naqvi who is
071315 - scheduled to perform follow up work today at 1200. ref SDS 14 6840
071317 -  ..
071318 - Sue said that doctors do not have time to review information from
071319 - patients, which supports Sylvia's comment on 990625. ref SDS 14 1978
071321 -  ..
071322 - We recalled Kaiser's Healthwise Handbook recommends on page 12 that
071323 - patients prepare a record of medical history to help doctors who feel
071324 - this is important. see on 990625. ref SDS 14 4752
071326 -  ..
071327 - Kaiser recommends that patients obtain feedback from the doctor...
071328 -
071329 -                 Take notes.  Write down the diagnosis
071330 -
071331 -    ...as reviewed on 990625. ref OF 3 5084
071333 -  ..
071334 - I mentioned the article in Bottom Line Tomorrow, that reflects Doctor
071335 - Tom Connolly's practice of using email to expedite communication with
071336 - patients, so more can be done in less time. ref SDS 14 2541
071337 - ..
071338 - Possibly, Sue could submit the letter to Tom and he can help
071339 - Sylvia use the computer, since she has not yet incorporated this into
071340 - her medical practice. ref SDS 14 1846
071342 -  ..
071343 - Sue suggested sending an ordinary letter to Sylvia.
071345 -  ..
071346 - We reviewed the advantages of using the Internet discussed with Sylvia
071347 - on 990625, that helps doctors pressed for time maintain alignment of
071348 - communications with patient medical history, which is important in
071349 - medical work. ref SDS 14 7040
071350 - ..
071351 - Sue said I can submit the letter to her and she will forward it
071352 - to Doctor Connolly with a copy to Doctor Syed Naqvi.
071354 -  ..
071355 - Prepared ref DIT 1 to Sue, that submits the letter, ref DIP 2, for
071356 - Sylvia on the medical history from the visit on 990625. ref SDS 14
071357 - 0001  The letter asks Sue to make distribution to Sylvia and to Syed
071358 - to support his new assignment to provide Primary Care.
071360 -  ..
071361 - While we were talking, she received my email, ref DIT 1, transmitting
071362 - the letter for Sylvia.
071363 - ..
071364 - She explained the link in the email to the letter would not
071365 - open.
071367 -  ..
071368 - Sue plans to talk to Kaiser's IT people about how to open linked
071369 - communications on the Internet.
071370 -
071371 -     [On 990701 Sylvia had not received letter, and is checking with
071372 -     Sue. ref SDS 15 2295]
071373 -
071374 -     [On 990706 Jeanne trying to transmit letter for Sylvia on work
071375 -     performed 990625. ref SDS 16 9493]
071377 -      ..
071378 -     [On 990706 Jeanne was able to open the letter, but tertiary links
071379 -     could not be opened. ref SDS 16 7410]
071381 -      ..
071382 -     [On 990915 Jeanne cited technology lapse as potential impediment
071383 -     to web mail for clear, concise, complete communiation. ref SDS 21
071384 -     4524]
071385 -
071387 -  ..
0714 -
0715 -
0716 - 1318
0717 -
071701 - While waiting to get the blood test Syed scheduled, ref SDS 0 0874,
071702 - I asked for the business office to visit with Sue about progress
071703 - getting the email/web page problem solved.
071705 -  ..
071706 - There is a metal roll-up door at the business office counter.  It was
071707 - closed.  I asked the attendant at the blood test desk next door, what
071708 - time the business office opens.  She said 1330.
071710 -  ..
071711 - I asked if Sue Jeulis works at this location.  The attendant said she
071712 - doesn't think so.  She did not recognize the name.
071713 -
071715 -  ..
0718 -
0719 -
0720 - 1406
0721 -
072101 - When I returned from meeting with Syed at Park Shadelands, shown
072102 - below. ref SDS 0 0977  I received a letter from Sue, ref DRT 3,
072103 - confirming she received my email, ref DIT 1, but was unable to open
072104 - the letter to Sylvia, ref DIP 2, for the work on 990625.
072105 - ..
072106 - I wrote back, ref DIT 2, with suggestions, and ask what she
072107 - learned from contacting Kaiser's IT people? ref DIT 2 0612
072109 -  ..
072110 - I mentioned Syed's request to see the medical history. ref SDS 0 2223
072111 -
072113 -  ..
0722 -
0723 -
0724 - Administration
0725 -
072501 - Met with administration rep.  Used Kaiser ID card to register for
072502 - examination by Syed at 1200 noon.
072504 -  ..
072505 - Paid $10 fee.
072507 -  ..
072508 - Received invoice ref DRT 1
072510 -  ..
072511 - It shows a "cholesterol screen is due on 990629. ref DRT 1 1419
072513 -  ..
072514 - This item was, also, shown on the invoice for the meeting on 990625,
072515 - ref DRP 1 1419
072516 -
072517 -
072518 -
072519 -
0726 -
072601 -
0727 -

SUBJECTS
Prostrate Cancer Testing
Annual Physical
Primary Care Physician

1005 -
100601 -  ..
100602 - Dr Syed Naqvi Primary Care Physician
100603 -
100604 - Follow up ref SDS 14 2300.
100605 -
100606 - Met Syed and explained Sylvia's recommendation on 990625 for him to
100607 - provide Primary Care, ref SDS 14 9991 based on communication standards
100608 - in Kaiser's handbook on doctor/patient communication. ref SDS 14 1978
100610 -  ..
100611 - Syed seemed familiar with Kaiser's Healthwise Handbook requirements in
100612 - chapter 2 for communication between doctor and patient on medical
100613 - history, symptoms and diagnosis.
100615 -  ..
100616 - Syed had not received the letter to Sylvia, ref DIP 1, with medical
100617 - history from meeting on 990625, ref SDS 14, and prior work on 940628,
100618 - ref SDS 14 2061
100620 -  ..
100621 - I explained work this morning by Sue Juelis to distribute the letter
100622 - via email, per above. ref SDS 0 0448
100624 -  ..
100625 - We reviewed prior difficulties communicating with Kaiser on getting
100626 - results from tests in 1994, which was discussed with Sylvia last
100627 - Friday. ref SDS 14 2300  She recommended Syed because he stresses
100628 - communication with the patient, ref SDS 14 9991, as called out in
100629 - Kaiser's Handbook. ref SDS 14 4752
100630 - ..
100631 - Syed said medical history is an important part of patient care.
100632 -
100633 -     [On 990719 Kaiser reviewed medical history. ref SDS 19 0888]
100635 -  ..
100636 - We briefly reviewed linking medical history, prescription records and
100637 - other patient information, discussed with Sylvia on 990625. ref SDS 14
100638 - 7040  Syed indicated this could expedite his medical practice, which
100639 - supports the concept in Kaiser's Healthwise Handbook, reviewed on
100640 - 990625. ref SDS 14 4752  He indicated that Tom Connolly is working on
100641 - some new Internet features.  Syed will contact Sue to ensure he gets
100642 - the record for today, so that his examination reflects the prior
100643 - history.
100645 -  ..
100646 - This point is mentioned in a letter to Sue submitted after meeting
100647 - with Syed, ref DIT 2 1392, reported above. ref SDS 0 4466
100648 - ..
100649 - Syed said we will be notified within a few weeks of results on
100650 - the examination today, as called out in the Healthwise Handbook
100651 - Chapter 2 on page 16. ref OF 3 3465
100652 -
100653 -     [On 990713 received verbal notice, sent letter to Syed asking for
100654 -     actual numbers. ref SDS 17 0001]
100655 -
100656 -     [On 990716 called about getting results of tests. ref SDS 18 0001]
100658 -      ..
100659 -     [On 990719 article says doctors should notify patients of test
100660 -     results. ref SDS 20 0846]
100662 -      ..
100663 -     [On 990719 received report on test results from Syed. ref SDS 19
100664 -     5035]
100665 -
100666 -
1007 -

SUBJECTS
Annual Physical
Blood Pressure/Pulse
Temperature
Testicles
EKG Heart Exam
Weight
Cholesterol
Blood Tests
Colonoscopy Test

1911 -
191201 -  ..
191202 - Annual Physical Exam
191203 -
191204 - Follow up ref SDS 14 4906.
191205 -
191206 - Prior to meeting with Syed, a nurse developed the following
191207 - information...
191208 -
191210 -                        ..
191211 -                       Blood Pressure    Pulse   Temperature
191212 -                       --------------    -----   ------------
191213 -    990628             112 - 77          96      99.1
191214 -    990625             111 - 67           -      97.4  ref SDS 14 1960
191215 -
191217 -  ..
191218 - I asked about the variance between the tests on 990625 and today.
191220 -  ..
191221 - Syed said these variances are normal and usually reflect differences
191222 - in machines rather a material difference in the body.  He noted that
191223 - variance does occur from day to day, and in this case, he is not
191224 - concerned by a change in the blood pressure reading from 77 to 67.
191226 -  ..
191227 - I suggested that a pulse of 96 seems high.  Historically it has been
191228 - closer to 60.
191230 -  ..
191231 - Syed checked the pulse again and said 96 is about right.
191233 -  ..
191234 - He will schedue an EKG examin today, to establish a baseline for
191235 - future evaluations.
191237 -  ..
191238 - Syed used a stethescope to investigate breathing at locations on my
191239 - back and chest.
191241 -  ..
191242 - He examined the testicles and reported no findings that require
191243 - treatment or further investigation.  Syed said this examination is
191244 - similar to breast examination.  The patient can regularly check the
191245 - testicles for unusual lumps, which would indicate problems.
191247 -  ..
191248 - Syed prepared a form to have blood tests performed.
191250 -  ..
191251 - A second form was for the EKG - see below. ref SDS 0 3270
191253 -  ..
191254 - A third form is to schedule a colonoscopy, presumably for colon
191255 - cancer, based on my age.  This will be done at another facility in
191256 - about 60 to 90 days.
191257 -
191258 -     [On 991008 inquired about status of exam. ref SDS 22 2860]
191259 -
191260 -     [On 000120 Caroline called and scheduled exam for 000208.
191261 -     ref SDS 23 0001]
191263 -      ..
191264 -     [On 000121 received letter from Jeanne Bradley on this matter.
191265 -     ref SDS 24 1681]
191267 -      ..
191268 -     [On 000208 sigmoidoscopy procedure performed. ref SDS 25 0001
191269 -
191271 -  ..
191273 -  ..
191274 - Syed suggests loosing 20 pounds, to below 170.
191275 -
191277 -  ..
191278 - Cholesterol
191279 -
191280 - I asked about the cholesterol test, which is noted on the
191281 - registration, as due. ref DRT 1 1352
191282 -
191283 - I mention prior plans by Kaiser to perform this work, that were not
191284 - carried out, as shown in the medical history, sent to Sylvia on
191285 - 990628. ref SDS 14 2061
191287 -  ..
191288 - Syed said a cholesterol test will be performed.
191289 -
191290 -    [On 990713 Tracy says colesterol is high. ref SDS 17 7469]
191291 -
191293 -  ..
191294 - Blood Test
191295 -
191296 - After our meeting, I went to the Sequoia building next door.
191297 -
191298 - After waiting about 30 minutes, a nurse took a blood vial for
191299 - testing.
191300 -
191301 -     [On 990713 Tracy called about results of tests. ref SDS 17 6392]
191303 -      ..
191304 -     [On 990719 received blood test results. ref SDS 19 5035]
191305 -
191306 -
1914 -

SUBJECTS
Annual Physical
EKG Heart Exam

2004 -
200501 -  ..
200502 - EKG - Perfect
200503 -
200504 - The nurse connected me up to equipment, and did an EKG test that
200505 - measures heart performance in greater detail than is shown by a pulse
200506 - test.
200507 -
200508 - This takes about 3 minutes to hook up and 10 seconds or so to
200509 - actually perform.
200511 -  ..
200512 - The nurse said the test was "perfect."
200513 -
200514 -
200515 -
200516 -
2006 -

SUBJECTS
Prostrate Cancer Testing

2103 -
210401 -  ..
210402 - Prostate Examination
210403 -
210404 - Follow up ref SDS 14 7885.
210405 -
210406 - Syed performed the rectal examination and said there is no indication
210407 - of a problem.
210409 -  ..
210410 - He prescribed a blood test for PSA, which is another part of testing
210411 - for prostate cancer.  I talked to Bill Palmer at Earnst & Young on
210412 - 940708 about the PSA test. ref SDS 4 9667
210413 -
210414 -    [On 990713 PSA test showed no signs of cancer. ref SDS 17 8561
210415 -
210416 -    [On 990720 PSA test results confirmed. ref SDS 19 8977]
210418 -     ..
210419 -    [On 990720 report 30% of PSA tests are false. ref SDS 20 0899]
210420 -
210421 -
210422 -
2105 -

SUBJECTS
Medical, Knees,
Cartelage Pills to Repair
Therapies - 8 New Proceddures
Examination

2406 -
240701 -  ..
240702 - Knee Problem Corrective Action Review
240703 -
240704 - Follow up ref SDS 14 4420.
240705 -
240706 - After meeting with Syed, and getting the blood test and EKG, it was
240707 - about 1330.  I visited Section B to let Sylvia know I submitted the
240708 - article she requested on 8 new therapies for knees.
240710 -  ..
240711 - There was no one at the Registration desck for Section B, so I walked
240712 - back into the doctor's area.  There was no one at the administration
240713 - desk, and none of the doctors were in their office.
240715 -  ..
240716 - I wrote a note and left it on the administration desk to alert Sylvia
240717 - that I found the article on knee therapies, which she requesed on
240718 - 990625, and that I submitted a letter to her with a link to the
240719 - article, which was sent to Sue.
240720 -
240721 -    [On 990713 asked Syed to assist Sylvia on this. ref SDS 17 7332]
240722 -
240723 -
240724 -
2408 -

SUBJECTS
Shoulder Right
Medication

2504 -
250501 -  ..
250502 - Received Motrin for Shoulder Problem
250503 -
250504 - Follow up ref SDS 14 4662.
250505 -
250506 - After meeting with Syed, stopped at the pharmacy at the hospital, and
250507 - got the motrin prescribed by Sylvia. ref DRP 2 4144
250509 -  ..
250510 - Paid $7 and received invoice. ref DRT 1
250511 -
250512 -
250513 -
250514 -
250515 -
250516 -
250517 -
250518 -
2506 -