Gosh, really thought about quitting last two days.
Wrote a piece in my diary and put it on the web log section that the hospital admin and other doctors saying you have to see 18 per day and see them for only one thing, feels totally unethical to me. I went into Family Practice to care for the whole person and the family. I currently have two couples who are divorced or divorcing where I take care of both parties. Neither seems to care. My brain carefully didn't connect them up until really recently.
I got together with C last night and talked. She thinks the admin/other docs are nuts. She works part time and works with Dr. L, the oldest doctor in the system, and she says that NO ONE has said 18 patients a day to her. And I suspect not to him either. I'm just getting flack because I am protesting. If I would keep my mouth shut I could fly under the radar but the problem is, we are going to burn out more doctors AND it is bad for the patients. My last patient last night said she'd never gotten as good care as with me. I saw her for her back, noted she was hoarse, bugged her into going to an ENT and lo, she has vocal cord polyps and needs surgery. They don't THINK it's cancer. But gosh, according to the admin/other docs, I should not have brought up her voice or I should have made her come back. Thing was, I was worried about it and I was worried that she wouldn't come back, so I thought, fuck the schedule and did what I thought was right. Sometimes there is only a small window of opportunity and one should damn well go through it. The other docs say I'm an amazing clinician but it's because I listen hard and pay attention to those windows. If you do not knock on the door, it won't open. It's the thing I love about Family Practice, you never know what in the hell you're going to see next. Toe pain turns out to be neuropathy because the person has diabetes and doesn't know it. Hello. Shove them out the door after you have tested their glucose and found that it is 300? I think not. They are sitting there in shock because they thought they needed insoles.
I did J's adult improv class two nights ago. It was fabulous. But I felt entirely comfortable in waiting to hear what the other person would say because it is the same as clinic. If you ignore the template, if you just go into a room open, it is improv. I am responding to whatever the person says, asking questions, knocking on doors, trying to figure out what to ask next and what is the problem and what, if anything, can I do about it? Also I have to pay attention to what sort of doctor they have in mind, though I am not terribly malleable that way. That's why the templates make me see red. They fuck up the process. One of the providers, who I do not like, even has his NURSE ask the template questions. Whew, that way he really hardly has to have contact with the patient at all. If the computer is going to ask the questions, let the patient talk to the computer. Otherwise, the fucking computer needs to stay out of my way.