Unwrapped

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Getting a new patient is sort of like unwrapping a Christmas gift from your weird Great Aunt Esther. It could be something really terrific. OR, it could be a holy nightmare on wheels. 

While healthy people are easy and quick, sick people are interesting. Sick people also come with baggage. Tons of emotional baggage from suffering and often a mistrust of medicine that complicates the myriad of other issues they are dealing with. It takes time to tease through all of that, untangling and unraveling until we have something we can use to knit them back together again.

The problem is that I am trying to squeeze both both types of patients into the same 30 minute slot. No warning. No way to prepare. No way to know if I need extra time or not. And who ultimately pays if I walk into the proverbial train wreck? 

The rest of my patients that day.

So, like yesterday, when I find that a patient I have never met before has been carried in unresponsive by a family member, I like the excitement. By the time we get them stabilized and the ambulance has come to collect them, though, my whole afternoon is shot to hell and patients that did not actually witness the stretcher being wheeled out get testy and irate. They pin my office on Facebook and leave snarky comments about how inconsiderate I am, how they need to charge ME for their time. And all of their friends get to join in on the virtual snark feeding frenzy.

Then, when they get the patient satisfaction survey and it asks them if they were seen within 15 minutes of their appointment time, they will answer with a resounding no. The suits will be angry and will try to dock my pay because I am not meeting their arbitrary goals. 

You know what? Some days, you just cannot win.

My last patient yesterday was glaring at me by the time I got to her. She was a work in, someone who had refused to go to the ER, wanted to see me instead. Staff kept her informed that I was running 45 minutes behind. They offered snacks. Water. Not good enough. 45 minutes in my office is still way cheaper and a lot faster than 4 hours in an emergency room and the quality of care is much, much better than that doc-in-box down the road. And YET…

Healthcare, by its very nature, is unpredictable.

I am sorry, you are going to need to reschedule that heart attack, sir. 

We are creating a whole generation of right now people who believe they are more important than any other patients in the office and it is getting worse every year. That is reinforced by surveys that ask questions that do not have a direct impact on the quality of the care received. Quite frankly, the implication that I am the one at fault makes me very angry and I am tired, just tired tired TIRED of my staff and myself getting yelled at for things like not working someone in who showed up 20 minutes late for no good reason. 

There. Now I feel better. I know none of you good people is responsible for any of this. It just feels good to do some venting. 

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140 thoughts on “Unwrapped

  1. Agreed. I think we’ve already talked about the excess “surveying” of every transaction. (Waste of time, excess f data, and not moving in the right direction)
    Maybe more communication is needed. Real-time gore photos sent to your waiting patients of you trying to fix somebody’s life? Not sure.
    A parallel phenomenon involving the same people is a growing – and frightening – phenomenon in France of parents literally kicking the crap out of teachers who’ve put bad grades to their wonderful, flawless, irreprochable offspring. And when I say “kicking” I mean Beating the crap of the teacher… So, let us wonder, if some parents give their children the example that it’s all right to break the teacher’s jaw, what will those children be like when they grow up…

    Liked by 1 person

  2. An afterthought: when my daughter was doing her residency, obviously in charge of an entire hospital ward, she was often faced with “I want it now” relatives, sons/daughters of patients, when she had no more room for that patient, and tried to explain the condition warranted a transfer to another hospital. On one occasion the son of an old lady was literally shouting at her. She just said: follow me Sir. I don’t care that you know the Secretary of HEW, just follow me. She took him to the saturated ward, with patients in the halls, on recliners, almost two to a bed. Then she said, I can put your mother here in the hallway. For a couple of days… Until somebody croaks in one of the beds. But I really think you should go to the other hospital… Guy apologized and took his mother elsewhere.

    Liked by 1 person

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