DOCTORS ' LOUNGE
DOCTORS ' LOUNGE
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Get the young docs competent help now .
That ’ s the only way it ’ s going to happen .
I talk to younger docs - and APRNs as well - all the time about this . The amount of their precious time wasted , plus all that tearing out of hair , takes a cumulative toll . Why oh why , they scream , why oh why does their Helper Person report that Drug A is not covered , for instance , but fail to mention Drugs B , C and D , that are ?
Why do they say things like , “ Your stat CBC is back ,” without helpfully handing the doc the result ? Even reciting it would work …
Why do they take messages about chest pain and shortness of breath without immediately involving the doctor ?
Why do they put the patient back without a weight when his main worry is horrible , visible ankle swelling , and they know in their bones this is mandatory ?
Why do they take routine messages from people with a temp of 103 instead of quickly using a same-day appointment AND telling the doctor ? Sometimes that ’ s an ER fever , not an office fever - and the doc has some hope of choosing the correct one if they hear about that sick person stat . We ’ d much rather start at 3:00 p . m . with the acutely ill than at 5:45 p . m ., when the only X-ray-taker has gone home .
Why don ’ t they fill out all possible parts of the form - the billions of forms a primary care doc has to fill out over a lifetime - like a nice person , doing a job properly ? Instead they slope off home and leave a stack of misery behind .
And why does all this matter ? Because it makes doctors miserable and resentful and bilious . We hold grudges and we get snappish .
30 LOUISVILLE MEDICINE
WANT A DOC WHEN YOU ’ RE OLD ? AUTHOR Mary Barry , MD
Eventually , we PCP types up and retire early , or go into concierge medicine , or switch to telemedicine , or abandon the office for some urgent care center , where the policy is No Forms Filled Out Ever .
I was blessed for many years with the peerless Ms . Sharon , who knew our patients , and had abundant common sense , cheer and style . She learned early that Sick People Come First . I had to grit my teeth far less often once she took over . Other docs I know - employed ones , who cannot hire or fire - have been both lucky ( at least once had a great assistant who prioritized the right things ) and then unlucky ( reorganizations - tag , you ’ re it ! for the new , untaught and unimaginative replacement ). Their nice little office world blows up - not like in Ukraine - but their peace of mind just disappears . “ What is being missed ?” is a question that will haunt you .
Aside from being cared for by only a host of non-doctors , if we are lucky to grow very old , why does this matter ? It costs the country millions of dollars , that ’ s why .
The Mayo Clinic Proceedings ’ February 2022 issue illuminates the issues . Christine Sinsky , MD , et al ., in Health Care Expenditures Attributable to Primary Care Physician Overall and Burnout-Related Turnover : A Cross-Sectional Analysis examined the average increased costs due to the loss / changeover of primary care docs who care for Medicare patients . They used a survey conducted from October 2017-March 2018 by Dr . Tait Shanafelt et al ., a doc who has studied burnout and wellness for some time and now works at Stanford in these same areas . His group got a 17 % response ( typical of such ) to their survey , which was the third in seven years of practicing doctors aged 35-65 , essentially on the same themes : what keeps you going , what makes your working life hard . These surveys helped to define the stated proportion of doctors who would retire early from primary care because of a multitude of intolerable insults ( endless typing , lack of support , the sense of being evaluated for box-checking not medical excellence , a long list ).