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Progress Note

So, the word that comes to mind to describe my first week on the job is disorganized.  Not to say that things are bad, just that there seems to be a distinct lack of planning.  Turns out Monday was orientation at the hospital, which admin. had forgotten to organize.  So it was an improvised -"Hey, so you have a minute to show the new doctor your department? Okay, thanks."  The pros and cons of working in a laid back environment, I suppose.  On the plus side, everybody is super friendly and helpful and seem to be glad I'm here.  It's nice.  Once I was thoroughly disoriented at the hospital, I finally got to see my clinic space and meet my staff on Monday afternoon.  Hallelujah, praise Jesus, they are kind, hard-working folk and we get along great!  Whew!  You never know, man.

When I came in Tuesday morning it was to discover that the physician previously working out of this office had packed up all the supplies and sent them back to the hospital.  There was nary a speculum left in the whole clinic.  Though I'm sure many would prefer it that way, it's actually a problem.  So day 2 was spent figuring out what equipment we needed to at least get started and how on earth to get ahold of it.  You know, tongue depressors and gauze and bandages - all that stuff that you take for granted that the doctor's office has.  And of course by that afternoon admin was asking why we weren't seeing patients yet.  Um, 'cause y'all put me in a clinic that was occupied by another physician through Friday and you didn't bother to check on Monday to see whether we had any supplies left.  I mean, they even absconded with the broom!  There are no clocks left on the walls.  If it wasn't nailed down, it's gone.  Which is fine.  Just means admin has to accept the fact that we're basically starting from scratch here.  In addition to that, I don't have access to the EHR yet.  That means we had to come up with some kind of paper charting system.  Thankfully, improv is a hobby of mine, so it didn't take long to come up something that will suffice until we get online.  And we started accepting appointments for Wednesday.  Yay!

Of course the first patient of the morning is a train wreck!  Don't get me wrong.  They are very personable and nice, but they have some serious risk factors and health problems.  A cold or cough to ease us in? A nice chronic disease management visit for starters?  No.  Of course not.  Let's jump right into the deep end, shall we?  Why not?  It's one of those visits that makes you think "Crap. What have I gotten myself into?" But it's all good.  That's why the good Lord invented subspecialists, right?  Right.  Crisis averted.  The rest of the day was much more bread-and-butter.  I think we saw 5 patients that first day, and then 7 the next.  Overall, a dozen patients in the first 2 days isn't too bad.  Friday was a half day due to my closing for my house and there was threat of wintry weather, so we only saw 2 or 3 patients.  Pretty respectable for the first week, I think.  I got 4 OB patients in that bunch too, so that's pretty exciting.

All in all, I feel like we're getting of to a good start - slow, but no slower than is to be expected, really.  It's exciting and scary and fun and frustrating.  You know, pretty much par for the course.  This week promises to be more of the same.  We shall see!


( 4 comments — Leave a comment )
Dec. 9th, 2013 08:37 pm (UTC)
It's really interesting to hear about day-to-day healthcare from a doctor's perspective. Thanks for the update!
Dec. 10th, 2013 04:42 am (UTC)
Thanks for reading! :-)
Dec. 10th, 2013 02:09 am (UTC)
Is this one of those bits where periodically over the next several months you'll have sudden realizations that you hadn't thought to pick up one seldom-used supply or another? Or is there a standard setup?

Sounds like you have it all moving forward! Yay!
Dec. 10th, 2013 04:56 am (UTC)
Haha! Probably so! "Geeze, I forgot to order a nail plate elevator for this toenail removal!" Unfortunately, or fortunately as the case may be, everybody's practice is a little different. Depending on where you train, you may be accustomed to different implements. Even in the same specialty folks do different sets of procedures based on their interests and expertise, so there's no standard set up for a clinic per say. Of course, you can order a "standard" tray for a given procedure which may or may not contain the exact equipment you're expecting. And I think I'm rambling now! I'm thinking about the ring forceps I need to request tomorrow... ;-)
( 4 comments — Leave a comment )