Sweatshop Medicine: A Day in the Life of Your Family Doctor
People ask me, why would I leave my amazing co-workers, access to a top level academic institution, and my wonderful patients to risk it on on my own small business venture?
Like I said in my earlier post, I feel the current practice environment is a disservice to patients and provider.
What the heck does that mean?
I would like to present my readers with an example. Last week I only had 3.5 hours of clinic before I had to rush off to a meeting at the medical center. In that 3.5 hours I was scheduled 11 patients. Here is what my schedule looked like in that short period of time (some small changes to identifiers and identifiers removed for patient privacy):
1. Autistic child scheduled for a 15 min follow up visit – 10 minutes late, mom was sure this was supposed to be the annual physical for the child and took the day off work. Mom demands the physical she was sure she scheduled.
2. A complicated psychiatric patient refractory to all medications, possibly suicidal, also scheduled for a 15 min visit
3. Complicated patient with multiple specialists on controlled substances for reassessment. 15 minute visit.
4. Elderly patient for her Annual Medicare Wellness Exam (30 min visit - but you can bet I’m running really late by now!)
5. Multiple issues, 15 min visit. Issues are: injury from a fall, chronic diseases, asthma, she also has lots of questions about random things, too, she can never get in because of her work schedule so they pile up.
6. Autoimmune disease and chronic pain. Recheck meds and referrals needed. Their mother came with them and has a bunch of questions. – 15 min
7. Visit for diabetes and ADHD. (Guess what?15 min!)
8. Multiple pain complaints, seen multiple doctors for pain, no primary care doc on file, I have never met this patient before – 15 min
9. Uncontrolled diabetes, also homeless, also he hasn’t been seen at all in the last year. 30 minute visit.
10. Thai speaking patient who had a stroke, have to use a phone interpreter. Thankfully, unlike other times, the line doesn't keep getting disconnected. 30 minute visit.
11. Patient of another clinic for acute motor vehicle accident injuries (...and by now I'm supposed to be on the road to my meeting). 15 minute visit.
That was 3.5 hours. Each of those patients deserved more time than they were allotted, and I deserved more time to help them.
I love my co-workers, I love my current patients (most of them), and I appreciate teaching and the access to a University Health System. But I can't abide this kind of "health care".
