The game

To be a doctor, you must get up really early. Yes, because you need to make rounds at the hospital before the patients are awake. That way they will not be able to ask you any questions, which will take up too much time and make you late for the office. Of course you must also get to the hospital before the nursing shift changes. Otherwise the new shift of nurses will be waking the patients for vital signs. Then both the patients and the nurses taking care of them for the day will be waiting for your.

Once you arrive at your office, it is important to stay one step ahead of the patients by ordering as many expensive and sophisticated tests as possible. This will not only impress your patients but if you can own or lease the machines that preform these tests, it will increase your revenue.

Also, be sure you employ plenty of physician extenders, nurse practitioners, physicians assistants, technicians, and the like. Those who can preform services that have CPT codes are the best. You can bill for these services as a source of additional income. These extenders are especially helpful when they can work in your office while you are not there. This being the case, you will generate revenue while you are away from the practice, thus helping the practice pay of itself while your office space would otherwise be idle.

Finally, get an electronic medical record with voice recognition software included. This way when you have spent 5 minutes with your new patient, you can say something like, "insert my usual review of systems" and a five page printout will result, making it possible for you to bill for a comprehensive evaluation where limited would be the case if you were taking the time to write out what you could remember discussing with the patient.

It is no secret that I played this game poorly. As frustrating as it may sometimes be, I enjoy tackling the patients questions, listening to their answers to mine, and trying to ferret out a diagnosis from the signs and symptoms as I pondered which tests might be useful and which were a waste of time (and money.) I also loved knowing the names of their kids, where they were going on vacation, and what books they would read when they got there.

After a year, it is now apparent to me why it takes me more than an 80 hour week to do what many of my colleagues consider a part time job. I hope I can always practice some type of medicine simply because I enjoy it.

Beginning the book

"If I wrote a memoir many would not believe me and a few people, who thought they recognized themselves would probably sue. If I wrote a book and called it fiction, most would say the stories were based on my own experiences. This later plan seems more safe some how, so that is what I will do...."

I am looking for a place to put all of the experiences, thoughts, ideas that I cannot but in this blog so my writing energies are elsewhere as I have found it is difficult to have a following and remain anonymous.

Spring

Every so often, usually once a month or so, I think about looking for a new job. Sometimes I even go as far as searching Internet sites to see what is available. Once I went to look at a hospital, clinic, and the surrounding area. That was in the middle of the winter, a particularly difficult time, as I was spending even my days off indoors.

Last week was a particularly awful week in terms of outcomes. Cancer in a pregnant woman can be devastating, so I don't understand why I expect something different. I can still remember a post mortem C-section I did as a resident on a young woman with advanced cancer. One of the nurses who cared for this woman told me she got a card with a picture of the baby each year for several years. The woman's parents raised the child and had become so bonded with the hospital staff, they wanted to share the good which came from this tragedy.

There are many situations where those working in this hectic world of artificial light and air never see any good. We are left to wonder what keeps the sun coming up, the moon rising, the seasons changing. Thankfully it is spring.