The Whore of Medicine
In the Broadway musical “The Life” a prostitute gets out her calculator and figures that in her lifetime ‘I’ve been laid by 15,000 men”.
I can relate - at least to the high turnover rate. I am in a profession with some parallels.
I interact with a lot of people; they are seen in quick 15 minute time slots. I work for bosses who want their money’s worth from me, so there is no down time. I too feel “worn out and weary” at the end of the day.
On my calculator, my counts are < 4 patients/hour x 8 hours/day x 5 days/week = 160 people a week. And not ‘just people’ but people in pain/crisis/on the verge of destruction.
And then there are the new patients, nicknamed ‘evals’ (short for an evaluation). I am used to having 90 minutes for an eval. I go through a persons’ present and past medical, social and psychological history. Even at 90 minutes it is hardly enough time to get a tip of the iceberg in a person’s life. Here in Arizona the ‘eval’ slot is 45 minutes long. I have to cut details, throw out interesting but hopefully not too relevant material, like their childhood. I have to come up with a diagnosis and plan – and explain it all – by 45 minutes. Since starting this new clinic I have seen 450 evals. 450 / 45 minutes = 10 people per minute. This doesn’t mean anything but it sounds cute.
I think I do a fair job at this. Between my intuition and years of experience I can usually get the gist, but do I really get to “know” anyone? Worse question; does it matter? If “Dicky Purdy” comes in with symptoms one makes the diagnosis/gives him options and goes with it. The analyst part of me cringes every time.
A confession – when a patient does not show up for an a scheduled appointment I am almost elated. Time! A break! Write some notes/return a phone call! or close the door......
I suppose I should not kvetch. Psychiatrists complain some that they are not treated like ‘real doctors. Now I am work like one, only without the stethoscope. Gotta take some bad with the good.
I can relate - at least to the high turnover rate. I am in a profession with some parallels.
I interact with a lot of people; they are seen in quick 15 minute time slots. I work for bosses who want their money’s worth from me, so there is no down time. I too feel “worn out and weary” at the end of the day.
On my calculator, my counts are < 4 patients/hour x 8 hours/day x 5 days/week = 160 people a week. And not ‘just people’ but people in pain/crisis/on the verge of destruction.
And then there are the new patients, nicknamed ‘evals’ (short for an evaluation). I am used to having 90 minutes for an eval. I go through a persons’ present and past medical, social and psychological history. Even at 90 minutes it is hardly enough time to get a tip of the iceberg in a person’s life. Here in Arizona the ‘eval’ slot is 45 minutes long. I have to cut details, throw out interesting but hopefully not too relevant material, like their childhood. I have to come up with a diagnosis and plan – and explain it all – by 45 minutes. Since starting this new clinic I have seen 450 evals. 450 / 45 minutes = 10 people per minute. This doesn’t mean anything but it sounds cute.
I think I do a fair job at this. Between my intuition and years of experience I can usually get the gist, but do I really get to “know” anyone? Worse question; does it matter? If “Dicky Purdy” comes in with symptoms one makes the diagnosis/gives him options and goes with it. The analyst part of me cringes every time.
A confession – when a patient does not show up for an a scheduled appointment I am almost elated. Time! A break! Write some notes/return a phone call! or close the door......
I suppose I should not kvetch. Psychiatrists complain some that they are not treated like ‘real doctors. Now I am work like one, only without the stethoscope. Gotta take some bad with the good.
posted by Ur-spo at 7:09 AM
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