I had a crashingly busy and stressful day in clinic yesterday.

[Aristus]

Came in to the office this morning and checked the day's schedule, and my heart sank all over again. They're trying to kill me, I swear it.

I got some help from an unexpected quarter: the weather. It started snowing about an hour ago, and I've already had two no-shows. I think I'm going to survive today after all.

Snow in November.

In the Pacific Northwest, we're having an unusual year if we get snow in December, so something is out of joint.

It's almost as if the climate is......changing...or something...

[cilla4progress]

1. Howdy, Aristus!

Thanks for entrusting us with your burden!

Yes - a lotta snow here on the east slopes of the Cascades, too!

I know it is a barrier for many... I do love how it slows (and quiets) everything down! And pretty. Living in snow country, we are prepared.

Thank you for all you do for the community. We are with you in spirit! Hope your day goes better!

[Aristus]

2. Thank you, cilla.

Your moral support is always very welcome. It helps a great deal.

[cilla4progress]

3. Wow - awesome!

Here for you - always!

[Faux pas]

4. It's

34 here in Hoquiam across the the road from the river. I have post traumatic snow disorder due to getting lost and caught in a blizzard in Lake Tahoe. Praying to the Universe for NO SNOW here.

I'm glad that it's saved your day for you Aristus!

[Ocelot II]

5. God sent snow, having decided not to kill you today.

Apparently he also decided not to kill my health care provider, either; I had an appointment this afternoon but we're in the middle of a winter storm warning. It's snowing to beat hell and we will probably have 6-8" of it by early afternoon, which is when the appointment was scheduled. Driving conditions are terrible and there have been accidents all morning (even here, it takes one or two snowstorms before people remember how to do winter driving). So I cancelled and rescheduled. Can't get a new appointment until January but it's nothing that can't wait. I'm sure mine wasn't the only cancellation so I'm sure the clinic folks are taking a breather.

[chillfactor]

6. I am willing to bet...

even if the weather had not loosened up your schedule, you would have been able to handle it with your dedication to service.

[Aristus]

7. Oh, that's nice! Thank you.

[mitch96]

8. I worked with one ER doc that did not care about schedules or amount of patients. He did one

at a time, very methodically. The ER admin and the nurses went nuts. Always a huge backup and the second shift doctor always got shit on.. Needless to say he did not last long.. The patients loved him. There is a fine balance between speed and accuracy in medicine.
m

[Aristus]

9. My former supervising physician was like that.

He would spend an hour with his patients, while all the time, the waiting room is getting backed up, and people are getting impatient. My own style is 'get in, fix the problem, get out'.

Our patient population learned to schedule appointments with either one of us depending on whether they had multiple issues and had all day to get them addressed, or whether they wanted a quick 'fix me up' visit.

Our staff actually like working with me better, because I never got complaints about long patient waits. And also, they got out of the clinic on time every night.

[3catwoman3]

10. A fully booked schedule right out of the gate was always disheartening.

In pediatrics, at least for me, it would take every minute of a 20 minute sick appointment to get everything done - take the history, examine an often uncooperative child, discuss the treatment plan, and then answer any questions. A 30 minute well visit would also take every allotted moment, especially once the kids were adolescents - review the family, medical, social and allergy history/ ask for any parental concerns before the parent leaves the room/review the sports participation questionnaire/ review the mental health screening questionnaire/ ask about tobacco, alcohol, drugs, and sex and hope that you are getting truthful answers (probably not)/ do the exam/ fill out the sports form/ fill out permission to take over-the-counter meds at school form/ talk to the parent one more time after the exam is completed. I'm exhausted remembering the relentlessness of it.

Unlike you, Aristus, I was not able to chart quickly, and so would spend most of whatever lunch break I'd get doing as many morning charts as possible, and then 2-3 unpaid hours at home in the evening getting the afternoon charting completed - unpaid time. Thank goodness I only worked 2 days a week.

Something I learned waaaaay too late in my career was not to conclude a visit by saying, "Any questions?" and thereby opening a potential Pandora's box of questions unrelated to the reason for that day's appointment.

I changed my end-of-visit statement to, "Any questions about what we talked about today?"

I miss new and young babies, and first time parents, but otherwise continue to be glad I am retired.

I recently read the following inked article on "Electronic Medical Records Are Strangling American Medicine." There were 144 comments, and I found myself agreeing with almost every word. Criticism was particularly vicious for EPIC, the system my former practice used.

https://www.medpagetoday.com/opinion/second-opinions/101354?xid=nl_secondopinion_2022-10-25&eun=g2091474d0r

[Aristus]

11. Oh yeah; no kidding. "Any questions?"

That always throws the game into extra innings...

[3catwoman3]

12. And the dreaded, "By the way...

...as long as I'm here."

On days when I was running behind, and anticipating that people were unhappy about it, as I'd enter the exam room, I'd close the door behind me, slump up against it and say, "Did you think I was never going to get here ? I was beginning to think I was never going to get here. I'm so sorry you've been waiting."

The immediate acknowledgement and the use of a little physical humor generally worked well and headed off getting crabbed at.

I always hoped parents realized that we hate to have people waiting for us as much as they hate to be the ones waiting.