The Other Side Of The Doctor’s Table

August 23, 2009 at 12:58 Leave a comment

Comp CNotes

Would you look at that? That is my load from a recent clinic session. Each green file represents one patient (of course I have blurred out all identifying markers). There were twenty-nine patients scheduled for my 3.5 hour clinic. 210 minutes, which translates into about 7 minutes per patient. Tell me, how do I adequately greet, question, diagnose, comfort, treat and then shoo out folks who could be sobbing, or angry, or manipulative, or outright psychotic, in that kind of time? Often with concerned and inquisitive relatives in tow? I’d like to know, because I really don’t have the answer.

Know what the worst thing is? It’s that this is the desired state of affairs, according to senior management. The feedback most frequently given to the registrars about our clinics is that we see “too few” patients, which equates to “inadequate training”, and “how can we learn if we don’t see enough patients?”.

One of my friends’ response in a recent departmental meeting was that registrars see cases that are more difficult, that are beyond the scope of the junior docs, whose clinics are meant to cater to patients who are stable and just need continuation of medication. Difficult cases mean that they require more time for interview and treatment. Basic mathematics lead to the obvious conclusion that there should ideally be fewer difficult cases per session, as compared to simple cases. Right? Wrong. Junglelord answered my friend with a formidable shake of his head. “No,” he said. “Numbers are important.”

Oh. Right. How could I have failed to understand? After all, this is the hospital that supported the idea of triple-booking certain clinic slots in order to reduce time wasted by patients who default their appointments. And then they held a meeting to show the doctors that more patients were complaining about us being “rushed” and “uncaring”. Oh no, really? I do wonder why. 

The message I get is this: in order to obtain approval of the people in charge, I ought to be squeezing more and more patients into my clinics, and seeing them faster and faster. It goes without saying that I must also satisfy all the patients and their relatives by providing very caring, thorough and detailed consultations, so that they will give the hospital compliments. And at the end of the day, I, too, should be utterly grateful to the institution for all the first-class training I received just by running this clinic.

Please. Call the spade a damn spade. More patients equals more revenue. For the hospital. More compliments equals more recognition. For the hospital. And there’s no point in trying to disguise work as personal training. Do we look that stupid?

To think that I was trained to see patients, and not to deal with this kind of crap. This is the kind of thing that happens in real life, but which no one ever teaches you about. It just is there and you just have to handle it. Bah. I feel angry, used and insulted. Every day.

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Entry filed under: Dear Diary. Tags: , .

Doc Talk From The Fitting Room

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Welcome to my blog!


My blog-name is Katie but I will not respond if you call me that in real life because it's not my real name. Yes, I do practise virtual-world paranoia. No, I do not enjoy stalkers. But I do enjoy writing and having folks reading said writing, so welcome to my world. It's nice to meet you.

Playing in my head over and over again argh

I'll Have To Say I Love You In A Song (Jim Croce)

Book(s) of the moment

Hogfather (Terry Pratchett)

Books read in 2010 and 2011

Harry Potter & the Deathly Hallows (JK Rowling) - 'cos the movie's coming out!
Frankenstein: Lost Souls (Dean Koontz) - ah, bugger, it's part of a series! Now I hafta find all the books...
Dismantled (Jennifer McMahon) - oh, good one
Tigerlily's Orchids (Ruth Rendell)
Shutter Island (Dennis LeHane) - reminds me too much of work
Holy Fools (Joanne Harris) - it's official: I prefer her scary books
A Series of Unfortunate Events; The Unauthorized Autobiography; The Beatrice Letters (Lemony Snicket)
The Little Friend (Donna Tartt)
The main books - 11 so far - of the Southern Vampire series; the Aurora Teagarden series except for A Fool & His Honey - that makes it 7; Sweet & Deadly (Charlaine Harris)
The Woman in Black (Susan Hill)
Full Dark, No Stars (Stephen King)
Room: A Novel (Emma Donaghue)
Miss Peregrine's Home For Peculiar Children (Ransom Riggs)
The Bachman Books (Stephen King)
Men At Arms (Terry Pratchett)
Carpe Jugulum (Terry Pratchett)
The Fifth Elephant (Terry Pratchett)
Beauty (Robin McKinley)
The Sandman, Vol 1 (Neil Gaiman)
The Burden (Agatha Christie) - her crime novels are waaay better
Snuff (Terry Pratchett)

Visit my photoblog!

I started my first photoblog on 3 May, 2009. Each post features one picture, with a little story of how it came about. Do take a look by clicking on: Manx Pictures
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Don’t say I didn’t say this…

Disclaimers: 1) I cannot help but bitch about work sometimes, but everything here comes under the realm of personal remarks, and nothing here is said in my professional capacity. Nor does anything here reflect the opinion of the institutions that employ me. This is just me shooting off. 2) Most identities have been anonymized, particularly those of folks I know on a personal basis. Same goes for my workplaces. However, commercial and public places and figures remain named. Otherwise some things just wouldn't make sense. 3) Links and sources have been provided where appropriate and possible. They are not meant to challenge anyone's ownership. If this causes any discomfort or offence, please let me know.

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