Barefoot in the doctor’s office


The patients I meet and I greet,

They walk right in off the street

     It doesn’t confuse

     The shoes they don’t use

They come in with the bare feet.

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  On sabbatical to avoid burnout, while my non-compete clause ticks away I’m having adventures, visiting family and friends, and working in out-of-the-way places.  Just back from a six-week assignment in Barrow, Alaska, the northernmost point in the United States, right now I’m working on the North Island of New Zealand. 

Bethany and I are staying in a beautiful beach house in Leigh, overlooking Matheson’s Bay on New Zealand’s east coast, not far from the west coast in this narrow part of the North Island.

This morning we drove to the clinic in Snell’s Beach, a village of about a thousand, half an hour’s drive from Leigh.  The road winds between vineyards, pastures, and fields.

In this practice, a doctor works out of one exam room with three times the area of the examination rooms I’m used to.  The physician calls the patient from the waiting room, and obtains and records the vital signs (temperature, pulse, blood pressure, respiratory rate).    

Registered Nurses (RNs) carry a good deal more responsibility here than they do in the States.  They manage diabetes, high cholesterol, and high blood pressure, unless the patient specifies a preference for a doctor.  They do a lot of triage by phone and in person, attending patients who would require a physician’s attention back home.

The Wellsford clinic has a half-dozen doctors working at any one time, and sports an ambulance entrance and two ER bays. 

The Snell’s Bay clinic has one physician full-time and sometimes has a locum tenens (substitute) like me to help fill in. 

I’m still getting the hang of how things work, and I asked questions of the nurse as often as of the other doc. 

The New Zealand Medical Counsel emphasizes confidentiality, and I will not be writing any identifying data about my patients. I probably won’t even ask. 

I can still record my thoughts and feelings. 

With only ten patients on my morning schedule, I saw something I’d never seen before, a syndrome well investigated years prior and extremely rare; I had a good handle on the basic nature of the problem because I’ve seen a lot of endocrinology patients in the past.

Many of my patients, smokers, ex-smokers, and non-smokers, suffered from respiratory problems.  A lot of them had superficial skin infections, and I prescribed a topical antibiotic.  I turned down a couple of requests for oral antibiotics.  I filled out a form for the government.

I attended a couple of Maori families, who seem just as friendly and outgoing as New Zealanders in general. 

I told several patients how erudite and sophisticated the Kiwi accent sounds to me, and they got a good chuckle.  They ask if I’m from Canada or the United Kingdom, some express surprise to learn I’m not from New Zealand.

I haven’t seen a “NO SHIRT, NO SHOES, NO SERVICE” sign here.  Many people go barefoot into businesses, bakeries, cafés, and doctors’ offices, and no one seems to think twice about it. 

I am treated with respect, not formality; I don’t mind being addressed by my first name.

Currently I have only limited access to the net and can only post every couple of days.

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2 Responses to “Barefoot in the doctor’s office”

  1. Mellie Podraza Says:

    Most of the skin infections that we have are caused by bacterias and viruses. We also need to build our immune system and take adequate amounts of vitamins and mienrals. “;,”;

    Please do head to our favorite website
    http://www.caramoantravel.com

    • walkaboutdoc Says:

      I disagree; most skin infections are caused by fungi. Bacteria on the skin are usually commensal, they live there and generally either do no harm or really do us some good. Few viruses can establish an infection on intact skin, it just grows too slowly.

      Howevere most of us are low on vitamin D.

      I do not endorse the website mentioned in Melli Podraza’s comment; click the link at your own risk.

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