Twenty-two years ago I came on board to my medical practice, and I’ll be leaving in about 12 weeks.
I do not walk away from a twenty-two year bond lightly. I will not go into the precise events precipitating my departure except to say the decision to leave belongs to me. My partners would prefer that I not go. I will have sterling recommendations.
The events have led me to a re-examination of my original mission statement, looking again at why I became a doctor and why I’ve stayed in medicine.
I went through my day, cajoling my adult patients about their diets and their exercise habits. I bonded to the young children by playing my way through the examinations. Two patients know. Some of my partners know.
One came to me today, three separate times, to talk about it. We agreed about a lot of things, but not about the bottom line.
I told an Hispanic couple who came in today as a new prenatal. Their young faces glowed with anticipation of the first child. In Spanish I told them that I would no longer be doing deliveries after May 7 (which is common knowledge) but I also told them that I’d be leaving the practice in the next few months, and that I would prefer that they not share that knowledge. They smiled just because I spoke to them in their own language.
A Nurse Practitioner whom I helped train several years ago stopped by after I finished with patients as I sat at my computer, entering data. I spoke to her about ten days ago about the medical directorship at the Carl T. Curtis Health Center on the Omaha Reservation, 44 miles south of Sioux City. The position offers a four-day work week and a competitive wage (monopoly money). Plus all the snow days off. Plus all the tribal holidays off. Plus insurance, both health and liability. We didn’t get as far as talking about vacation and Continuing Medical Education.
She loves her work and her position, and in her words, she can concern herself more with taking care of people than with RVU’s.
(About thirty years ago an evil consortium of government and private bureaucrats teamed up to make a fee schedule equivalency system for medicine. It disses the thought process and rewards procedures, and I rate it as Terrible. If I spend twenty minutes taking care of a person’s high blood pressure, high cholesterol and diabetes, I will earn almost as much as I will from freezing her wart. Which you can train a monkey to do. A stupid monkey. The system measures medical care in Relative Value Units.)
I have decided to Go Walkabout. If you haven’t heard the phrase before, it’s Australian for wandering around and having an adventure. I’m looking forward to it. I’m still generating a time line.