I said, “Now that I’m back,
I suppose I’ll have to unpack
Those papers of mine
I will have to sign
Of paperwork there is no lack.”
Synopsis: I’m a family practitioner from Sioux City, Iowa. While my one-year non-compete agreement ticks away, I’m having adventures working and visiting family and friends. I just finished a one-month assignment in Van Buren County, in southeast Iowa, which has neither stop lights nor fast food.
I cleaned the apartment and packed up the car in the morning while day crept into Keosauqua from the other side of the river.
Any time a doctor leaves an assignment, a backlog of paperwork faces an uncertain future. Who will do follow-up on the abnormal lab and x-ray? Who will sign the papers that need to be signed, though the signature does not contribute to patient care? What about the dictations?
I stopped down in medical records and gave my email address as well as my home address. “Call me before you send anything,” I said, “as I might be in Barrow, Alaska, when the mail arrives.”
I left town in light rain. I had given Sweetheart, my mostly reliable GPS, to Bethany for her trip back to Sioux City, and I navigated by memory. The dashboard thermometer crept from 38 to 54, and light rain fell.
As I left Van Buren County, I spotted a flock of birds feeding on a road-kill deer, and when I passed, the largest flapped slowly up, a bald eagle with bright white head and tail.
Two other eagles, eight hawks, and seven more road-kill deer graced the rest of the six-hour trip.
I met Bethany in the south part of town for lunch at a Chinese buffet. When we left the restaurant the temp had fallen to 28 degrees.
I enjoyed the feeling of being back in Sioux City after an absence of eight weeks. The nicest motel never is home.
Exhausted, Bethany and I went to bed before 9:00PM, and I woke at five. The temperature had fallen to 12 degrees, and snow lay on the ground.
I went to St. Luke’s Regional Medical Center to sign documents that hadn’t been signed since I started going walkabout; everyone at medical records seems to have been out on vacation but I hung out in the doctor’s lounge.
All the docs I ran into love what they do. I saw the accumulated sleep deprivation on their faces. The conversation kept returning to the theme of decreasing reimbursement in an era of increasing work; complying with regulation takes more and more time but does little or nothing for patient care. Several docs talked about wanting to cut back, but they’ve said such things for a long time. I heard about one who wants to either work shorter weeks or retire.
One doctor, a good businessman, gushed about how much better care he gives because of improvements in pharmaceuticals.
Two used the phrase, “since my bypass.”
All complained about their beepers, a few said they’ve learned to sleep soundly even when they’re on call.
I left the hospital in single-digit temperatures.