Blog end: I’ve reintegrated

I had a great time, it’s a fact

My life had been so out of whack

I flew cross the sea

From Barrow to Leigh

Now I’m home and it’s good to be back.

I received an email from a doc who went walkabout to New Zealand for a good deal longer than I had, and asked me questions about my reintegration.  I asked for permission to post the original missive, but three weeks later haven’t heard back.

I replied: 

It’s interesting that you emailed me six months to the day after I started back into work here in the States, and if it’s OK with you I’ll use your email and this return as a post.

I’ve enjoyed reintegrating to US society and the medical care system.  I’m back doing hospital work, which, strangely, I really enjoy.   I know my consultants on a first-name basis and I like the camaraderie in the hospital.

It helps that I’m working for a Community Health Center.  For a lot of reasons, our patient population gets sicker earlier.  The pathology load weighs heavy on them.  At any one time, half of our twenty to thirty hospital patients also appear on the nephrologists’ list because of chronic renal failure and dialysis.  Usually we have three people in active DT’s and three others in liver failure. 

I have had to get used to the paranoid reality of defensive medicine.  Our patient population has made the transition easier because many have no money and no insurance and hence can’t pay for procedures that probably weren’t needed in the first place.

For those with insurance, I worry that I overuse medical technology.

Getting labs back the same day, like glycohemoglobin and TSH, makes patient management easier, as does having in-house x-ray.  

I liked MedTech32, the electronic medical record (EMR) system that makes documentation so easy throughout New Zealand, and the hardest part of coming home has been dealing with Centricity, whose software engineers remain isolated from any contact with this particular end user; for example, I have to click through five data fields to make a back to work/school slip and I have no way to fix it.  My productivity has gone way down; eleven patients in a morning or afternoon taxes my resources; not that I spend more time with each patient but I spend more time fighting the computer to enter data.  And about half the problems could be fixed easily.

I miss the way I always started on time in New Zealand because I brought my own patients back from the waiting room, and I miss the way the patients (mostly) respected my time.  In my current situation I limit the patients to three problems per visit.

Narcotics seeking remains a problem here as well as everywhere.  I’m building up a reputation in the street-drug community here, just like I did in the South Island, as parsimonious with opiates and benzodiazepines. 

Still, my practice swells with new patients every day.  I like pediatrics, and I find that a new practice attracts young people and young families, even with an old practitioner.

In the long run, most people either fit into the category of wanderers or homebodies, and I am definitely a homebody. 

But man, did I have a great time.

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3 Responses to “Blog end: I’ve reintegrated”

  1. Tim Schiller Says:

    Greetings Dr. Gordon. This is Tim Schiller you met us – my son and I – the one night up near Singing Hills Blvd while you went muzzle loader hunting and we went archery hunting.

    Josiah saw a doe walk by down below him right at last light while I saw nothing other than birds and a few squirrels.

    I found your note the other day and re-read it today in my office. To answer your question, yes, I was the one who did the funeral for Denny Watterson. We just prayed for Tony Watterson’s family this past Sunday at the news of his passing due to cancer this past week.

  2. Raul Nepomuceno Says:

    It’s a pity the blog closed. It’s great.

    Have a nice day.

  3. Doug King Says:

    I am a Kiwi who has lived and worked in the US since the 80’s.
    I have been working In NZ for the past couple of years, and got my first taste of an EMR. The crowd I have started to work for here have Centricity. I will never trust flying across the Pacific in a jet with GE engines again.Yours was the first cogent summing up of this
    atrocity I have found. Are there any other sites I can show to our IT folk?
    I have really enjoyed your blog. Glad you had a good time Down Under. best Doug King

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