An afternoon off


Doctors are in short supply,

Demographics can tell you why.

Agencies try to recruit

By offering loot

But most of us come off as shy.

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  In May 2010, I left my position of 23 years, and honoring my non-compete clause, traveled for a year doing locum tenens work.  In June of 2011 I joined up with the Community Health Center, which provides care for the underserved.  I’m now working part-time, which, for a doctor, means 54 hours a week.

On my afternoon off I got 11 business phone calls in an hour, as I tried to nap.

A radiologist paged me, to report a very odd set of findings. 

I’d like to tell about the patient, the drama and the irony, the impact of the illness for the person and their social context, the facts and the meaning.  I did not obtain the permission; I ordered the study more as a formality than with the expectation I’d have to launch a full-court diagnostic press. 

But I called the nurse back and ordered MRI’s and magnetic resonance angiography, on the advice of the radiologist.

That radiologist doesn’t call me for routine findings.  I wouldn’t mind if he did, I enjoy him and his conversation and we have a very good working relationship.  He has a lot to teach me, and every time we talk I become a better physician. 

After that flurry of calls, while I started to close my eyes, my phone rang, and I took the call from a physician recruiting company.

During my year of walkabout, one of the recruiters from that company rubbed me the wrong way with pushiness.  I kept my words calm, respectful, and professional, but made it clear to him that I wouldn’t work with him or his company, ever.  Which, in the 21st century means not for three years (by then it’s a different company).

I told the recruiter I’d had a lengthy call from one of her coworkers the day before.  I learned that their primary care department has 10 full-time recruiters, and the company employs more than 400.

No wonder I get so many calls; that company competes with 80 other agencies. 

Yes, I still toy with the idea of going back walkabout, and if I had enough annual leave hours built up, I’d go on a working vacation.  And I’d go for spots mostly shunned by other docs.  I’d enjoy rural, Indian reservations, even prisons or Armed Forces installations.  I like low population density and the opportunity for outdoor adventure.  Even if it means lousy weather. 

I had barely hung up when another recruiter from a different agency called.  One of the places where I worked suffered a leadership crisis, making them critically short-handed.  I had to turn him down; I have a contractual obligation here.

Yet rural America’s health care force runs chronically short, and a lot of people in Western states live hours away from the nearest health care. 

The radiologist called me back; a CT scan I ordered showed an ominous set of fractures that hadn’t shown up on plain x-ray.  I called the nursing floor back and ordered calcitonin, highly effective only in fracture pain.  I put out a page to Utilization Review; and on the strength of the findings got approval to keep the patient in the hospital another day.

I got in a short nap, and cleared up documentation at two hospitals and the office, while fielding another 8 calls.

But I never got rushed.

After all, it was my afternoon off.

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4 Responses to “An afternoon off”

  1. Pale Says:

    Years ago, my dad, who worked at Hahnemann Medical College (now Drexel) in Philly, did grant work for the state of Pennsylvania trying to figure out how to increase HCP vocations in the rural, underserved areas of the state. I think they ultimately tried mentoring sciences at the high school level … on the assumption that if they could get local kids interested in the field … they were the ones most likely to return to their home town to serve the community. I don’t know if it helped … or if they still do it.

    • walkaboutdoc Says:

      Trying to get docs into the underserved areas has proven difficult. For a long time, the National Health Service Corps gave med school scholarships to those willing to take the locations, on a year for a year payback plan, with a two year minimum. I had such a scholarship, and I stayed 5 years on a 2 year commitment. Those days were sweet and fleeting; the three years I spent in New Mexico went by like a breath in and a breath out.

      Doctors usually have spouses. Rural assignments offer low crime rates, good schools, and great hunting and fishing, but most spouses face terrible isolation. The key to physician retention is spouse retention, no matter what the gender, and cities offer more for spouses than rural areas do.

  2. Michael Barker Says:

    I’ll give you two words, “Caller ID”.

    I enjoy this blog.

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