What “weekend on call” means here


What does call mean, can you tell?
A 3 day or 12 hour spell?
Does it make me a cynic
To see folks in the clinic?
The sick along with the well.

Synopsis: I’m a Family Practitioner from Sioux City, Iowa. In 2010 I danced back from the brink of burnout, sold my share of a private practice, and, honoring a 1-year non-compete clause, went to have adventures in Alaska, Nebraska, Iowa, and New Zealand. I returned to take a part-time position with a Community Health Center, now down to 40 hours a week from 54. Right now I’m in Petersburg, Alaska, on a 1 month working vacation.

Different people can use the same word and mean different things, and the same word used by one person can mean different things at different times.

At the Practice Formerly Known As Mine, “weekend call” meant from Saturday at 8:00AM to Monday at 8:00AM; it included seeing patients in the ER, rounding in the hospital, and delivering babies.

In Barrow, “on call” always meant 12 hours, covering the ER and caring for the patients in the hospital.

At the Community Health Center where I now have my main part-time gig, before December 1 “weekend call” meant Friday 8:00AM to Monday 8:00AM, no ER, and responsibility for 20 to 40 hospitalized patients. Now, with the same time parameters, the hospital census seldom exceeds 8, all of them children. Interactions with the ER come only with pediatric admissions.

Here in Petersburg, “weekend call” starts at 8:00AM Saturday, ends 8:00AM Monday. It includes a Saturday morning walk-in clinic and scheduled afternoon patients. If someone comes to the ER, the on call doctor goes in to see them, but most of the hospitalized patients will see the doctor who admitted them. When a patient in long-term care (much like a nursing home) needs to see a doctor, they see the doctor on call.

On Saturday call I saw a number of cases involving infectious diseases. We have strep making the rounds of the school system, and an epidemic of hand, foot, and mouth disease (a viral illness causing (blisters on the palms and soles and in the mouth) in the day care system. In the wake of a respiratory virus, lungs compromised by years of smoking develop problems. Commercial fishing brings its own set of medical risks, complicated by the vagaries of being away from port for days to weeks, as well as port changes. The Forest Service employs about 50 people, making it one of the larger employers; those workers have medical problems associated with spending protracted time in the wilderness. But we also have people who work desk jobs and run into overweight, diabetes, high blood pressure and high cholesterol as a result.

And sometimes I see the worried well along with the well children.

Most cannery workers left before the end of September, but some remain for the halibut, crab, and shrimp season.

Where people walk on ice, the doctors can count on seeing slip-and-fall injuries.

But in such a small village most people walk most places. In a town where people observe the posted speed limits of 15 and 20 MPH I get little motor vehicle collision work. And the school system teaches water safety conscienctiously and effectively.

Still part of the US, we have our share of problems stemming from meth, heroin, prescription pain relievers, marijuana, tobacco, and alcohol.

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