Work hunger


With the questions they’re asking of me
You could say that I’m working for free.
I really don’t mind.
I think that it’s fine
I darn sure don’t want the fee.

Synopsis: I’m a family practitioner from Sioux City, Iowa. I danced back from the brink of burnout in 2010, and, honoring a one-year non-compete clause, went for adventures working in out-of-the-way locations. After jobs in Alaska, New Zealand, Iowa, and Nebraska, I returned home and took a part-time position with a Community Health Center, where I worked for 3 years. I left last month because of a troubled relationship with the Electronic Medical Record (EMR) system. Now back from a road trip to visit, and take in Continuing Medical Education, I’m helping to fill in at a clinic not far from home.

In a social gathering, a physician can be sure that people will approach with personal medical questions, unless doctors comprise the gathering, and even then sometimes the doctors will reality test with other doctors.

One doc I know got fed up and said to the person at hand, “Just go back to the bedroom and take off all your clothes, and I’ll be there in a minute to examine you. After all, a medical visit includes an examination.”

Another, while in med school, told her less-than-sober relative who had harassed her with sexual innuendo thinly disguised with a medical question to take down his pants, and let’s have a look at the part involved. Which effectively shut him up.

And on one occasion, I confess that I snapped, “I’ve just worked 14 hours, my mother died 8 days ago, and if you want advice, make an appointment and expect to pay just like anyone else. You’re not giving away your refrigerators for free.” (I didn’t refer to refrigerators; but even in public I’ll protect confidentiality. That only happened once. And while I’m not proud of my response, I can see that the comment found me in the midst of the grieving process.

Mostly, we get used to it.

Over the holiday, people with skin, weight, headache, chest, emotional, and sleep problems came to me in the context of prolonged sedentary feasting.

And I didn’t object, in fact, I welcomed it.

I miss my work. My current situation finds me with an unsatisfying number of patient contact hours. I got to give sound advice, especially what the person should say to their doctor, in an unhurried fashion. I didn’t have to worry about the tyranny of documentation or billing. Nor did I write a prescription.

And I got the chance to delve into the patient’s situation: what did the illness mean to him/her? Friends and family contributed to the history, and I got a much better picture of the whole situation. So I could say, for example, make sure you tell your doc your whole family history. Or, metoprolol is a better, cheaper beta blocker than atenolol or labetalol.

And later on, I could go on the internet and access Sermo.com, a website exclusively for licensed physicians. A doctor can post details of a puzzling case, and other physicians can comment. They brought me a new perspective: testing might show you the patient’s allergies, but the allergies may or may not cause the problem.

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