Trade-offs


I like to care for the sick

For me it just does the trick

But after reflection

I miss the connection

If the pace of my work goes too quick.

Synopsis: I’m a Family Practitioner from Sioux City, Iowa. In 2010 I danced back from the brink of burnout, and honoring a 1 year non-compete clause, travelled and worked in out-of-the-way places in Alaska, Nebraska, Iowa, and New Zealand. After three years working with a Community Health Center, I am back having adventures in temporary positions until they have an Electronic Medical Record System (EMR) I can get along with. I spent the winter in Nome, Alaska, and I just finished assignments in rural Iowa and suburban Pennsylvania. After detours for my brother-in-laws funeral and a bicycle tour of northern Michigan, we’re back in Sioux City.

I got a new computer.  I paid for the set up at the big box store.

When I returned to the store to pick it up, the young man helping me asked insightful questions about my career.  I didn’t recognize him.  He, however, recognized me.  I was his doctor, and, when he grew up, we used to see each other at the gym.

I delivered him and cared for him through his adolescence.  He has grown into a knowledgeable professional.  (He gave me permission to write more than I have.)

I don’t like talking about patients’ lives in public, and I enjoy talking about myself (frequently more than people want to listen), so I kept my end of the conversation about me.  I talked a lot about Alaska, and the freedom that locum tenens work gives.

Still the conversation brought me to reflection.  The 23 years I worked in private practice brought me intense professional satisfaction, but more than that it brought me to a perspective on the human condition that could only happen by intense involvement in people’s personal lives while staying in one place for more than a generation.

But inevitably, I had to talk about my 84 hour weeks, and a pace of work and life nowhere near sustainable.  I didn’t mention the 70% overhead that made slowing down impossible.

I also talked about what a great time I’m having on my current gig.  The Urgent Care outfit I work for has the problem Figured Out.  The top management, clinicians all, keeps the corporate vision of putting the patient first.  A person can walk into one of the clinics without an appointment, be seen in a prompt fashion, and be out in less than 45 minutes (the stated corporate goal).

I find the work very gratifying: single problem visits, almost all curable, resulting in easy documentation.  The patients tend to the younger age range, and I get to take care of an unusual number of older children and adolescents.

In the beginning, I felt a little uncomfortable taking away what I regard as the easy stuff from primary care providers.  But I heard over and over from my patients that their docs couldn’t get them in for 3 days to three weeks, or even told them to go to an Urgent Care.

Trade-offs fill the human condition.  I don’t particularly enjoy chronic care of medical problems which have treatments but not cures: diabetes, high blood pressure, high cholesterol.  But if I didn’t attend those problems I wouldn’t have the perspective for the grand spectacle of family development.  I like the travel and adventure of locum tenens, but I like running into people I know all over town (like in a big box store).

I would like to think I could find an optimum or a sweet spot.  More likely I’ll have to settle for one or the other, or even an oscillation from time to time.

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