Locks on the Clothes, Keys on the Shoelace: the dress of a millwright.

The millwrights has many a key

For the mill cuts up many a tree

On the machine go the locks

Preventing visits to docs

And keeping the workplace accident-free


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, traveled 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 went back to traveling and adventures in temporary positions. Assignments in Alaska, rural Iowa, suburban Pennsylvania and western Nebraska have followed.  I finished my most recent assignment in Clarinda on May 18.  Right now I’m in northern British Columbia, getting a first-hand look at the Canadian system. Any identifiable patient information has been included with permission.

Thursday I took care of 17 patients. One pediatric patient required all my patience, skill, and accumulated experience to get the job done without alienating the kid.  The oldest patients barely qualified as septuagenarians.

I wrote a lot of prescriptions for blood pressure drugs.

I used my deep-breathing techniques on three patients to bring blood pressures into the acceptable range.

Though only 15% of Canadians smoke, the nicotine addicted comprised more than half my patients.

I wrote several back-to-work slips, all employees in the timber industry.

I cared for even more millwrights and former millwrights. Changing logs into useable products involves a lot of dangerous machinery, and the people who fix the machinery come in loaded with padlocks on their clothing.  They lock a machine before they work on it, to make sure it won’t start accidentally.  Spare keys get carried where they can’t get lost, such as tied into shoe laces.  During the work day, a “whistle” signals a need for a millwright.

One of my patients in frustration said, “Can you give us a referral to see a specialist we can actually see?’ and we laughed after I asked for and received permission to use the quote in my blog. While I know my way around the human body, and most of the things that go wrong with it, I don’t know the local medical community.  Yet the permanent doctors trained near here, and know the consultants personally.

There’s also a province-wide network providing phone-in advice for docs . The consultants get paid on a fee-for-service basis; the patient has a unique identifying number, and the doc has a bunch of unique numbers (I have 8), one of which is the right one to use.  Computer algorithms coordinate compensation.


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2 Responses to “Locks on the Clothes, Keys on the Shoelace: the dress of a millwright.”

  1. KC Says:

    I really enjoy reading your adventures. This statement,”One of my patients in frustration said, “Can you give us a referral to see a specialist we can actually see?’” is that because of lack of doctors or are the appointments scheduled so far out you wonder what is the point? I could be dead or cured by the time the scheduled appointment date arrives. Just wondering.

    • walkaboutdoc Says:

      While there seem to be plenty of specialists in Vancouver, specialist support out in rural areas can be thin or even non existent. For example, to the best of my knowledge there is no dermatologist north of Kamloops though computers and digital cameras can do a lot and an occasional dermatologist is willing to travel for once-a-month clinics in select communities. Right now there’s one functioning MRI for a very large area, and people who need the scan within a week have been given a wait list date of 2019. Which means that I’m ordering CT scans when I would really rather avoid the radiation. Yet, as I understand it, there’s a very old MRI in Dawson Creek and if you’re willing to shell out from your own pocket you can have your knee scanned for about 1/6th of what it would cost in the States. Yet given the choice between an overabundance of resources in the US and what’s very close to the right amount in Canada, I would choose the Canadian system. Perhaps because the government treats the doctors better.

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