The thirty days that they require
Has now come right past the wire
I think that it’s fitting,
Not quite that I’m quitting,
I’m hoping someday for re-hire
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. I did two short assignments in Petersburg, Alaska. On Sept 2, I turned in my 30 days’ notice.
I finished up my most recent job this week.
I liked the position, I had wonderful nursing support, and our new CEO has gone a long way to improve the problems that her predecessor brought on.
I got the chance to speak a lot of Spanish. Opening up my patient panel brought in a flood of pediatrics and young people.
I got to see pathology I wouldn’t get to see elsewhere, because of our patient population. I took care of many schizophrenics, with a high prevalence of Type I Diabetes. East and West Africans came with a whole range of unusual problems including TB and its late consequences. Rarely a week went by when I didn’t declare, “Weight loss in Iowa in the 21st century is NOT NORMAL.”
I also got a waiver to prescribe buprenorphine, a narcotic used to treat narcotics addicts. By Federal law, a doctor can’t get that credential without 10 hours of Continuing Medical Education and taking a test.
I learned a lot about narcotics addiction by getting my name on the national list. Opiate withdrawal turns out to be a lot worse than I’d thought, and takes weeks to conclude. I developed my own mnemonic, DANDY LIPPS (dysphoria, aching, nasal discharge, diarrhea, yawning, lacrimation, insomnia, piloerection, pupillary dilatation, salivation) to remember the features. Diarrhea, sleeplessness, and pupillary dilatation resolve after all the other symptoms have disappeared.
I learned other lessons about the ugly process of addiction. My own narcotics prescription habits have gone from conservative to stingy to the point where I baulked at 15 hydrocodone for a patient with well documented kidney stones.
The corporate subculture of functional, mission-driven dynamics and support made the work day go well.
Why, if my job had so many positives, would I want to leave?
The answer comes down to one item, the electronic medical record (EMR) system. Poorly designed and badly installed, I found it barely tolerable till June. The vendor sent us an update without beta-testing, and the system slowed down from snail to glacial. Clicking on a button would not bring a response in less than 20 seconds. Clicking on a particular, popular button would guarantee a freeze-up that could only be fixed by the System Administrator. I found myself spending more than 8 hours weekly watching an unresponsive screen.
One day the system kicked me off 11 times, with each sign-on costing an average of 5 minutes. At the end, I finished my documentations and started in on the queue of 35 messages from the Billing Department. The first one took 14 minutes to complete, most of it involving an hourglass that didn’t seem to move.
I gave my 30 days’ notice and I did my best to burn no bridges. I left eligible for rehire, on such good terms that I’ll cover the 12/25 holiday.
In the meantime, I’m going walkabout again.