Posts Tagged ‘FedEx’

Where FedEx doesn’t go

April 17, 2018

My summer plans just fell through

There’s a thing or two I should do

It takes hours and ages

To fill out the pages

To serve at a clinic that’s new.


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. I followed 3 years Community Health Center work with a return to traveling and adventures in temporary positions in Alaska, rural Iowa, suburban Pennsylvania and western Nebraska. 2017 brought me adventures in Iowa, Alaska, and northern British Columbia. After a month of part-time in northern Iowa, a new granddaughter, and a friend’s funeral, I have returned to British Columbia.  Any identifiable patient information has been included with permission.

My original summer plans fell through but another opportunity arose, slightly closer to home. If all works right, I’ll take 24 hour call Wednesdays, with clinic on Thursday and Friday.  I would face a 38 hour work week, perilously close to the 40 hour norm.

For me, every work place change involves applications and credentialing. I worked on the packet, and put together 59 pages with 2 passport pictures I just happened to have.  While I could receive the forms electronically, the hospital wants what is now called a “wet copy:” the actual signed forms rather than scanned/emailed or faxed.

FedEx gets as far as Prince George. Using the Canadian Postal interface slows down mail to the US by weeks, and, from experience, sending things Express across the border involves a time frame that could be paired with the word Pony.

Purolator courier service, however, does a lot of business here. While they don’t have an office in town, they do have a driver.

The hospital has an account. With my Monday free as a reward for my weekend on call, I stopped in to the front office to inquire about Purolator.  Come back at 1:00PM, they told me, when we expect the pick up.

I walked to the mall and found an adequate manila envelope. I stuffed and addressed it and walked back over to the hospital at 11:00AM to find the Purolator van parked in front and the agent doing business in the parking lot.  When she finished delivering a C.O.D. package, I approached her with my packet.  She knew exactly what to do, but had run out of international labels in her van.  She had other stops to make, and asked how she could contact me.  I gave her my business card, and we agreed to meet in the hotel lobby in an hour.

She arrived on time, to the minute. Her consummate professionalism did not get in the way of her Canadian small-town friendliness and sense of humor.  I don’t think she expected me to have weighed the envelope (320 grams) nor to have called and found out the charge ($53.28CD).  Neither did the hotel front desk staffers who watched the transaction.

Everyone knows everyone here. I answered questions about why the package would go to Texas if the job were in Iowa.  I found out I don’t have to have my own Purolator account to send packages.


I Sent My Medical License Application to Canada.

October 7, 2015

A surveyor came to the door.

The design of the questions was poor

Doctors’ treatment gets worse

Regulation’s a curse!

And the EMR is a chore.

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 (EMR) system I can get along with. I spent the winter in Nome, Alaska, followed by assignments in rural Iowa. This summer included a funeral, a bicycle tour in Michigan, cherry picking in Iowa, a medical conference in Denver, and two weeks a month working Urgent Care in suburban Pennsylvania. Any patient information has been included with permission.

After wrestling with a recalcitrant, truculent printer, I put together a packet to go to PhysiciansApply, a Canadian agency that helps doctors put their credentials into one central place in the system, so that the various provincial licensing boards can access them.

They wanted: notarized copy of passport, a copy of my American Board of Family Practice certificate, a copy of my residency certificate, a copy of my medical school diploma, a copy of my Iowa medical license, and a Certification of Identity.  This last form required 2 passport pictures less than six months old and a Notary stamp.

I understand the need for these documents, especially, from the Canadian point of view, because I’m an International Medical Graduate.  I hope they go through a thorough verification process.

Luckily I live in a small town, where I can get passport pictures at a nearby drugstore and my next door neighbor has a notary credential.

I sent the packet via FedEx.  I have only sent things internationally once before, when I went through a similar procedure for New Zealand 5 years ago.  I had never considered the importance of declaring contents for the purpose of customs.

A survey taker came about two hours later to ask loaded questions about the Affordable Care Act, also known as Obamacare.  He carried an electronic device.  I sat on the glider on the front porch and leveled with him.  In my experience, every time the taxpayers squawk loud enough, the kleptocrats cut meat from the program rather than fat, so that the taxpayers complain louder, the program gets expanded, and the taxes go up.  I think our government spends too much and spends foolishly (and a lot of that has to do with health care).  But I think we should tax the wealthy more and not tax the poor at all.

I also told him about my experience in Denver, talking to doctors at the breaking point.  The Electronic Medical Records keep getting worse, paperwork requirements keep getting worse, reimbursements keep going down, and the ACA failed to bring in tort reform.  I talked about my fears that our medical capital, our primary care physicians, will start leaving the country.  Already, Canada offers better incomes and more protection from medical malpractice suits than the US.  New Zealand has a polite society, a great EMR and no medical malpractice at all (no tort law, for that matter), a lower income for doctors who have found a good work/life balance.  Australia doctors work hard, bill fee-for-service, and make more than American doctors.

And then I told him I had, that very day, sent my application to Canada for a medical license.

I didn’t tell him I had no intention of moving there.  I want to try the system out, and write about it, honestly.

A privileges and credentials packet goes out

October 22, 2010

It’s not the status that’s quo,

After quite a few flops in a row

     It was quite a long caper

     To fill out the paper

And the agent came through like a pro.

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  While my one-year, thirty-mile non-compete clause runs out I’m having adventures and writing about them.  I’ve worked in Barrow, Alaska (the northernmost point in the United States), I went to the American Academy of Family Practice Annual Scientific Assembly in Denver, and I took a week to visit a suddenly stricken friend.

Yesterday I got together the final paperwork pieces for the job I plan to take for the month of December.

A new medical position never runs without complications; a locum tenens job where the duration is short carries its own complications.  A Curriculum Vitae precedes any negotiation.  So far all prospective employers have asked for copies of medical licenses, residency certificate, medical school diploma, DEA certificate, CSR certificate (a state registration that qualifies a doctor to prescribe narcotics and other controlled substances), along with work history, malpractice history, and criminal history.  If the process continues, there’s a questionnaire from four to eighty-seven pages long (I didn’t fill out the monstrosity intended for another country; I decided I’d rather go somewhere else than spend weeks completing paperwork) which is sometimes accessible online.  And if all goes well, at the very end comes approximately twenty-five pages called Privileges and Credentials.  This last batch recaps everything submitted so far with a few more things thrown in.

The agency I’m working with took the information I’d given prior and filled in most of the P&C form. 

As I’ve said yes so far to 17 jobs (of which three have panned out), I’ve gotten good at completing the paperwork.

I got a call around noon, asking me if I’d like to have the raw material for privileges and credentials FedEx’d or emailed.  As I’ll be out of town for two weeks, I of course asked for the PDF file.  I printed it out at 1:00 PM and went to work.  At 1:38PM I called with some clarification questions.  I had to phone to find out the number of my professional liability insurance policies for the last seven years as well as the email addresses for those docs I’ve listed as references.  At 2:00 PM the material was ready to go.  However I had to learn how to use the FedEx system.  After a few more calls, and a light lunch, I dropped the material off at the FedEx store nearby.

I’m not complaining about the process.  Indeed, for the last 22 years I’ve sat on St. Luke’s Credentials Committee.  We’re very careful about who gets to practice, as every hospital should be.

This same agency’s recruiter has shown exceptional attention to detail, asking me to specify six parameters of reimbursement before she started negotiating with the client.   Yesterday afternoon I received my schedule as well as reimbursement plan, about 4:00 PM.

Regretfully, not all agencies have been so well organized.