There is a financial pressure to see a lot of patients in a day. Seeing patients equals revenue. Revenue equals a paycheck for me and everyone else that I employ. It also feeds the giant corporate machine to which I now belong. In all honesty, I haven’t felt specific pressure from the corporate machine because for now, I am flying under the radar. Plus they are nonprofit. At least on paper.
I know that this reprieve won’t last for long. We recently changed computer systems, which if I were a few years older, probably would have forced me into retirement. It was one of the hardest transitions I have ever endured. Everything feels like a fight. There is no one accountable when things go south. You have to talk to a half dozen people just to get to someone who knows WTF you are talking about.
When I print a prescription, it is going to a Pediatricians office in another city. Why can’t you fix my printer? Why can’t my computer print to my printer in my office? That took like 3 weeks. Not joking.
For now, they are not giving me too much shit, because they know somewhere in their corporate brains that they can’t push us too much. Not yet. Not until we get our footing with this system. With being part of a big machine. With trying not to lose our humanity.
I had a conversation with another provider recently who said one of their partners saw more than 50 people a day.
This. Would. Kill. Me.
I seriously contemplated the enormity of this. My first thought was -Jeez, I must suck, I feel overwhelmed when I see 25. What’s wrong with me? What am I doing wrong? Then, I wondered how they weren’t screwing everything up, missing parts in the chart, forgetting to send someone for a mammogram, misdiagnosing a disease because they were in a rush, working on their charts into the wee hours of the night. If that’s what it takes to stay in this business, to make money, to be a doctor, count me out. I’ll just be poor. Debt-ridden. And happy.
Who once said and I paraphrase, If you do what you love, you’ll never work a day in your life? This work is a labor of love. I don’t see dollar signs when I look at these people. I see mothers, fathers, factory workers, waitresses, broken hearts, fear, perseverance, despair. I see resilience, faith, trust, joy, prosperity, and forgiveness. I see healing.
I learn their stories. I want to learn their stories. That’s why I feel overwhelmed when 25 people come through my rooms. I can’t give all of them my attention. I can’t learn their stories. Oh, I could see a hundred people in a day. Line them up like an assembly line. Dole out the antibiotics. Gloss over their questions. Send them for tests. Refer them out to someone else to deal with. Run ’em through like cattle. I can’t be that kind of doctor. I won’t be that kind of doctor.
If you listen carefully enough, the patient will tell you what’s wrong with them. The diagnosis will be given to you. The patient will tell you. If you just listen.
If you are my patient and I don’t know that your dog died last month, or that your grandson has been deployed, that your daughter is getting married, or that you got that job you wanted, then I am not doing my job right. If I am not listening to your stories, how will I ever find out what ails you?
deconstructingdoctor.com 
I wish I had or could find a doctor like you… you give me hope that they are still out there… that not all have yet been run into the ground, so to speak.
As a patient with EDS, I have nearly given up. All my doctors are so overworked.. I feel quite badly for them but at the same time, I feel like a teeny tiny field mouse drowning at sea.
I can no longer keep up with the testing that 8/10 times leads to nowhere. I have a stack of orders over a month old that I just can’t bring myself to complete inspite of my suffering because as experience has shown, the doctors, especially my GP, more than likely won’t even remember why they gave me the test in the first place.
Just for swollen turbinates, it took a year of multiple GP and specialist visits to be told my only option to reduce them and breath right again is surgery and the only thing I was told before that was to use flonase. I got frustrated at my last visit and told my doctor that he has already told me to do this several times and that I have been using it two weeks on and two weeks off for a year now with no success to which I was told that surgery was my only option. And that’s just my nose, almost my whole body needs treatment in one way or another.
I try to be as helpful as possible, doing my own research, taking notes, making notes, trying to condense my questions, narrowing stuff down, and even asking what I can do as a patient to make my GP’s job more easy to treat me.
I even hand painted a calming card for my GP to express my gratitude for my GP’s services and sympathy basically for being overworked and having a hard to treat patient with a rare disorder that as my GP said, hasn’t been on the exams for 30 years. My GP literally tossed it aside… My GP looked almost offended. I just feel like giving up and I am getting the sense that so do a lot of doctors.
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You sound like an excellent doctor, and anyone who listens, is ok in my book because it is a rare commodity these days. Computers, now that is another thing altogether.
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Yes, computers are my arch enemy 🙂
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Stick to your ideals! 25 people is more than enough, but 50? How is that supposed to be helpful? My doctor refuses to overwhelm herself and her patients by pushing the numbers and we patients are very appreciative.
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It’s a catch-22. Some patients (like you) get it, some don’t and get pretty pissed when “their” doctor is not available and they have to wait for an appointment for the next day or see someone else in the practice. You have inspired me to write about that aspect…..patient expectations…stay tuned 😉
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What city are you in? I’d LOVE to be one of your patients!!I have aPulmonologist that I adore as he’s just such a “real” honest doc that even tells me when he’s clueless of why I’m having certain issues and I love that honestly! I cried when my pediatrician retired (he was like you 😄) and to this day we have stayed in touch! Never ever let the”machine” change your beliefs and passion because it really does matter a lot to your patients (and their loved ones)! Although I once really had zero signs of a DVT because my pulmonologist knew me so well he shocking discovered it on a hunch due to our relationship and no other reason! Otherwise I’d have likely died! It’s always such a shot in the arm of faith in humans when I read your blog so thank you for being you!
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I wouldn’t call where I practice much of a city. It’s in a rural area in North Carolina. Maybe too much of a commute for you? Your Pulmonologist sounds awesome! I am glad you have that kind of caring physician and astute clinician in your life. Sounds like they were a lifesaver!
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Yep that’s a bit of a drive from Houston 😃
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Why don’t we have more doctors like this woman?
I’m almost tempted to ask if I can come and work for her.
p/s: Please, guard your humanity with all your might. The machine wants to make minions out of us all. I resist. *winks. And you should too.
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Thanks doc! I remember your post about your name -so I use ‘doc’ lovingly❤ we must guard our humanity who else will?
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so why did you join the big corporation?
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Good question unfortunate it was not my intention. I joined an ACO that failed and got bought out by a corporate hospital
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We need so many more like you 🙂
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They are out there I promise
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Beautiful. Please continue to be who you are. We need more physicians lik eyourself. You bring light and love to your patients everyday.
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❤❤❤
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Amen.
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❤❤❤
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