When you don’t see 50 patients a day

This blogpost was inspired by One Woman’s Quest who wrote in response to my blog Profit or Prophet:  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.

img_2145What happens when you don’t see 50 patients a day?

People get pissed.

You don’t have any appointments left?  I can’t be seen today?  Can’t you just squeeze me in?  Well, then, I ‘ll just have to find another doctor.

OK.  Bye Felicia.

You won’t like me if I see 50 patients a day.  You won’t like me AT ALL.  I won’t be the same person.  I won’t be the same doctor.  I won’t have time to listen to you.  I won’t have the capacity to give a shit about your grandkids, your pet bird, the death of your mother last week, how your husband cheated on you, your kid getting into college.  Nope.  Don’t tell me anything.

Just the facts.  Where does it hurt?  Doesn’t matter that you haven’t slept in weeks because they are going to foreclose on your house.  I don’t have time for that.  How long has it hurt?  What have you taken for the pain?  OK try this, call me if you’re not better.  NEXT.

Consider a lifeboat.  There’s been a shipwreck.  The lifeboat can save lives.  Until it is overcrowded and people are scrambling to get in, they topple it over, overwhelm it, water enters, the lifeboat starts to sink, and everyone is screwed.  The life raft saves lives when it is not overwhelmed, once it is, all bets are off.

I am sure a robot/computer/cyborg could do a better job than me.  It could be programmed with all of the latest/greatest medical knowledge, perform around the clock for millennia.  It could see 50 patients a day easily.  No problem.  It would never tire.  It would never need to have a lunch break, a bathroom break, it never gets sick, it never runs late, it doesn’t have to take its kids to basketball practice.  It would only consider the facts.  There would be no room for art.  The art of medicine.

Art takes time.  Art needs to be considered.  All the aspects of a person’s life contribute to their well-being, I need to know the factors that could be contributing to their ailment.  Your blood sugar is too high because you can’t afford the right foods?  You can’t afford the right foods because you lost your job?  I need to know that.  It matters.  It changes the treatment.  It changes my approach.

If I am overwhelmed, truly overwhelmed, the human part of me begins to get angry, bitter, resentful.  I start to express those feelings to those that are overwhelming me.  I start to treat my patients differently.  That part of me that they love and seek out because I care about them, starts to die.  I no longer give a shit.  I no longer care.  And that’s dangerous.  I can still do my job, but that’s just what it will become, a job.  Not a career.  A work of art.  A mission.  A purpose.  A joy.  A life’s work.  Something to be proud of.

It will just be a shitty job, with shitty patients, who only give a shit if they get what they want from me.

So if you can’t get an appointment with me the instant that you want it, be grateful.  Be patient.  Know that I am doing what I can for who I can while preserving that thing that makes me  –me.  Know that I will be the doctor that you have come to love and trust because I get to take my time with you, too, when it’s your turn.

I think I’m worth waiting for 🙂


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19 Responses to When you don’t see 50 patients a day

  1. I can’t imagine seeing that many patients in a day – is that the norm?? As a therapist, the most clients I’ve ever seen in a day was 9 and I’ve sworn since then that I won’t do that again. You’re smart to set boundaries as you need – I wouldn’t want you to burn out 🙂

    Liked by 1 person

    • Lord I hope it’s not the norm! One of my colleagues said her partner saw that many a day! I can not do it. It’s like being a factory worker just making numbers! Thanks for the encouragement. Burn out is rampant.


  2. 2ndhalfolife says:

    Funny, one of my paramedic friends used to say all the time when someone was complaining why some doctor couldn’t figure something out: “that’s why the call it the ART of medicine”. 🙂 And we emergency workers were always taught in the time of a crisis, we needed to make sure we were safe first, because we could never save anyone else if we got killed or hurt…. To me this carries over to every day in healthcare, the providers much care for themselves first so we can care for others. xo

    Liked by 1 person

  3. dawnkinster says:

    It’s hard to get in to see my primary care doctor too….and I’ve been frustrated by it, though never considered leaving him. You have opened my eyes. Of COURSE it’s hard to get into see him…he takes time with me when I’m there, he hugged me when my parents died, he celebrated with me when I retired. He’s worth waiting for. I’ll have to tell him that when I see him at my next physical.

    Liked by 1 person

  4. Jane Park says:

    Thanks a lot for your post!

    Do you think what you say applies similarly across different areas of medicine? Would it be possible that acting upon the art/mission of being a doctor could possibly entail seeing greater number of patients over ensuring quality time with the patients, for, let’s say, ER doctors? Or surgeons whose extra working hours could possibly save another life?

    Just to place the question in perspective, I am a current undergraduate aspiring to be a doctor, and I am asking in part because I wonder – out of sheer curiosity and a little bit of concern- if one could/should be able to rightfully advocate for oneself’s well-being as a doctor (through having more time to see patients vs. increasing the number of patients) across all areas of medicine. I hope my question makes sense…! Thanks always for your blog posts – I really enjoy reading them 🙂

    Liked by 1 person

    • It is a constant battle as a physician to protect your personal time. I don’t think it matters the field although I can only speak as a primary doc and as a woman. The expectation is to be always available. The insurance companies and corporate medicine have created a kind of factory mentality. They have tried to mechanize the dr patient relationship and have whittled it down to productivity, dollars, efficiency. Internally I fight that mentality everyday. I won’t let them suck the joy out of what I love to do. It is a great profession!


  5. I try to tell colleagues, legislators, and insurance companies that I max out at about twenty client sessions per week. Beyond that, I lose the ability to truly be present and useful. The pressure to see more people is unrelenting, and the economics are demanding. Still, I prefer to be sane and of aid so I do as I must. I probably could not do so if I were just starting in the counseling profession or had a young family.

    Liked by 1 person

  6. Sounds like you are worth waiting for to me doctor. Great post. ☺☺☺

    Liked by 1 person

  7. Susan says:

    “All the aspects of a person’s life contribute to their well-being,..” You nailed it right there. Patients want to be treated like a whole person. Sometimes even they don’t realize how much more they need from you than just dissemination of their most acute problem. The patients have no patience.

    I love hearing that you take everything into consideration. I changed providers when a Nurse practitioner ignored the information that my mother and grandmother both had Thyroid conditions. And that I was falling asleep at the wheel. She told me I needed to exercise more.
    My new provider put her hand on my neck, sent me for an ultrasound, and the biopsy that followed confirmed Hashimotos.

    Liked by 1 person

    • We have to pay attention to what the patient tells us and we have to ask the questions about their lives. It matters. I feel the most annoyed with my job when I can’t fully do my job, when I don’t have the time to ask. I’m glad you had someone ask the right questions and figure out what ails you.

      Liked by 1 person

  8. Mike Kizer says:

    I wholly agree that you are worth waiting for as is your blog. If I lived in your part of the world you would be my doctor – Kaiser be damned! And I wouldn’t be a pest, because I am very healthy. MK

    Liked by 1 person

  9. Deb says:

    I wonder, do you see this as a general rule- an across the board ideal no matter if it’s a new patient, established patient, families versus singles… I’m curious as I think back to the many dental patients I’ve encountered. I always believed it was mostly like this for us when it came to new patients-typically the ones who waited too long (for whatever reason) and “had to be seen NOW” and I think that was correct most of the time, although my employer at my last practice had a few older patients, clearly believing that they were entitled to drop in and be seen on a whim.

    Whatever the reason, I can empathize with how much it sucks because as support staff I think we took the brunt of it in trying to manage these sorts of patients 🙂

    Liked by 1 person

    • I agree the staff gets the brunt of the feelings of entitlement. As healthcare providers it is expected that there is a sense of duty that our interests and comforts are spared for the greater good of those we serve. And in some respects that’s true, but it can not go on indefinitely. We get tired and we need balance. I have found no real difference between the type of patient they has these expectations. It seems to be the same across the board.

      Liked by 1 person

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