It's 10pm.
Seven days before Christmas.
I'm sitting at work "finishing" up some charts.
I am suddenly overcome with anger.
WHAT am I doing here right now?? At this minute? I am helping NO ONE.
This work I'm typing away at, trying so hard not to just scream, it's hoops. Fucking hoops. For insurance companies. So I can BEG them to pay me. Pay me peons for the hard, good. compassionate, humanitarian work I'm out here trying to do, but can't, because of this.
This death trap of notes.
I put quotations around "finished" because, at this moment, I know, no matter how diligently I try. No matter how much time I spend here. Typing. Instead of completing my shopping list for my 5 children. Instead of seeing my husband AT ALL today. Instead of eating a complete meal. Instead of enjoying the rest of the evening, after finishing clinic at 8pm, to provide walk-in hours for my sick patients. I will quite literally, NEVER BE FINISHED.
I am typing away.
Clicking box after box after box after box after box after box after box.
Reading reminders on each patient. Have they gotten their mammogram? Their pap? Their flu shot? Their colonoscopy? Have you checked their labs? Their HgA1c at least twice this year? Have you talked to them about their "health care goals"?
Did you order an Xray within 30 days of their acute back pain? You did? Ok...ding...you're no longer a "quality" physician. So...we're going to actually pay you less.
As quickly as I resolve them, new results come in. New documents. From specialists. Labs. Physical therapists. Insurance.
F.U.C.K.I.N.G insurance.
Under the guise that they "care". That they are courteously reminding me of all the "missing" items for the "quality" care of my patients.
Do you know what quality care is!??
I do. It's my passion. I love speaking to people. Meeting them. Getting to know who they are. What makes them tick. What makes them enjoy life. Are they enjoying life? Are they not? What's stopping them? Is it mental? Is it physical? Is it chemical? Is it biological? I have these answers. All of them...if I just had the time to dig a little bit. The time to help them trust me. To understand their communication style. The time to really, REALLY understand their healthcare goals.
If I were allowed to do it my way, I could help all of my patients.
But, instead, I am in front of this horrid, white, glowing, screen...typing away.
As I type, I'm neglecting something.
My patients can't stand it. They confuse lack of time, with lack of compassion.
We don't care about them. We don't return their calls. We don't get their forms in on time. We don't give their lab results until 2 weeks after their drawn. Their referral wasn't sent. Their refill wasn't sent.
I hate it more than they do.
I am a problem solver. I like solutions. I like to help.
Sitting here. Typing. At now 10:24pm, is the last thing on EARTH I ever wanted to be doing.
Yet, here I am.
Drowning.
In this, slow death by charting.
3 comments:
Right...
My only saving grace is the ability to work at home, on the cloud, after everyone has gone to bed.
But you're right.
This isn't quality of care, it's "let's see how much we can pile on before you slip up and presto...no check this week" from those Philistines at the insurance company
Three more years....
Erin, when you feel the time is right, strongly consider moving to a "concierge" personal care type of practice. I am retiring this month after 51 years in practice, the last seven of which have been in a personal care practice. It is heaven compared to standard care. The level of care than you can give, the relationships and trust you can build with your patients is just wonderful. You have a beautiful family and you only get one chance to get it right. Good luck.
Thank you. This makes me feel like less of loser for NEVER CATCHING UP. I can't. I try. It gnaws at me, this chronic incompletion, some of which I know I'm never going to get to. I too love seeing patients, talking with them, knowing them, helping them (I think?).
I don't really consider being able to work from home a saving grace...I want to be a wife and mother when I'm at home. As much as possible, I'd like to be able to leave work at work.
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