I am in a CSA, Community Supported Agriculture. I go pick up my box on Wednesday. Early in the year we get tulips as well as greens. I love both.
This is for Cee’s Flower Photo of the Day.
I am in a CSA, Community Supported Agriculture. I go pick up my box on Wednesday. Early in the year we get tulips as well as greens. I love both.
This is for Cee’s Flower Photo of the Day.
I am a rural Family Medicine doctor, board certified and board eligible. I have used the Telemedicine groups in the nearest big University Hospital since 2010.
Initially I started with the Addiction Telemedicine. I accidentally became the only physician in my county prescribing buprenorphine for opioid overuse in 2010. I panicked when I started getting calls. Dr. Merrill from UW had taught the course and gave me his pager number. I acquired 30 patients in three weeks, because the only other provider was suddenly unavailable. Dr. Merrill talked me through that 21 day trial by fire.
I think that I presented at least 20 patients to telemedicine the first year. The telemedicine took an hour and a half. First was a continuing medical education talk on some aspect of “overuse”, aka addiction, and then different doctors would present cases. We had to fill out a form and send it in. It had the gender and year of birth, but was not otherwise supposed to identify the person. TeleAddiction had a panel, consisting of Dr. Merrill (addiction), a psychiatrist, the moderator/pain doctor, and a physiatrist. Physiatrists are the doctor version of a physical therapist. They are the experts in trying to get people the best equipment and function after being blown up in the military or after a terrible car wreck or with multiple sclerosis. There would usually be a fifth guest specialist, often the presenter.
After a while, TeleAddiction got rolled into Telepain and changed days. They added other groups: one for psychiatry, one for HIV and one for hepatitis C. These can all overlap. I mostly attend TelePain and TelePsychiatry.
After a while, I pretty much know what the Telepain specialists are going to advise. So why would I present a patient at that point? Ah, good question. I use Telepain for the weight of authority. I would present a patient when the patient was refusing to follow my recommendations. I would present to Telepain, usually with a very good idea of what the recommendations would be. The team would each speak and fax me a hard copy. I would present this to the patient. Not one physician, and a rural primary care doctor, but five: I was backed up by four specialists. My patients still have a choice. They can negotiate and they always have the right to switch to another doctor. Some do, some don’t.
I am a specialist too. Family Practice is a specialty requiring a three year residency. The general practitioners used to go into practice after one year of internship. My residency was at OHSU in Portland, with rotations through multiple other specialties. We rotated through the high risk obstetrics group, alternating call with the obstetrics residents, which gave me excellent training for doing rural obstetrics and knowing when to call the high risk perinatologist. In my first job I was four hours by fixed wing from the nearest more comprehensive obstetrics, so we really had to think ahead. No helicopter, the distance was too far and over a 9000 foot pass, in all four directions. That was rather exciting as well.
Gnomes have dermatomes
call me on their cell phones
inflammed neurons fire moans
after lifting heavy stones
gnomes with grumpy dermatomes
stop riding on your spotted roans
ice your backs, lie down at home
gnomes complain and curse and moan
gnomes with calming dermatomes
glad they iced them there at home
families help, they’re not alone
healing gnomes pained dermatomes
For the Ragtag Daily Prompt: dermatome.
Rural doctor, mom, writes poems, dance, sing.
๐ ๐๐๐๐๐พ๐ ๐ถ๐๐๐ฝ๐ฏ๐๐พ๐๐.๐ผ๐๐ ๐๐๐๐พ.
Taking the camera for a walk!!!
A blog designed to remember the past and celebrate the present.
From the Existential to the Mundane - From Poetry to Prose
1 Man and His Bloody Dog
Homepage Engaging the World, Hearing the World and speaking for the World.
Anne M Bray's art blog, and then some.
The Home for All My Coding Projects
An onion has many layers. So have I!
My Personal Rants, Ravings, & Ruminations
...out of a digital shoebox
Writer
Poetry/Poems, Photography, Travels, Musings, Quotes, Challenges, Awards, Reblogs, Uncategorized
Vietnamese art and literature, beyond borders
Author โข Editor โข Writing Instructor
Discover and re-discover Mexicoโs cuisine, culture and history through the recipes, backyard stories and other interesting findings of an expatriate in Canada
Word painter and story slave
Reflections on Life through poetry, essays and photos
To participate in the Ragtag Daily Prompt, create a Pingback to your post, or copy and paste the link to your post into the comments. And while youโre there, why not check out some of the other posts too!
Beauty is everywhere waiting to be captured
Authentic Nautical Accessories, and Custom Furnishings
food for the body; food for the soul
Aspergers syndrom, bipolaritet, fotografi, konst, poesi.
I'm Victoria Stuart, a poet committed to love's transmission.
Martha Ann Kennedy's Blog, Copyright 2013-into perpetuity, all rights reserved to the author/artist
A navigation of the bipolar life
Passion for writing ignites my soul's momentum