Rebel in clinic

Right before my hospital district informed me that they no longer wanted my services, I was rebelling. The fight from my perspective, was over good patient care. They had set a quota. 18 patients a day. One every 20 minutes and one 40 minute visit. 8 am to noon and 1 pm to 5. I argued and argued and argued. I knew finishing the note in the room took me 25 minutes on the hateful electronic medical record and I had averaged 16 patients a day my whole career. I was not fast but I was super thorough and had just gotten an excellent report on a chart review and had been told that I was a great diagnostician. Which was mostly due to my nearly OCD thoroughness. I was not diplomatic with the hospital administration.

One day I was feeling wicked, just wicked. I had a brainstorm and started whistling softly. The other two doctors and PA were all in the same small office.

One took the bait. “What is that? I know that song.”

“Oh, we are singing it in chorus. For some reason it is in my head today.” So I sang this song.

I did not have the words memorized. I swear that the temperature in the room dropped and the male doctors hunched in their chairs.

“Yeah, don’t know why that one keeps playing in my head.” I said. “I hope you can all come to the concert!”

But answer came there none.

I took the photograph at Quimper Family Medicine, the clinic I opened after the hospital clinic kicked me out. The skeleton was named Mordechai in a contest. This is from 2014. Mordechai lived in our waiting room every October, with different outfits.

4 thoughts on “Rebel in clinic

  1. My neighbor is a high school science teacher. I did not find out for several years that he is also a medical doctor. My anatomy professor told me a story about him. I asked my neighbor if it were true and he said, “pretty much”. He was in a family practice residency and an older woman came in with a shopping bag full of medications. She didn’t know what they were or why (or if) she should be taking them. He went through the bag, tossing old drugs, checking for interactions, checking her history to see what she was on and why, examining her to determine current needs. She left with her meds sorted out and her needs met. The supervisor chewed my neighbor out for spending too much time with her, telling him he had 15 minutes per patient. He quit the program, realizing this was not why he went into medicine. He has been a happy science teacher for many years since. My son, who took a biology course from him, still refers to him as “Doctor Smith” 15 years later. He had been neighbor “George” until then. [Name changed to protect the innocent.]

  2. Lou Carreras says:

    Organizations have a tendency to forget why they created the rules, and become mired in enforcing rules rather than achieving the results the rules were created to enable. In medicine it was the difference between a Health Maintenance Organization and a Health Management Organization.

    • drkottaway says:

      Another doc who was way more diplomatic AND worked with the senior internal medicine doc said, “Katy, we do not see 18 patients a day and no one bothers us.” After he retired, she was in a different clinic. And rumor has it that she stood up in a meeting and said, “Katy was RIGHT!” and stomped out. I do not know if that is true, but she quit medicine. Pity, because she was excellent.

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