Tag Archives: telephone

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Conserving energy

I was out of clinic for two years and then very part time for a year and now not quite full time as a temp. I bargained to not quite be full time.

The electronic medical record is having a consequence, along with the pressure to see more people faster. The primary care doctors, at least the younger ones, do not seem to call their peer specialists any more. (Family Medicine is a specialty, just as Internal Medicine and Obstetrics/Gynecology are.) I called a gastroenterologist and left a message last week about a difficult and complex patient. The patient had cried three times during our visit. The gastroenterologist was very pleased I had called, was helpful, agreed with my plan of using the side effects of an antidepressant to try to help our patient, and thanked me three times for calling her. Wow. I am used to calling because during my first decade in Washington State, our rural hospital had Family Practice, General Surgery, a Urologist, Orthopedics and a Neurologist. For anything else, we called. I knew specialists on the phone for a one hundred mile radius and some knew me well enough that they’d say a cheery hi.

Now communication is by electronic medical record and email on the medical record and by (HORRORS) TEXT. Ugh. I think that there is quite a lot of handing the patient off by referring them to the Rheumatologist or Cardiologist or whatever, but the local Rheumatologist is booked out until February for new patients. That leaves the patient in a sort of despair if we don’t keep checking in on the problem. If I am worried, I call the Rheumatologist and say, “What can I do now?” I’ve had two people dropping into kidney failure and both times a call to the Nephrologist was very very helpful. I ordered the next tests that they wanted and got things rolling. One patient just got the renal ultrasound about three months after it was ordered. Sigh.

I have one patient who is booked in February for a specialist. I called that specialist too, they did not want any further tests. I told the patient, “You aren’t that sick so you won’t be seen for a while. It isn’t first come first serve: it is sickest first. We all have to save room for the emergencies and sometimes those are overwhelming.” The specialist agreed and the patient is fine with that and I think pleased to know that we do not think she’s that sick. She feels better. If things get worse, she is to come see me and might get moved up. Neither I nor the specialist think that will happen.

Is this conservation of energy, to communicate by email and text? I don’t think so. I think sometimes a phone call is much more helpful, because the other physician knows exactly what I am worrying about and they can tell me their thoughts swiftly. Sometimes they want me to start or change a medicine. Things can get lost in the overwhelming piles of data and the emails and labs and xrays and specialist notes all flowing in.

My Uncle Jim (known as AHU for Ancient Honorable Uncle Jim) used to sing part of this:

Yeah, that’s just how I call my fellow specialists.

For the Ragtag Daily Prompt: conservation. Don’t cats win at conservation of energy?

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If I were your child

Living in a town of 9000, now 10,000, I did not feel that my children needed cell phones. They could walk home from school. It is reasonably safe, though I knew too much about local use of heroin and methamphetamines to believe that anywhere is completely safe.

I spoke to a friend from high school in the early 2000s. He asked me to text him my address.

“I’ve never texted.” I said.

“NEVER?” he said.

“Nope.”

“Haven’t your kids taught you how?”

“My kids don’t have cell phones.”

Long silence. Then: “If I were your child, I would run away.”

I laughed. My son got a cell phone when he headed for college and my daughter got a track phone, ten dollars a month, in high school. Calls and no texting. My son ran away the same way I did, as an exchange student. He went to Thailand at age 16 and was on the Maylay Peninsula, two years after the tsunami hit. His first comment calling home was, “Mom, the world is a really scary place.” Going off to be an exchange student is a fabulous way to run away, because you learn tons and come home.

My daughter had one friend who she would go to sleep over in her teens.

“I don’t want to sleep over any more.” she said after one night.

“Why?” I asked.

“She is up texting and by midnight she and friends are having arguments by phone and she cries. I want to sleep.”

Don’t leave the phone in the kids’ rooms, parents. And don’t have the phone in your bedroom either!!!

For the Ragtag Daily Prompt: texting. With music: https://youtu.be/hkmZGh9DQZ4.

The photograph is Studt’s Pumpkin Patch and Corn Maze again.