April 19, 2024

In one week, Friday Night Buzz Thread returns!

I'm still not at my goal weight, but I'm steadily increasing my cardio every week. I'm hoping that will be the definitive action to get me there.

And got-DAMN, I need a drink!

Hope to see you all there...

April 16, 2024

Just submitted my application for the new primary care position at our soon-to-open new clinic.

It's a five-minute drive from my house. My commute will be twenty minutes shorter each morning. Since we will have dental there as well, Mrs. Aristus may be coming over, too. It will be nice working in the same building at last...

April 11, 2024

Man, oh man! I just saw some backpedaling so hard, they could have done the Tour de France backwards!

The "You're not working hard enough" types who recently pissed in my corn flakes just did a "Gracious! Did WE do that?!?"

No doubt after getting a monumental WTF??? from the rest of the float pool, they have amended their 'do another provider's work for him' fiddlyfuck to "We're sorry! We're sorry! We meant 'only if that provider requests help first'!"

So, with any luck, that is sorted out. I'll ask for an apology for their abusive language some other time. Right now, I'm just going to savor the fact that their explanatory e-mail reeks of apologia. Someone higher up than they must have asked them "Is this really how you want to treat trained, seasoned, experienced, and dedicated professionals?"

I can't thank you all enough for your supportive messages. My dear, darling Loungers are the best. I love you all.

April 11, 2024

Trouble in Paradise: If someone was looking to disrupt my enjoyment of my new job, they succeeded.

Since coming back on board my old community health organization after thirteen years of overwork with their crosstown rival, I've been working in the urgent care department, and also as a float, going to whichever clinic needs help on any particular day. I'm hoping to secure my primary care position in the next few months.

Urgent care stays pretty busy, and we have a good-sized team of providers, all of whom are wonderful colleagues to have, and with whom I really enjoy working. Sometimes, however, the unpredictable schedule in urgent care can lead to days that are slower than others, resulting in a decrease in billable patient encounters.

The organization's bean-counters think they have found a wonderful way to increase the number of billable encounters. Any time any of we urgent care providers are "not doing anything", they want us to surf the electronic in-boxes of certain specific medical providers who are not in urgent care, and sift through the items looking for opportunities to create billable encounters. If we find a notation that might lead to a follow-up visit for a medication refill or a lab result review, we're supposed to forward it to scheduling. This, according to those who dreamed up this cockamamie scheme, is because the primary care providers are too busy with their own encounters to work their electronic in-boxes.

If this sounds sketchy to any of you, it certainly does to the rest of us in urgent care. Why the hell should we be responsible for another provider's in-box? Isn't it that provider's responsibility? Claiming to be "too busy" to do one's paperwork is the height of unprofessionalism, as is expecting someone else to do it.

For thirteen years, I spent every single day keeping tabs on my e-inbox. Because I was always facing a tall stack of papers on my desk in the mornings, and needed office time to tackle that, I had to make sure my electronic in-box was cleared out so I didn't have to waste office time on it. Every single day, days off, weekends, sick days, vacations, holidays, I was always in there taking care of the work. When every category of item was cleared out, it was never more than an hour or two before it would start to fill back up again. I never allowed the work to get to an overwhelming level.

Now, I'm being told I have to do someone else's work. I pointed out to the architects of this scheme that it was ill-advised, and unfair to those of us who are doing our own work. They just about came unglued. The words "unprofessional", "insubordinate", and "a bad PA", names I was never, ever called before in my old job, were hurled at me all in the space of about fifteen seconds. After getting ambushed with this, I got up to leave, and one of them barked "WE'RE NOT DONE YET!"

It's been a pretty rough couple of weeks since that disastrous meeting. Mrs. Aristus is urging me to quit, even though we have the chance to soon be working in the same clinic. My confidence in myself and my work has taken a huge hit, and the Medical Director, and the Director of Operations, both of whom I have known and respected for nearly twenty years, are hearing from people who don't know me or my work that I'm unprofessional and insubordinate.

It's enough to make a man drink. (Which I intend to, soon. )

One of my colleagues in the float pool, whom I assume suffered her own ambush after objecting to that crazy scheme, has e-mailed the rest of us, requesting a meeting amongst ourselves before going to upper management. As in everything else, it's nice to know one has allies. The MD at the head of the float pool was scandalized when I told her how I had been treated, and I think I can count on her support, too. We'll see what happens.

But it's been a nasty knock, since I came here to get away from the toxic atmosphere of my old job. Right now, I'm holding out for my primary care position, when I will no longer be required to do some other provider's work for them.

If you've gotten this far, thank you for listening.

You are all very dear friends, and I love you all.

April 8, 2024

Are we still here?

Did the shit-spewers get raptured?

Man, the rest of our lives without those shitnozzles...

April 6, 2024

Attention In The Lounge: Friday Night Buzz threads will resume on Friday, April 26th.

I’m looking forward to it. I’m losing weight, and dying for a drink.

I hope you will re-join me when we start up again. I miss our social get-togethers in which we relax and look forward to the weekend, and share recommendations for our favorite libations.

See you soon…

I love you all…

March 29, 2024

My supervising physician just showed me the CV, with picture, of today's applicant for clinic manager.

My God, she's gorgeous!

I told her: "She's hired!"

BTW, yes, she is qualified. Years of experience in the field as an RN, and medical administrative experience on top of that. All that and she looks like Naomi Watts.

March 28, 2024

I'm working at our small town clinic today, way out on the Kitsap Peninsula. It's so nice and quiet here.

It's my second time working here. It's slow, pleasant, unhurried, and I can more or less spend as much time as I need to with a patient, without constantly worrying about having to move on to the next exam room and the next patient.

The manager at this clinic used to be a Medical Assistant with whom I worked nearly twenty years ago before I left for PA School. So it's been nice catching up.

I could get used to this.

Yeah, it's a long drive out from Puyallup, but it's worth it.

March 23, 2024

Did another fitting the other day. Tried on all my tailored clothing items. Not much more progress.

Still, I was easing into my old workout routine at the urging of Mrs. Aristus. Not too much too soon, she asked. She doesn't want me to have a heart attack.

But I'm done easing in now. Today, I increased both my cardio time, and the maximum weight lifted per workout. I ended my routine feeling pleasantly tired, but not exhausted. So I think I'm taking it at the right pace. I hope so. I plan on ending my dry spell sometime in the next month. (And man! Am I looking forward to hoisting a few with my beloved Loungers on Friday nights again!)

I think by stepping up my game, I'll see some faster progress in fitting back into my suits and sport coats.

I'm so grateful for your words of support and encouragement. You are all very dear friends.

March 16, 2024

Man, do I hate it when patients second-guess my diagnosis.

A guy came in yesterday with an open and shut case of bleeding hemorrhoids. Classic risk factors, classic presentation.

“Nah,” he said, “I don’t think it’s hemorrhoids.”

“Well”, I responded, “it could be a case of rectal polyps. I’ll need to do a digital rectal exam to know more.”

“Ugh! No! I don’t want that again!”

“You’re bleeding down there. I need to figure out why.”

“I had a colonoscopy five years ago, and they gave me a clean bill of health.”

“That was five years ago. A lot may have changed since then.”

“No. I don’t want the exam.”

I gave up. I ordered an occult blood test for him. I prescribed standard treatment for bleeding hemorrhoids. It’s up to him if he wants to adhere to the treatment plan.

If his occult blood test is positive, I’m going to refer him for a flexible sigmoidoscopy. But, man! Coming in for medical advice and then dismissing that advice out of hand seems like such a waste of one’s time. It was sure a waste of my time.