22 February 2011

Frustration

Not that I have a desire to be a primary care doctor. Not that I don't think they have a challenging job for which most folks are less than grateful.  BUT, if I have to trade 5 phone calls with your office for a simple medication refill for a scrip I've had for YEARS (which is somehow never simple from their end), you're doing something wrong. I would have given up at the first refill, despite the fact that every time I see my doctor, she touts the benefits and safety.  All because her office continually blocks my access.

Docs want to talk about how they don't have time to spend with patients any more but nobody wants to talk about why doctors are sometimes the ones providing barriers.  Our curriculum covers all sorts of stuff about patient interactions, billing, procedures, ethics, non-compliant patients, on and on, but nobody is discussing how something like this can be improved to benefit both parties.  I'm sure it costs money for the office to have a nurse sitting around doing nothing but making phone calls for this (yet I can never get through to a live person) and I know it causes the patient great aggravation to submit an electronic request for a prescription, wait 2 days, then start playing telephone tag with the office.  There has to be a way to streamline this for both parties so it doesn't take a week and 2 hours of time to authorize the use of a non-narcotic, non-addictive prescription medication.

15 February 2011

Grind

No matter how worn down you feel, that wheel just keeps grinding away.  Medical school just doesn't quit.  Instructors come and go and I'm still sitting in the same seat, feeling the same struggle to memorize, synthesize and apply.  At least we're on to GI so when I'm feeling down I can make diarrhea jokes...when you're sliding into first and your pants begin to burst, diarrhea, diarrhea. That song is now stuck in your head, you're welcome.

02 February 2011

Lottery

Since this fall, I've been a bit concerned about the lottery process for third year rotations.  There were four places I was willing to be happy about going out of ten possibilities.  The downside was that those four places had less than 25% of the student slots.  I had a strong first choice that would allow me to spend much more time home with K while the others would keep me living within 2 hours of him.  Every time I thought I had a strategy for lottery day, I would check the list again and find myself discouraged at the likely outcome of the strategy.  My future rested on a single ping pong ball.

I fully acknowledge the ridiculousness of that statement though.  It isn't my future, it isn't anything more than a place to spend a year learning to be a physician.  Yes, I was concerned about the quality of the education offered but that is extremely hard to determine from my seat in the classroom.  So much of a clinical experience depends on the specific physician, resident, nurses, etc. I will be working with and the attitude and skills I present to them.  Dr. Jones might be a terrible fit for me but a great match for the student in the next seat, but we have no way to figure that out and are left stressing over the details of location, housing options, call schedules and things we really shouldn't care this much about.

The lottery room opens and everyone heads over to their first choice site and ping pong balls go in the bucket. 1 seat is removed for the loser lotto, and my choice has 7 seats to fill with 10 balls in the bucket. I'm nervous and messaging madly with K who is peering in a window because he's not allowed inside yet. Ball after ball gets pulled and then we're done, 7 happy students. My ball is still in the bucket. Wait! My ball is still in the bucket.

There is a quick second round which is irrelevant because there are only two locations with seats open outside the lottery and those two are nobody's second choice. I joke around with the first year students running the lottery and accidentally find the girl who will be pulling the balls in the loser lotto, making sure to tell her that she's "looking" for #58. Now, K gets to come in to help me decide where to go when my ball finally gets pulled. I still have options, there are five seats left at the four places I was willing to go.  All the balls go into the bucket.

Before I even realize that we've started, they pull the first ball.  #58.  K looks at me and wonders why I'm not moving.  I'm waiting for them to realize there was a mistake, or it is a joke, or I'm not really sure what.  I get my first choice spot, crushing the hopes of the two other students who wanted it - including the friend I've sat next to in class for two years.  I leave feeling happy about my luck and upset for those still in the room, there isn't anyone in there I don't know well.  Even though the story ends happily for me, it still feels like a terrible night and a painful way to make a difficult distribution of students across clinical sites.