The world of medicine is like a bubble. A lot of people THINK they know what goes on there, but unless you're down in the trenches it's unlikely you do. So here is my semi-anonymous blog, here to tell you what really goes on in the life of a medical resident.

Tuesday, September 30, 2008

So What Else am I Doing?

Now that I finally have time to talk about things OTHER than my emergency medicine board exams...

I got a new job. I actually started it in late August. Since my hospitalist gig wasn't really working out (I didn't like the one hour drive, I didn't like the fact that half the time my orders didn't get carried out, I didn't really like the 'hospitalist' role in general) when they started pushing me to commit to a more consistent schedule I took the opportunity to bail out.

Then, something better fell into my lap. I was working with one of the emerg docs in August when she mentioned something about a 'shift at the clinic'. I asked her if she did walk-in clinic work in addition to the emerg, and she confessed that she did. I say confessed simply because around these parts (and in most parts, I guess) walk-in clinic doctors don't have the best reputation. At best, they're solely motivated by money and cranking through patients as quickly as possible. At worst they're seen as antibiotic dispensers, willing to give patients whatever the hell will get them out of the office in the least amount of time. But this was an emerg doc that I admired, and here she was admitted that she also worked at a walk-in. Huh. Interesting.

I told her that I had looked into working for one past-time at the beginning of my residency and didn't know how to get into it. She told me that the clinic she was working at was always looking for docs to provide more coverage. She paged the doc who ran the clinic... and boom. By the end of the week I worked my first shift as 'one of those walk-in clinic doctors".

And I liked it.

Why?

Well, I can't deny that the amount of money that I can make in one short 5 hour shift is awesome. My $200K line of credit for medical school liked that part. But there were two things that I liked even more...

The first was the fact that I didn't answer to anyone. I didn't have to justify my decisions to a preceptor, and no one had the option of seeing the 'real' doctor instead. I finally felt full accountability and full responsibility... and I loved it.

The second was the fact that I felt appreciated. I never thought that was all that important to me, but it made a big difference. I understand that emerg is a pretty thankless job. You're seeing people at their worst, they're sick, their family members are worried and stressed, they're often angry at being made to wait for hours on end... I get that. But there were a few times... after seeing a woman in early pregnancy after a stillbirth, counselling a guy with first-episode HSV infection, reassuring a new mom that she wasn't doing anything wrong... simple things, really. But the patients were just so thankful to me afterwards. Maybe they expected the typical 'McMedicine' that walk-in clinics are famous for and were surprised that I took the time to sit and listen. But I was actually surprised by how much a simple 'thank you' meant to me. It made me feel a little narcissistic, but it was a stark contrast to the emergency department.

So I have a new part-time job. Emerg resident by day, walk-in clinic doctor by night. And mom at all other moments of the day. No wonder I'm exhausted.

14 Comments:

Anonymous Anonymous said...

You know, I can see why doctors don't like those clinics, but they are a godsend to people like me, who work long hours without a lot of flexibility, have no major medical conditions, and just sometimes need to see a doctor- good luck getting an appt at a regular one when you are sick! But last week, after a week of coughing and sore throat and fever, I went to an urgent-care place after work, got a strep test and some antibiotics, and bam! Problem solved. If that clinic hadnt been around, I would have been able to see a dr at a regular clinic... today, a week later, and I would have lost money I need by having to leave work to do it. It might not be life and death, but it sure does help make life better.

10:34 AM

 
Blogger Julien's mommy said...

I'm really glad your enjoying the clinic....I have had many visits with doctors that don't seem to care....but, I also found my family doc at one....and she is amazing!

1:46 PM

 
Blogger med neophyte said...

Congratulations. Sounds like a good, if exhausting, fit.

I think most people have a walk-in doctor horror story but encountering a good doctor that will listen to you when you don't have any other options is a huge relief.

8:35 PM

 
Anonymous Anonymous said...

I "secretly" liked working those clinics too, pretty much for the same reasons you decribed. I also dreaded having to send something to the ER for fear of being chastised.

10:22 PM

 
Blogger Cate said...

I will often choose to go to our walk-in clinic in preference to my primary care doctor (who is really a nurse practitioner).

They are nice to me at the clinic, and really seem to care. The service is prompt, and I don't have to wait forever. They don't ask me extraneous questions, and I feel like I get my money's worth in a way I don't at the "real" doctor's office. A real difference for me is in the attitude of the front office staff, who are SO much happier at the "doc in the box."

It's just a happier place all-around. I'd want to work there too.

11:06 PM

 
Blogger Lisa b said...

My new GP from our women's hospital works two days a week at a walk in clinic near my home. I think it would be my first choice for most non-routine care. I hardly waited, the office was nice and it is closer to my house.

10:08 PM

 
Blogger Old MD Girl said...

Um, WHAT other hours of the day?

I'm glad you've been enjoying your new job. It IS nice to feel appreciated from time to time.

8:16 AM

 
Anonymous Anonymous said...

are the results out?!

12:55 PM

 
Blogger Dragonfly said...

Those clinics certainly have their place. Hope your energy levels remain as high as possible.

11:11 PM

 
Blogger stacychen said...

This comment has been removed by a blog administrator.

9:34 PM

 
Anonymous Anonymous said...

Just to let you know, I came across your blog and would like to say that I would love to have had you as a doc at a walk in clinic--what you said about having to counsel the guy with his first hsv breakout was awesome...I was in a walk in clinic when I first found out that I had hsv too, and the doc sounded almost embarassed to say it, and offered absolutely no words except, "Well it came back positive for type II so here's a slip to follow up with your regular doctor or a website that will help you find a pcp and the nurse will show you to counter to check out". and I don't know what the hell he could have said to "counsel" me but anything would have been better than nothing! Anyway, its good to see that you truly care about people.

10:43 PM

 
Blogger Jackie Champion said...

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Well, I'd like to add that I have read in one article that emergency medicine encompasses a large amount of general medicine and surgery including the surgical sub-specialties. Emergency physicians are tasked with seeing a large number of patients, treating their illnesses and arranging for disposition—either admitting them to the hospital or releasing them after treatment as necessary. The emergency physician requires a broad field of knowledge and advanced procedural skills often including surgical procedures, trauma resuscitation, advanced cardiac life support and advanced airway management. Emergency physicians must have the skills of many specialists—the ability to resuscitate a patient (critical care medicine), manage a difficult airway (anesthesia), suture a complex laceration (plastic surgery), reduce (set) a fractured bone or dislocated joint (orthopedic surgery), treat a heart attack (cardiology), work-up a pregnant patient with vaginal bleeding (Obstetrics and Gynecology), stop a bad nosebleed (ENT), place a chest tube (cardiothoracic surgery), and to conduct and interpret x-rays and ultrasounds (radiology).
Emergency medical pros with a combined 40+ years of experience all in one pace.

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10:42 AM

 
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6:00 AM

 
Anonymous Ramiro said...

This is a attention-grabbing article by the way. I am going to go ahead and bookmark this post for my brother to read later on tomorrow. Keep up the good work

Greetings from Gasteiz / Vitoria

2:45 PM

 

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