Gear Grinding 8: I Got A Lot Of Problems With You People!

[leswp1]

Re: Gear Grinding 8: I Got A Lot Of Problems With You People!

When you were practicing, didn't you spend most of your time charting?

Yep and if you did it wrong the insurance company didn't pay you. Nothing about what is good for the patient. All about whether the insurance co can mine the info it wants. Takes 4 times as long (or sometimes way longer) to do anything in an electronic record. Also a bagillion windows to open so no matter how efficient you are you need to spend most of your time with your eyes on the screen. THey used to tell us if we could touch type it would solve things. BS- when you have to open 26 windows or more to look at what you need for one patient how much is touch typing going to help? I can touch type- it meant Nada
THen they say do it all afterwards. What afterwards? I was up until 1AM every day I worked and still had my eyes on the screen way more than I wanted.

[melmac]

Re: Gear Grinding 8: I Got A Lot Of Problems With You People!

My doctor has a scribe follow her from room to room. That way, the doctor can do her thing, and the the scribe can take the notes. The doctor still has to do some computer stuff, but she can mostly spend the appointment chatting and finding out what’s up.

[leswp1]

Re: Gear Grinding 8: I Got A Lot Of Problems With You People!

My doctor has a scribe follow her from room to room. That way, the doctor can do her thing, and the the scribe can take the notes. The doctor still has to do some computer stuff, but she can mostly spend the appointment chatting and finding out what’s up.

How do you feel bearing your soul when the second person is in the room listening in? In theory it sounds good but it has the potential to mess with the dynamic in a relationship b/w the pt and provider. People won't open up- esp about things like abuse, substance use or stuff about sex or relationship issues.
Think about how fvcked up it is that we need to add another person into a thing that worked perfectly fine before the insurance co decided they wanted to track all the variables.

[MissThundercat]

How do you feel bearing your soul when the second person is in the room listening in? In theory it sounds good but it has the potential to mess with the dynamic in a relationship b/w the pt and provider. People won't open up- esp about things like abuse, substance use or stuff about sex or relationship issues.
Think about how fvcked up it is that we need to add another person into a thing that worked perfectly fine before the insurance co decided they wanted to track all the variables.

There was a student in the room at my last appointment. I became hesitant to share anything with him in the room.

[Deutsche Gopher Fan]

There was a student in the room at my last appointment. I became hesitant to share anything with him in the room.

I agree. I appreciate how med students need to learn, but I do not like being that open in front of a nurse or assistant whose only function appears to be admin desk job

[joecct]

Re: Gear Grinding 8: I Got A Lot Of Problems With You People!

How far does the doctor/patient relationship extend? Does it include the 3rd person??

[dxmnkd316]

Re: Gear Grinding 8: I Got A Lot Of Problems With You People!

That’s how it works nowadays it seems. My last urgent care visit had one. I didn’t care.

[bostonewe]

Re: Gear Grinding 8: I Got A Lot Of Problems With You People!

Bob -- this is the new reality. Every MD appt I've had for the last 3 years has been that way. It's annoying and inefficient, but the new reality. And I've been incorrectly billed for a bunch of them because of incorrectly input billing codes. I keep hoping that this will streamline care, but working on one side and being a patient on the other, I can tell you it hasn't improved anything. I have a maximum of 2 patients in my care when I'm working and it can take me an hour each to document. So that's up to 2 hours, every 4 hours, that are spent charting and away from the patient. Sometimes, I don't even sit to document until 4-5 hours into my shift if the assignment is busy and then I end up staying late, which can make for an interesting drive home.

My doctor has a scribe follow her from room to room. That way, the doctor can do her thing, and the the scribe can take the notes. The doctor still has to do some computer stuff, but she can mostly spend the appointment chatting and finding out what’s up.

Doesn't seem cost efficient for the provider, though it is nice to have the doctor freed up to actually do work.

How do you feel bearing your soul when the second person is in the room listening in? In theory it sounds good but it has the potential to mess with the dynamic in a relationship b/w the pt and provider. People won't open up- esp about things like abuse, substance use or stuff about sex or relationship issues.
Think about how fvcked up it is that we need to add another person into a thing that worked perfectly fine before the insurance co decided they wanted to track all the variables.

I think I lead a fairly vanilla life for the most part and I don't think there are things that I would discuss with another person in the room. There are things that I don't even like to discuss with my doctor.

How far does the doctor/patient relationship extend? Does it include the 3rd person??

Right. This would be my concern as well.

[melmac]

Re: Gear Grinding 8: I Got A Lot Of Problems With You People!

How do you feel bearing your soul when the second person is in the room listening in? In theory it sounds good but it has the potential to mess with the dynamic in a relationship b/w the pt and provider. People won't open up- esp about things like abuse, substance use or stuff about sex or relationship issues.
Think about how fvcked up it is that we need to add another person into a thing that worked perfectly fine before the insurance co decided they wanted to track all the variables.

I forgot she was there. However, I’m fairly boring. If something big were to come up, that might change things, but I wouldn’t know that until/unless it happens.

I’m also used to students. I go to the University hospital and associated clinics. It’s something I feel just comes along with it. That, and having everything out in the open having two c-sections kind of helps being open with the providers.

[aparch]

Re: Gear Grinding 8: I Got A Lot Of Problems With You People!

I got a gear grinding regarding standing for the national anthem before sporting events.

No, I don't care if you kneel, stand, whatever. I completely get what Kapernick and Co. were doing.

My gear grinding is with the morons who blindly stand and face the flag in an arena when the colors are being presented on field/on ice by a military/police/fire/Boy Scout/Girl Scout troop/whoever.

Turning your back and not facing the color guard is more disrespectful to me than this stupid controversy over kneeling or standing. At least Kapernick faced the colors!

[leswp1]

Re: Gear Grinding 8: I Got A Lot Of Problems With You People!

I got a gear grinding regarding standing for the national anthem before sporting events.

No, I don't care if you kneel, stand, whatever. I completely get what Kapernick and Co. were doing.

My gear grinding is with the morons who blindly stand and face the flag in an arena when the colors are being presented on field/on ice by a military/police/fire/Boy Scout/Girl Scout troop/whoever.

Turning your back and not facing the color guard is more disrespectful to me than this stupid controversy over kneeling or standing. At least Kapernick faced the colors!

This!
Also-I have always stood and put my hand on my heart. I still do but now I associate the Anthem with the current president and that makes me feel like the Anthem is a dirty thing associated with all sorts of nastiness. Like if I stand I am also providing tacit approval for his misguided interpretation of what the anthem, flag and constitution (you know, that thing we are supposed to ignore). Like a cancer.

[CLS]

Re: Gear Grinding 8: I Got A Lot Of Problems With You People!

How far does the doctor/patient relationship extend? Does it include the 3rd person??

Don't have an authoritative answer in any case, but do you mean the judicial doctrine of doctor-patient privelege, the medical ethics doctrine of doctor-patient confidentiality, or the legal definition under HIPAA?

As far as some "third parties" go, I've encountered some nurses, physician assistants, and nurse-practitioners that I felt more comfortable with than the doctor. And I've frequently found that interns are more willing to give more informative answers to questions than the doctor. The doctor might answer "That's nothing to worry about" while the intern might say "You shouldn't worry about that because _____."

On the other hand, my wife had what she was told was an excellent cardiologist. Problem was, my wife never go to see her! It was always a nurse-practitioner, even after a rather significant diagnostic procedure. When my wife asked if she could see Dr. _____, she was told "The appointment has to be within a week of the procedure. Dr. ____ is on vacation." The first statement may or may not have been true. The second statement was a flat-out lie.

[CLS]

Re: Gear Grinding 8: I Got A Lot Of Problems With You People!

I got a gear grinding regarding standing for the national anthem before sporting events.

No, I don't care if you kneel, stand, whatever. I completely get what Kapernick and Co. were doing.

My gear grinding is with the morons who blindly stand and face the flag in an arena when the colors are being presented on field/on ice by a military/police/fire/Boy Scout/Girl Scout troop/whoever.

Turning your back and not facing the color guard is more disrespectful to me than this stupid controversy over kneeling or standing. At least Kapernick faced the colors!

My beef is that silently kneeling is “disrespectful”, but

– shouting “RED” or “STARS” or whatever at that point in the anthem; or

– that drowning out the last line with cheering; or

– that shouting “GO ____!” before it’s over; or

– that some of the god-awful renditions

are all apparently OK.

[FlagDUDE08]

Re: Gear Grinding 8: I Got A Lot Of Problems With You People!

My beef is that silently kneeling is “disrespectful”, but

– shouting “RED” or “STARS” or whatever at that point in the anthem; or

– that drowning out the last line with cheering; or

– that shouting “GO ____!” before it’s over; or

– that some of the god-awful renditions

are all apparently OK.

Don't forget yelling "SUCKS" after said shouting.

Although one of the more creative "protests" to what you're mentioning is when they yell "OH".

[Kepler]

Re: Gear Grinding 8: I Got A Lot Of Problems With You People!

Why is the stupid thing played before sports at all?

Would somebody please show some real balls and stop playing it? Cold War's over; we don't have to demonstrate our loyalty publicly like well-trained seals.