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For the clinic docs on here, current and former, how many patients are you seeing in a day? How many Tcons? My clinic is arguing over what a reasonable schedule is.
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I think it's also important, when comparing military numbers to private practice, that my office hours are 8:00-ish to 11:30 and 13:00-14:30-ish. This is not by my choice. My staff starts checking patients in about 08:20 even if the patient shows up at 07:45. My last scheduled patient is 14:20, and I have to actually ask my front desk staff to be available after that time if someone comes up from the ER. They usually start shutting off the room lights around 13:30. From my experience, there is no 8 hour shift in any office in the Army. Do I end up seeing patients over lunch? All the time, but I'm usually on my own save for 1-2 good techs who would stick around n questions asked if I needed them. If I was seeing clinic 07:30-12:00 and 13:00-17:00 with a scribe and good MSAs who had any interest in taking a good history or doing a med recon, I could do twice as much work. Not to mention AHLTA, but we all feel the same way about that.
I realize that we're only expected to be 3/4ths of a provider in the military, but based upon the tools we have available to us, I think that's still a stretch.
There is no comparison, even if I am supposed to meet the 40%ile MGMA for productivity. I have one exam room (also my office) which I turn over myself, other than the kiosk checking the patients in and a medic getting vitals I do everything else from walking the patient back, giving them directions to the pharmacy, ordering all their labs and meds and arranging their follow-up. I receive all of their questions directly on Relay Health and take care of them myself. When I worked in civilian and private settings for the first time my mind was frickn blown when a nurse checked the patient in, got the medications, and past medical history, and was available to order tests etc after the appointment. Through my residency training and first duty assignment, I really had no idea what an RN actually did in a clinic setting (which is very sad). Every time someone tries to compare us to Cleveland Clinic or some other well funded and staffed system a little bit of me dies inside.
http://gomerblog.com/2016/05/new-monitor-anesthesiologists/Two, maybe three or four. Some days are really busy and I might see 8 or 10, all by myself.
Oh, you said clinic docs.
I'm not quite this badly off. Two exam rooms plus an office, and some clinical support from the nurses blocking the more protocol based Tcons. I do have one full time Corpsman assigned to me and they honestly can get a decent chunk of the hx entered in in addition to the vitals and turning over the room (unfortunately the hx is only useful after they've been with me for a month or two, which is the problem with them leaving every three months). Also it really not fair to compare the remote duty stations to the Cleveland clinic, it should be compared to the in area alternative. The in area alternative to my current MTF has infinitely more problems than we have.
That'd be a great point, except for the fact that socialized medicine is actually the norm in almost every other industrialized country and works just fine.This is a big reason why, IMO, socialized medicine can never work in this country. You can't change human nature. If you pay someone a set salary no matter the volume of patients they see, do you really think that physician is going to go the extra mile?
Yup, the upheaval in NHS is clear evidence of it working "just fine."That'd be a great point, except for the fact that socialized medicine is actually the norm in almost every other industrialized country and works just fine.
Really? The Pediatricians in my class were sent to 5 separate commands and this seems to be about the standard.That's the best supported clinic I've ever heard of for a primary care doc in DoD.
Really? The Pediatricians in my class were sent to 5 separate commands and this seems to be about the standard.
Very fair point, "fine" might be overstatement, but "better than here" wouldn't be. 1/4 of all bankruptcies due to medical bills? Nuts.
There's a reason no one else does it like us. And a reason no one does it as expensively.
Absolutely. We get trained on all the fancy toys and all the new techniques and testing and use all of it liberally because the system is financially invented for the overuse of services to a select group of the public. This makes us well trained. Maybe we are the model for training, but we sure aren't the model for healthcare, as is evidenced by almost no one doing it the way we do it, including countries poorer than us and countries richer than us. And we have more people going bankrupt due to healthcare and dying or having a shortened lifespan from lack of healthcare than almost any other industrialized country.This is different from the quality of service that is produced here compared to other countries - this is why we're the model for training. If you're boarded here, you'll be accepted into any other country in the world without question.