Worrying about my clinic pts during my off time

[CaliforniaAppli]

First year fellow, starting to struggle with my continuity pts and worrying about them after I see then in clinic or after starting chemo. I worry I forget to follow up on abnormal labs and imaging and that ultimately something bad will happen to them and it would be my fault. I never had this problem with my continuity clinic for IM.... is it just me? Starting to burn me out... How do oncologists deal with this ?

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[whoknows2012]

First year fellow, starting to struggle with my continuity pts and worrying about them after I see then in clinic or after starting chemo. I worry I forget to follow up on abnormal labs and imaging and that ultimately something bad will happen to them and it would be my fault. I never had this problem with my continuity clinic for IM.... is it just me? Starting to burn me out... How do oncologists deal with this ?

happened to me all the time especially in the beginning. The responsibility is a lot to handle at first but you do get used to it and some of those anxieties did wane

 

[gutonc]

Not sure if this will make you feel any better, but I worry WAY more about my clinic (AKA...all) patients now when I'm not in the office than I ever did as a fellow. It's part of the business. The good news is that I have a lot of support (MA, Triage RN, RN Coordinator, Clinic Pharmacist, Research coordinator) to help me manage it all now.

A more positive way of thinking about things is that, for the vast majority of your patients, they are going to do well or poorly almost no matter what you do, or don't do. And most of the truly important abnormal lab/imaging findings you're going to come across are going to be clinically evident as well, so the patient is unlikely to let you ignore it.

The soul killing stuff is the Stage I ER+ breast cancer patient who demands labs every 3 months (despite just being on an AI) and then pummels you with questions about why her MCHC, % Eosinophils, MPV and Cl levels are 1 point out of range and what you're planning to do about her critically low BUN.

 

[gutonc]

Also, if your continuity clinic is at the VA, take heart. You can’t kill those guys.

 

[QuizzicalApe]

pummels you with questions about why her MCHC, % Eosinophils, MPV and Cl levels are 1 point out of range and what you're planning to do about her critically low BUN.

prescribe 3 hotdog buns BID x 14 days for repletion