The Imposter Syndrome

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  • CM
    Member
    • Jan 2017
    • 2094

    #31







    There isn’t enough time in our appointment slots for me to study old records thoroughly, spend time with the patient, and document thoroughly–so I spend an average of two hours and 20 minutes either before or after each clinic day studying charts and taking notes for every patient I will see the next day. (I’m doing this today, on my “day off,” and every Sunday.) This is a tremendous additional workload that I voluntarily take on just so I can both stay on schedule and provide care that I believe is thorough.
    Click to expand…


    How long have you been doing this?  Why not cut down the number of patients per day?  That doesn’t sound sustainable!
    Click to expand...


    Three and one-half years. I'm an employee and my schedule is set by my employer. My schedule doesn't feel sustainable, but that is primarily due to call. I could handle the clinic over the long-term.

    To be fair, I'm the only one in my group who studies charts this way in advance. Most of them spend 30 seconds outside the room glancing at a recent note and then proceed. Their dictated notes are also less comprehensive. When I have to cross-cover I find it difficult to figure out what is going on with their patients. On the other hand, I've had several physicians tell me that they search for an old note from me when they see a new patient.

    We have a hospitalist like that; when I see a new patient I look for a note from him.

    In my experience, important things are often missed with a more expeditious approach. Guideline-directed therapies are omitted. A statin is prescribed but the patient is already taking one, so the patient then takes both. The med list on the chart turns out to have no resemblance to the meds the patient is actually taking.

    In one case, my review of records turned up a scan that showed a thyroid mass months earlier. No one followed up. That's not my area, but I sent the patient to ENT who found thyroid cancer. She is alive today possibly because I spend time studying charts before clinic. I wouldn't have found that with a brief review of a recent note outside the exam door.

    BTW, I am far from perfect and not nearly as good as the director of my fellowship program (and never will be). I hate spending extra hours studying charts, and I know good physicians who seem to catch everything while being less compulsive. I'm just not one of them.
    Erstwhile Dance Theatre of Dayton performer cum bellhop. Carried (many) bags for a lovely and gracious 59 yo Cyd Charisse. (RIP) Hosted epic company parties after Friday night rehearsals.

    Comment

    • MaxPower
      Bone Doc
      • Feb 2016
      • 1146

      #32



















      From the stories I hear from my wife about the OR, there are some physicians (surgeons at least) that absolutely have a “god” syndrome. The stories typically include either an older male surgeon or a new male surgeon. Only once has it been an older female surgeon. But I believe these are outliers. Most docs I talk to are intelligent and friendly.


      bad survey or yelp reviews for refusing narcotics or long wait times (which are almost always due to factors outside of my control). 
      Click to expand…


      I used to work in process improvement for a medium sized regional hospital, and the metrics some of my colleagues used to gauge performance of physicians were patient satisfaction scores. While some really good info can be taken from these, there were always a ton of bad scores due to ridiculous expectations or just plain ignorance.


      And the really important question: is it “Imposter” or “Impostor”? 
      Click to expand…


      I’ll go with Impostor as it’s been around longer than the also correct Imposter.
      Click to expand…


      I hate satisfaction scores. You’re mad you had to wait? Okay, then next time I work in a patient with a newly diagnosed miscarriage, I’ll give her the bad news then say “Gotta run! I have a patient who needs a pap and it’s 15 minutes past her appointment time!”  But you can’t explain that to the patient who was waiting b/c it’s a HIPAA violation. Yes, you should be polite, give an apology and have the staff update the patient as to how much longer it will be but some people just don’t get it. Multiple other issues besides wait time (narcotics, advice to lose weight, warnings that sound rather dire when you refuse something to CYA, etc etc)
      Click to expand…


      For what it’s worth, having to wait is a legitimate complaint.  Other professionals aren’t allowed to essentially always run late like most docs seem to do.  Appropriate times are set for client encounters and if there’s uncertainty as to how long a meeting will run, extra time is allocated.  “Working in” another client is something done in between other commitments, at lunch, or after the last appointment of the day even if it runs after business hours.  And yes, if a meeting is running over and there is another commitment, you have to end the meeting.

      OB is a relatively unique field where you’re literally having to deliver children and perform other emergency procedures that do not follow a set schedule, and the patient wants you to be there for those procedures, so there should be a little more understanding.  But there’s no legitimate reason for patients to have to wait an hour past appointment time, every time, to see their dermatologist or ENT.  It’s completely unprofessional and insulting to the client.

      I understand it’s the nature of the practice, with reduced reimbursement etc. docs and hospitals try to cram as many patients as possible into a day.  Also dealing with the general public you get no-shows, but that’s a cost of doing business.  If doctors charged by the hour instead of by the encounter, like virtually every other professional does, this problem would be largely solved.

      This isn’t directed at you, but just a trigger for me.   ????   ????

       
      Click to expand…


      There are many reasons that doc appointments run late, and the doc is usually low on the list of potential causes. Earlier patients running late, procedures taking longer than expected, patients taking more than their allotted time, approval snafus, staff delayed by wait times, being on hold for insurance company or RBM/PBM, patients with “emergencies” that need to be seen or need procedures, staff calling in sick, etc. The idea that the doc is greedy and overbooking or maybe having a leisurely lunch at a Michelin star restaurant is laughable.

      This system is not set up to allow for extra time to accommodate add-ons, appointment overruns, and other delays. If you think that the doc can simply charge more for more time spent you have no clue how appointments and procedures are reimbursed.

      In my experience, no one wants to be more on-time than the doc. He/she is motivated to get to get home on time and is as disappointed as anyone when things run late. He/she also has to deal with and apologize for delays and gets to see the cranky patients who are annoyed by delays, most of which are beyond the doc’s control.

      Maybe in some medical utopia where docs are just paid to show up and can create a schedule that can accommodate the regular variances that occur in both the human condition and in the medical-industrial complex, wait times can be eliminated. The fact is that the generalists and specialists that have the longest office wait times (or surgical/procedural delays) are often in the greatest demand, are often overwhelmed, and some would even be happy if you went somewhere else (if there was even somewhere else to go).

      Sorry, this diverges from the point of the thread, but the post struck a chord. Yes, Imposter Syndrome is indeed prevalent among docs, but the patient or public is not likely to perceive it, IMO.
      Click to expand…


      There are some docs that run late all the time, every time.  Or at least every time I have the pleasure of going.

      I have literally been the first appointment of the day and had to wait 30m.  Early morning appointment in the day and waited over an hour.

      I have literally sat in a waiting room with my wife and listened through the paper thin walls to her doc shooting the ************************ with the other patients about their vacation for 20 minutes while we had waited for an hour.

      Obviously medicaid and the insurance companies don’t reimburse that way or pay for missed appointments, but in every other line of work, you’re charged by the time it takes to complete a job.  The patient who comes in with a quick issue shouldn’t be charged the same as the old lady who comes in with a laundry list.  The way the money is made in medicine creates a perverse incentive to pack as many patients into a day as possible.  Some/most of the fault is the hospitals setting the schedules.  But, yes, some is the greedy doc running his or her own practice trying to make as much money as possible (or perhaps just make payroll).  No, not every doc is in a hurry to get back to the wife and kids.  ???? I’m sure we all know docs like that since it’s quite common.

      I totally understand that the nature of many specialties includes emergencies.  Like Liz said, a patient with bleeding or an emergency section is going to push back other appointments, that’s the name of the game.  But again there’s no legitimate reason that the ENT or the dermatologist or just about any other physician on clinic day runs late all the time, every time.  The actual reason is that the doctors and/or their employers want to maximize their time and production, at the expense of respecting the patient’s time, or they are very poor at managing time in general, again at the expense of meeting all subsequent appointments, or some combination of both.

       
      Click to expand…


      I hate to run late, hate to keep anyone waiting, and hate to wait for anything myself. Makes me crazy.

      There isn’t enough time in our appointment slots for me to study old records thoroughly, spend time with the patient, and document thoroughly–so I spend an average of two hours and 20 minutes either before or after each clinic day studying charts and taking notes for every patient I will see the next day. (I’m doing this today, on my “day off,” and every Sunday.) This is a tremendous additional workload that I voluntarily take on just so I can both stay on schedule and provide care that I believe is thorough.

      My clinic would run on schedule more than 99% of the time if my patients arrived on time, but about 25% of them are late for their scheduled appointment times, i.e., the time they are supposed to see me. We ask them to arrive 20 minutes prior to appointment time because it takes that long for the front office and nurse to do what they have to do before I can even see the patient. More than 80% of our patients arrive later than that requested arrival time. Therefore, their allotted appointment time is generally over before I can even see them.

      In my case, many patients don’t respect my time, or the time of their fellow patients. When a couple of them arrive late, everyone behind them runs late.
      Click to expand...


      So why do you still see them if they run late?  If patients are 15 minutes late to their scheduled appointment times, I cancel them and make them reschedule, and even then I feel this is pretty lenient.  Especially for new patients who are supposed to show up 20 minutes before their scheduled appointment time to fill out paperwork and get entered into the system, etc.  If they're showing up 15 minutes late to their scheduled appointment they are really 35 minutes late.  No excuse for that in my book.

      I also run fairly close to on time, most of the time.  We all have our patient encounters where things go over, or patients are crazy, or whatever, but that's pretty rare.  If I run close to on time I expect my patients to be on time.  Allowing them to be late perpetuates the cycle and they'll never show up on time if you allow it.  I've found when I force people who are late to reschedule, more often than not, when they come back they're plenty early, and the ones who aren't or won't come back are probably people I wouldn't enjoy treating anyway.

      Comment

      • CM
        Member
        • Jan 2017
        • 2094

        #33






















        From the stories I hear from my wife about the OR, there are some physicians (surgeons at least) that absolutely have a “god” syndrome. The stories typically include either an older male surgeon or a new male surgeon. Only once has it been an older female surgeon. But I believe these are outliers. Most docs I talk to are intelligent and friendly.




        bad survey or yelp reviews for refusing narcotics or long wait times (which are almost always due to factors outside of my control).
        Click to expand…


        I used to work in process improvement for a medium sized regional hospital, and the metrics some of my colleagues used to gauge performance of physicians were patient satisfaction scores. While some really good info can be taken from these, there were always a ton of bad scores due to ridiculous expectations or just plain ignorance.




        And the really important question: is it “Imposter” or “Impostor”?
        Click to expand…


        I’ll go with Impostor as it’s been around longer than the also correct Imposter.
        Click to expand…


        I hate satisfaction scores. You’re mad you had to wait? Okay, then next time I work in a patient with a newly diagnosed miscarriage, I’ll give her the bad news then say “Gotta run! I have a patient who needs a pap and it’s 15 minutes past her appointment time!”  But you can’t explain that to the patient who was waiting b/c it’s a HIPAA violation. Yes, you should be polite, give an apology and have the staff update the patient as to how much longer it will be but some people just don’t get it. Multiple other issues besides wait time (narcotics, advice to lose weight, warnings that sound rather dire when you refuse something to CYA, etc etc)
        Click to expand…


        For what it’s worth, having to wait is a legitimate complaint.  Other professionals aren’t allowed to essentially always run late like most docs seem to do.  Appropriate times are set for client encounters and if there’s uncertainty as to how long a meeting will run, extra time is allocated.  “Working in” another client is something done in between other commitments, at lunch, or after the last appointment of the day even if it runs after business hours.  And yes, if a meeting is running over and there is another commitment, you have to end the meeting.

        OB is a relatively unique field where you’re literally having to deliver children and perform other emergency procedures that do not follow a set schedule, and the patient wants you to be there for those procedures, so there should be a little more understanding.  But there’s no legitimate reason for patients to have to wait an hour past appointment time, every time, to see their dermatologist or ENT.  It’s completely unprofessional and insulting to the client.

        I understand it’s the nature of the practice, with reduced reimbursement etc. docs and hospitals try to cram as many patients as possible into a day.  Also dealing with the general public you get no-shows, but that’s a cost of doing business.  If doctors charged by the hour instead of by the encounter, like virtually every other professional does, this problem would be largely solved.

        This isn’t directed at you, but just a trigger for me.   ????   ????

         
        Click to expand…


        There are many reasons that doc appointments run late, and the doc is usually low on the list of potential causes. Earlier patients running late, procedures taking longer than expected, patients taking more than their allotted time, approval snafus, staff delayed by wait times, being on hold for insurance company or RBM/PBM, patients with “emergencies” that need to be seen or need procedures, staff calling in sick, etc. The idea that the doc is greedy and overbooking or maybe having a leisurely lunch at a Michelin star restaurant is laughable.

        This system is not set up to allow for extra time to accommodate add-ons, appointment overruns, and other delays. If you think that the doc can simply charge more for more time spent you have no clue how appointments and procedures are reimbursed.

        In my experience, no one wants to be more on-time than the doc. He/she is motivated to get to get home on time and is as disappointed as anyone when things run late. He/she also has to deal with and apologize for delays and gets to see the cranky patients who are annoyed by delays, most of which are beyond the doc’s control.

        Maybe in some medical utopia where docs are just paid to show up and can create a schedule that can accommodate the regular variances that occur in both the human condition and in the medical-industrial complex, wait times can be eliminated. The fact is that the generalists and specialists that have the longest office wait times (or surgical/procedural delays) are often in the greatest demand, are often overwhelmed, and some would even be happy if you went somewhere else (if there was even somewhere else to go).

        Sorry, this diverges from the point of the thread, but the post struck a chord. Yes, Imposter Syndrome is indeed prevalent among docs, but the patient or public is not likely to perceive it, IMO.
        Click to expand…


        There are some docs that run late all the time, every time.  Or at least every time I have the pleasure of going.

        I have literally been the first appointment of the day and had to wait 30m.  Early morning appointment in the day and waited over an hour.

        I have literally sat in a waiting room with my wife and listened through the paper thin walls to her doc shooting the ************************ with the other patients about their vacation for 20 minutes while we had waited for an hour.

        Obviously medicaid and the insurance companies don’t reimburse that way or pay for missed appointments, but in every other line of work, you’re charged by the time it takes to complete a job.  The patient who comes in with a quick issue shouldn’t be charged the same as the old lady who comes in with a laundry list.  The way the money is made in medicine creates a perverse incentive to pack as many patients into a day as possible.  Some/most of the fault is the hospitals setting the schedules.  But, yes, some is the greedy doc running his or her own practice trying to make as much money as possible (or perhaps just make payroll).  No, not every doc is in a hurry to get back to the wife and kids.  ???? I’m sure we all know docs like that since it’s quite common.

        I totally understand that the nature of many specialties includes emergencies.  Like Liz said, a patient with bleeding or an emergency section is going to push back other appointments, that’s the name of the game.  But again there’s no legitimate reason that the ENT or the dermatologist or just about any other physician on clinic day runs late all the time, every time.  The actual reason is that the doctors and/or their employers want to maximize their time and production, at the expense of respecting the patient’s time, or they are very poor at managing time in general, again at the expense of meeting all subsequent appointments, or some combination of both.

         
        Click to expand…


        I hate to run late, hate to keep anyone waiting, and hate to wait for anything myself. Makes me crazy.

        There isn’t enough time in our appointment slots for me to study old records thoroughly, spend time with the patient, and document thoroughly–so I spend an average of two hours and 20 minutes either before or after each clinic day studying charts and taking notes for every patient I will see the next day. (I’m doing this today, on my “day off,” and every Sunday.) This is a tremendous additional workload that I voluntarily take on just so I can both stay on schedule and provide care that I believe is thorough.

        My clinic would run on schedule more than 99% of the time if my patients arrived on time, but about 25% of them are late for their scheduled appointment times, i.e., the time they are supposed to see me. We ask them to arrive 20 minutes prior to appointment time because it takes that long for the front office and nurse to do what they have to do before I can even see the patient. More than 80% of our patients arrive later than that requested arrival time. Therefore, their allotted appointment time is generally over before I can even see them.

        In my case, many patients don’t respect my time, or the time of their fellow patients. When a couple of them arrive late, everyone behind them runs late.
        Click to expand…


        So why do you still see them if they run late?  If patients are 15 minutes late to their scheduled appointment times, I cancel them and make them reschedule, and even then I feel this is pretty lenient.  Especially for new patients who are supposed to show up 20 minutes before their scheduled appointment time to fill out paperwork and get entered into the system, etc.  If they’re showing up 15 minutes late to their scheduled appointment they are really 35 minutes late.  No excuse for that in my book.

        I also run fairly close to on time, most of the time.  We all have our patient encounters where things go over, or patients are crazy, or whatever, but that’s pretty rare.  If I run close to on time I expect my patients to be on time.  Allowing them to be late perpetuates the cycle and they’ll never show up on time if you allow it.  I’ve found when I force people who are late to reschedule, more often than not, when they come back they’re plenty early, and the ones who aren’t or won’t come back are probably people I wouldn’t enjoy treating anyway.
        Click to expand...


        .
        Erstwhile Dance Theatre of Dayton performer cum bellhop. Carried (many) bags for a lovely and gracious 59 yo Cyd Charisse. (RIP) Hosted epic company parties after Friday night rehearsals.

        Comment

        • MaxPower
          Bone Doc
          • Feb 2016
          • 1146

          #34

























          From the stories I hear from my wife about the OR, there are some physicians (surgeons at least) that absolutely have a “god” syndrome. The stories typically include either an older male surgeon or a new male surgeon. Only once has it been an older female surgeon. But I believe these are outliers. Most docs I talk to are intelligent and friendly.




          bad survey or yelp reviews for refusing narcotics or long wait times (which are almost always due to factors outside of my control).
          Click to expand…


          I used to work in process improvement for a medium sized regional hospital, and the metrics some of my colleagues used to gauge performance of physicians were patient satisfaction scores. While some really good info can be taken from these, there were always a ton of bad scores due to ridiculous expectations or just plain ignorance.




          And the really important question: is it “Imposter” or “Impostor”?
          Click to expand…


          I’ll go with Impostor as it’s been around longer than the also correct Imposter.
          Click to expand…


          I hate satisfaction scores. You’re mad you had to wait? Okay, then next time I work in a patient with a newly diagnosed miscarriage, I’ll give her the bad news then say “Gotta run! I have a patient who needs a pap and it’s 15 minutes past her appointment time!”  But you can’t explain that to the patient who was waiting b/c it’s a HIPAA violation. Yes, you should be polite, give an apology and have the staff update the patient as to how much longer it will be but some people just don’t get it. Multiple other issues besides wait time (narcotics, advice to lose weight, warnings that sound rather dire when you refuse something to CYA, etc etc)
          Click to expand…


          For what it’s worth, having to wait is a legitimate complaint.  Other professionals aren’t allowed to essentially always run late like most docs seem to do.  Appropriate times are set for client encounters and if there’s uncertainty as to how long a meeting will run, extra time is allocated.  “Working in” another client is something done in between other commitments, at lunch, or after the last appointment of the day even if it runs after business hours.  And yes, if a meeting is running over and there is another commitment, you have to end the meeting.

          OB is a relatively unique field where you’re literally having to deliver children and perform other emergency procedures that do not follow a set schedule, and the patient wants you to be there for those procedures, so there should be a little more understanding.  But there’s no legitimate reason for patients to have to wait an hour past appointment time, every time, to see their dermatologist or ENT.  It’s completely unprofessional and insulting to the client.

          I understand it’s the nature of the practice, with reduced reimbursement etc. docs and hospitals try to cram as many patients as possible into a day.  Also dealing with the general public you get no-shows, but that’s a cost of doing business.  If doctors charged by the hour instead of by the encounter, like virtually every other professional does, this problem would be largely solved.

          This isn’t directed at you, but just a trigger for me.   ????   ????

           
          Click to expand…


          There are many reasons that doc appointments run late, and the doc is usually low on the list of potential causes. Earlier patients running late, procedures taking longer than expected, patients taking more than their allotted time, approval snafus, staff delayed by wait times, being on hold for insurance company or RBM/PBM, patients with “emergencies” that need to be seen or need procedures, staff calling in sick, etc. The idea that the doc is greedy and overbooking or maybe having a leisurely lunch at a Michelin star restaurant is laughable.

          This system is not set up to allow for extra time to accommodate add-ons, appointment overruns, and other delays. If you think that the doc can simply charge more for more time spent you have no clue how appointments and procedures are reimbursed.

          In my experience, no one wants to be more on-time than the doc. He/she is motivated to get to get home on time and is as disappointed as anyone when things run late. He/she also has to deal with and apologize for delays and gets to see the cranky patients who are annoyed by delays, most of which are beyond the doc’s control.

          Maybe in some medical utopia where docs are just paid to show up and can create a schedule that can accommodate the regular variances that occur in both the human condition and in the medical-industrial complex, wait times can be eliminated. The fact is that the generalists and specialists that have the longest office wait times (or surgical/procedural delays) are often in the greatest demand, are often overwhelmed, and some would even be happy if you went somewhere else (if there was even somewhere else to go).

          Sorry, this diverges from the point of the thread, but the post struck a chord. Yes, Imposter Syndrome is indeed prevalent among docs, but the patient or public is not likely to perceive it, IMO.
          Click to expand…


          There are some docs that run late all the time, every time.  Or at least every time I have the pleasure of going.

          I have literally been the first appointment of the day and had to wait 30m.  Early morning appointment in the day and waited over an hour.

          I have literally sat in a waiting room with my wife and listened through the paper thin walls to her doc shooting the ************************ with the other patients about their vacation for 20 minutes while we had waited for an hour.

          Obviously medicaid and the insurance companies don’t reimburse that way or pay for missed appointments, but in every other line of work, you’re charged by the time it takes to complete a job.  The patient who comes in with a quick issue shouldn’t be charged the same as the old lady who comes in with a laundry list.  The way the money is made in medicine creates a perverse incentive to pack as many patients into a day as possible.  Some/most of the fault is the hospitals setting the schedules.  But, yes, some is the greedy doc running his or her own practice trying to make as much money as possible (or perhaps just make payroll).  No, not every doc is in a hurry to get back to the wife and kids.  ???? I’m sure we all know docs like that since it’s quite common.

          I totally understand that the nature of many specialties includes emergencies.  Like Liz said, a patient with bleeding or an emergency section is going to push back other appointments, that’s the name of the game.  But again there’s no legitimate reason that the ENT or the dermatologist or just about any other physician on clinic day runs late all the time, every time.  The actual reason is that the doctors and/or their employers want to maximize their time and production, at the expense of respecting the patient’s time, or they are very poor at managing time in general, again at the expense of meeting all subsequent appointments, or some combination of both.

           
          Click to expand…


          I hate to run late, hate to keep anyone waiting, and hate to wait for anything myself. Makes me crazy.

          There isn’t enough time in our appointment slots for me to study old records thoroughly, spend time with the patient, and document thoroughly–so I spend an average of two hours and 20 minutes either before or after each clinic day studying charts and taking notes for every patient I will see the next day. (I’m doing this today, on my “day off,” and every Sunday.) This is a tremendous additional workload that I voluntarily take on just so I can both stay on schedule and provide care that I believe is thorough.

          My clinic would run on schedule more than 99% of the time if my patients arrived on time, but about 25% of them are late for their scheduled appointment times, i.e., the time they are supposed to see me. We ask them to arrive 20 minutes prior to appointment time because it takes that long for the front office and nurse to do what they have to do before I can even see the patient. More than 80% of our patients arrive later than that requested arrival time. Therefore, their allotted appointment time is generally over before I can even see them.

          In my case, many patients don’t respect my time, or the time of their fellow patients. When a couple of them arrive late, everyone behind them runs late.
          Click to expand…


          So why do you still see them if they run late?  If patients are 15 minutes late to their scheduled appointment times, I cancel them and make them reschedule, and even then I feel this is pretty lenient.  Especially for new patients who are supposed to show up 20 minutes before their scheduled appointment time to fill out paperwork and get entered into the system, etc.  If they’re showing up 15 minutes late to their scheduled appointment they are really 35 minutes late.  No excuse for that in my book.

          I also run fairly close to on time, most of the time.  We all have our patient encounters where things go over, or patients are crazy, or whatever, but that’s pretty rare.  If I run close to on time I expect my patients to be on time.  Allowing them to be late perpetuates the cycle and they’ll never show up on time if you allow it.  I’ve found when I force people who are late to reschedule, more often than not, when they come back they’re plenty early, and the ones who aren’t or won’t come back are probably people I wouldn’t enjoy treating anyway.
          Click to expand…


          This would be ideal, and the office staff have rescheduled an occasional pt who shows up late (e.g., 40-90 minutes late), but not if they’re just 15-20 minutes late. I have some influence with the office manager, but I’m an employee and the hospital does not allow this as a matter of routine (so I’ve been told).

          I don’t push for this even though the late patients cause much aggravation. A recent late patient turned out to be in rapid atrial flutter. He was asymptomatic with that, and if we turned him away he might have turned up later with a tachycardia-induced cardiomyopathy. There was another recent late patient who also turned out to be sick, and I would have felt badly if we rescheduled the patient without an evaluation that day. The consequences would have been out of proportion to the crime (rude behavior).
          Click to expand...


          So sounds like you're running an urgent care (walk-in clinic of variable acuity) on top of your already scheduled clinic.  Good for you, but I wouldn't stand for that.  You can always say that you're helping people by seeing the ones who are truly sick but "40-90 minutes late", and that's true, so why not stay open all night?  That's what the ER is for.

          To me, your schedule sounds untenable.  I would be burned out and unable/unwilling to practice medicine anymore if I had to review charts for 2.5 hours for every clinic and still be expected to see a full clinic.

          Comment

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