Actually at Work

Well, here's a post for those medical readers who have been wanting some info on actually working here.

Carolyn and I alternate our time between having scheduled appointments and being on the Duty Team. The scheduled appointments are what you might expect, people are given a 15 minute appointment slot to discuss their acute or chronic conditions. The duty rooster involves seeing acute patients but also patients who are not able to get to see a provider with appointments. At our clinic there are two MDs and usually 2 Nurses who are seeing duty patients.

We have found that our average daily visit numbers are very similar to what I have seen at Clinica and Carolyn at Indian Peaks. The differences reflect the support staff. Here, the front desk will check in the patient but I personally call the patient to my exam room, personally take whatever vital signs I deem important ( vital signs are vital, PSSHAW, not for knee pain!), personally review their medications, etc. So much of what we rely on in the States before we see the patient is up to us.

Overall though, the mix of patients has been great, the people have been friendly, We have seen traumatic amputations, sore throats, chronic mental illness,and gyn problems. The medicine is much the same as what we are used to in our Colorado practices, though I personally have yet to see the problems presented by the chronically homeless that we see at home. Also, though I keep ordering A1cs here expecting the typical diabetic or prediabetic result that I see at home, apparently the New Zealanders have not succeeded in matching our soda and sugar intake to make those tests so consistently abnormal.

We wanted to write this entry before our impressions were colored by our first weekend call experience. You might know, unlike the states, when we are on call here we get not only the on-call beeper but the on-call car, complete with a hard hat, flashing lights, emergency cape and all sorts of things to respond to emergencies. We cover the only ED within 100 KMs, cover the hospital ward, and cover the long term care wards. Transfers out of here have to go by helicopter. Obviously, this is not exactly how it works in Boulder Colorado when you can not have dinner at Mateos without bumping into three other MDs, every major intersection has a hospital with an MRI. So wish us well. I hope our post call post is as enthusiastic.