September 20, 2022

by Dr. Plastic Picker

I must be doing something right. I worked on Saturday afternoon from 130-5pm and was still able to joyfully make dinner with Mr. Plastic Picker’s fancy radiology friend and pharmacist wife at 630pm. I wore a pretty dress and heels, and we talked about our mutual children and life. I had fun listening to them chat, and they listened to me – avidly at times as I recounted some of my adventures. Then last night I worked the staggered late shift, part of a shift I helped pilot and design. The system is not perfect but it’s certainly better for the five years I devoted to trying to make it more livable. I worked last night and it was certainly busy. I even had a resident that I mentored. All the patients were seen on time. A late newborn that had checked in over 4 hours late, I saw as well. I just asked our nursing staff to remind the parents I needed to see everyone in order. That baby ended up needing me anyway, for some simple lab follow up and saved them from having a drive back and the earth some carbon. Oh and the Saturday afternoon shift? I had one of the sickest patients I’ve had in a long time check in at 4pm. The nursing staff and I were able to turn around that patient within 45 minutes, and get them into the ambulance and off to the hospital already stabilized. I had dinner plans and our clinic technically closes at 5pm. I’ve been a doctor for a long time now and I know what to do quickly. At 530pm as the child and mother were safely in the care of the EMTs, I had my backpack with both straps on and walking out the door with most of my charts done.

I know I must be doing something right because last night I was working, I happened to glance an appointment access. There are absolutely no appointments and it’s absolutely horrible right now. I was initially irritated and began to get angry. I had been tasked with this integral part of management for four years. Like any responsibility given to me, I had done it with care. I had made sure there were at least 100-150 appointments available every day. I had recruited per diem pediatricians and kept an eagle on their credentialing to make sure they got through. I learned the intricacies of our system from nursing staffing, to our schedulers optimal work schedules when they were easiest to reach, and created a well-oiled machine on appointment access. It all came tumbling down when I made the decision not to let others take credit for my work, and not involve me in giving out positions and credit to those pediatricians who had taken these part-time positions for our department. When I own it, I own it completely. I literally said at a meeting, you want to take it – then you take it all. And then four years of proper access that lasted through some of the most horrible flu seasons I’ve been through and holiday schedules where we had one new doctor quit unexpectedly, yet everything still opened up with enough appointments – it all came tumbling down.

So last night I was just trying to find appointments for follow ups for my own patients I was seeing, and I happened to be looking at the different clinic schedules the way I used to look at things – and there were no appointments. I was angry initially. I could have written several different versions of scathing blog posts about this. When one is emotional, the writing actually comes out very well. Those are blog posts that get clicked on.

But I know I’m doing something right when I choose positivity and I choose beauty. I chose to let those thoughts meander in my brain as I numbed it with two Kdrama episodes last night. I chose to let the HMO middle management system try to right itself. I choose to be like my father, forever the small business owner that did not let the union machinery nor corporate largesse take credit for his work. He went out his own and built something beautiful. I choose this morning to blog and to remember the beautiful parts of yesterday.

The beauty yesterday as I left clinic was getting to really look at the decals in one of my new exam rooms. It’s a slow project and all I did was buy the decals. I love them and the new nursing partner I have. She also brings beauty and chooses positivity. I chose to chat with a young father who is a Family Practice doctor about his new baby, and give him some advice about life. And I choose to not get involved again in a system that needs to cleanse itself. And if the system doesn’t, than a new system will come. And I got to talk to my daughter last night, and my son as well – and oh yes Mr. Plastic Picker too. We all gathered at 830pm and had a late snack as everyone had a busy Monday. Volleyball tournament for our daughter, AP Biology homework for my son, invitation to speak at Harvard/MGH grand rounds for me, and the continuing adventures of the private school lunch line.

I’m up at 642am and finished a short blog to sort out my thoughts. My matcha green tea soy latte is delicious, and I’m going for a short jog to get my heart rate about 160. I remember pushing myself to run after working until 10pm, and then falling for the first time in my life after running about 7 years ago. I came home scrapped and bloodied, yet still forced myself to work the next day after having worked the night before. Back then my freshman daughter was 7 years of age, and I’m sure it scared her to see me scraped up and pushing myself. But now I’m not scaring anyone anymore, especially not myself.