At times I feel I am really out of place here, and at times I really am. I have this thing about putting patient care in front of policy. I have never seen an organization with more policies than the IHS. I suppose it's a governmental thing. I mean, how would they spend all our tax dollars if they didn't have 10 policies, written by 20 people to cover 1 thing. Last week I did battle with the pharmacy. In the rest of the world a physician sees a patient, comes up with a diagnosis, and writes for medication, if needed, on a prescription that the patient takes to a pharmacy and waits for the pharmacist to fill the prescription and educate the patient about the medication. (except for if you pick it up through the drive through, as I discovered when I treated a bus full of puking, and other things, baseball players).
In this system, we not only have to provide the diagnosis to the dispensing pharmacist, we have to complete our chart note so he can review it before he will dispense the medication. No big deal, you say. Well, I counted mouse clicks and waiting time whilst trying to create a note on a patient in this ridiculous EHR system the IHS uses. Between 60-70 mouse clicks and 2 minutes watching the circle go round before you can enter a note into the system. An average of 7-10 minutes all together. Per patient. If I see 15 patients, I have spent about 2 hours looking at my computer. So I see a patient, type for 10 minutes, see a patient, type for 10 minutes, and get further and further behind. And at 4 I have 3 more patients to see, but the problem is, the clinic staff walk out, literally, at 4:30. I am supposed to be done. If I'm not, I should be. After all, the government contract says so. Unfortunately the patients have not read the contract and don't know that they can't show up septic (really, badly infected) and withdrawing from alcohol at the end of the day. So I stay until all patients are cared for, AND notes are written, and then get called to task for being here too late. There must be a separate Hippocratic oath for docs who choose to do this full time. And what, may I ask, does a friggin' pharmacist need my note for to give a drug I have ordered????
There, I got that out. On to fun stuff. Kind of.
On Saturday I decided to find an out of the way trading post that is supposed to have an incredible Navajo rug museum. The reviews say it is great, but expect to have some loose teeth after traveling over the bumpy, unpaved road to get there. So I head north, past the community where my clinic is located, and see the sign to Toadlena about 50 miles north. Then my phone dies. No problem, I will follow the signs. Except there are no more. I am bouncing over roads that make NW logging roads seem paved and see nothing nor nobody. But maybe around the next turn....Well after 30 minutes of this I decide the further I go the further I will have to walk when I pop a tire on one of the many rocks I have been trying to avoid, so I turn around. Then I have to pee. But I am afraid to turn off the engine for fear it won't start and I literally have seen no signs of life in a very long while. (altho the scenery is pretty). I stop the car, put it in park and brake, and step behind the car to take care of my bladder and then realize that I am in rattle snake country. I am envisioning the head lines: local doctor run over by own car after getting bitten in the butt by a rattler, when the only car I have seen in 45 minutes drives by. Timing is not my strong point. Turns out the place I was looking for was 5 minutes from the highway.
Sunday I toured the beautiful Canyon de Chelly with an old residency friend that is working in Chinle, my favorite place in the Navajo Nation. I will try to post pics on Facebook, but internet connection is slooooowwww tonight. This place is magical. Ruins and pictograms from the 13th century. Red rocks and green trees. And homes placed 50 feet up a solid rock cliff. And I complain about the 3 steps into our house from the garage!!
Speaking of my garage, I will be home for a week soon. Can't wait. This is a long time to be away from my chickens!!
No comments:
Post a Comment