Category Archives: Physician Mobility

It’s Hard Being An MD

I spent 26 hours of a 34 hour period this past weekend, 6 hours driving to and from the location and the other 20 hours working at a pediatric urgent care in NC and…I am tired. I am tired of the 7000 steps to see an increasingly large volume of patients, and I am not all that efficient nor fast. I am tired of there never being another provider that will come help. I am tired of there not being any true Mee-Maws that can tell sick from not sick and not demanding kids have the go to the doctors because they developed a runny nose 1 hour ago. I am tired of system that promotes hypochondria, yes faking illness. I am tired of being so tired that going to my full time job, that I actually love, is a chore because I am so beat down. It is really sad you would prefer to be broke than work extra.

A ray of light was a cute little girl that I hadn’t seen since birth. In my position as an itinerant Pediatric Hospitalist and UC doc I never meet patients that I have cared for in the past. I never get to see the positive or negative impact. It was gratifying to see this beautiful kid and family, but I worry that my mental fatigue and whole body aching did not leave the most positive impression. I worry that this pace is not sustainable and I do NOT want to affect my current position over a part time position. Why I like my current position? I have the support of my colleagues, I have the tools to perform well including an easy to navigate EHR, EPIC in this case. They actually care that I live closer because 1 hour drive on 264 and 95 is hazardous to anyone’s health. They actually care. I don’t get that feeling from my contract position, I just feel like a filler , and only contact I have is punitive.

My baseline is slightly salty, always sarcastic, sleep-deprived, and automatic default a skosh cranky. I try to avoid events and people that highlights those things. So why do it you may ask? It was for the pay, and the opportunity to be in Charlotte. But after taxes, the pay is not all that and I work so much and my drive is so far, I don’t get to enjoy Charlotte. So why exactly am I doing this? Dunno. Will I be doing this going forward? Nope.

Live from DC it’s Felicia!!!

So I’m here a full day early and what a day it has been!! I am going to go on record to say I am still salty with American Airlines in spite of getting here on time and getting from DCA to hotel on Metro was a solid experience!! These little brown birds are psychotic, they are so mean to each other and have no fear of humans.

During this post, I can’t be as chatty, because I am in the M Lounge at the Marriott Marquis and I don’t think the other guests would appreciate geek speak into my Dragon Anywhere app…I am looking forward to the first actual day of meeting and will plan to attend classes next meeting. I discovered how jammed packed and distracting this entire area is. I had an amazing lunch at Ping Pong. There is a whole new area with Hermes, Dior and LV surrounding an eternity pool…The Smithsonian, Martin Luther King’s, and the Washington Monument all very close. Blackboard, American Medical College, the VA Administration are all on the same block. I have had my iPad Pro a little over 1 month and I have already lost that blasted pen. I went to find a replacement at the ATT store in Chinatown and the manager and I grew up in Virginia Beach and graduated from Bayside High!! 6 degrees of separation wow!!! There is so much here, where do I start?

Well first things truly first…I came here for this…

http://www.physicianleaders.org/classroom/Course/L-SUMM-04-2016/

I have to complete Social Media Training and my CAPM Bootcamp…ugg!!! I am so far behind. Well I am signing off for now. Off to the Smithsonian to hit the spots I didn’t hit during my last time here…I wonder if there are any cherry blossoms left?

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Physician Mobility?

Distracted practice

In my day to day, I am Queen Multitasker. I look like the guy in the photo trying to balance phone calls, note taking, and all the multimedia gadgets required of someone in my administrative position. Unfortunately, I know a fair number of colleagues look like this guy instead of the fitted one button coat, they are in their lab jackets in a hospital or office near you.

So what should happen to reduce the juggling of the gadgets? Can we balance accessibility and still practice efficiently? Can we foster 2-way patient interactions and still respect provider downtime? Yes, Yes, and Yes.

I believe it’s a combination of having multiple platforms integrated and optimized for the use of a busy and efficient provider. So what’s out there? We are an iOS world for now(Apple Rules, Android Users just get over it) If most consumers are like me, Steve Jobs’ company has gotten lots of my money over the years. There is the Apple watch, an Apple phone, as well as a tablet either surface or iPad Pro(The gold Ipad Pro is pretty but the verdict is still out on its usage in-house) but do any of these devices make the physician more efficient? Which front end dictation tool should be utilized and optimized? Nuance ™  apps it particularly Dragon Anywhere™ which I’ve been experimenting with more in the previous several weeks is particularly useful input tool.  I found in comparison to previous forms of Dragon™, Siri on my iPhone actually worked better than the previous iterations of the front end dictation tool really previously released by the company Nuance™. But there has been a marked improvement with the release of the Dragon Anywhere tool™. For a nominal subscription fee you have a hardware light version of Dragon™ on your phone. It has a more robust command structure as well as powerful editing tools in which you can enjoy the accuracy in the hardware heavy version of this tool.  I find that my ability to transfer and copy text into a Word document and then easily save it to my cloud Dropbox is almost seamless and then I can actually update the text and repeat that within less than 30 seconds. It has made my ability to post my blog a lot easier. I  still have to go back to my laptop/tablet to make the final corrections and formatting just because I find it easier but it actually has been a godsend as far as my ability to be able to create this post. (FYI, I’m using Dragon Anywhere™ to create this post.) I would suggest that you number 1, have the latest updates on your phone, have a subscription to office 360, and you can ensure that the embedded mic within your phone actually works well. The microphone on the iPhone has excellent noise canceling capabilities however what I have found is my Bluetooth, the accuracy has been affected by the LG 750 even up to LG 760 with a Bluetooth device.  You may actually have a better chance with a wired Beats™ as well as the white earbuds that actually come with your iPhone. I would also ensure that your screen saver or power saver mode is set to a minimum of 15 minutes or so before the  screen locks.

I am a iOS geek through and through.  However, the Surface 3 with Windows 10 and Citrix 14.3 from a healthcare information systems perspective actually affords the end-user the best experience and will truly increase their efficiency. And is also necessary to have a tool either like Dragon 360™ medical or Dragon Direct™. When Windows 10 was released someone told me you will experience a loss of functionality, but could not tell me exactly why. If the device is correctly imaged, with properly formatted applications, and Office 2016, it will only enhance your experience not detract from it. I just wish people that don’t have the full story and can’t give you clear directions on how to change something,  they need to take Madea’s advice and go and sit down somewhere and be quiet. We providers are under pressure from a regulatory standpoint to document thoroughly to tell the full story and to allow proper charges to be created and submitted in a timely manner. And from a business stand point, we are tasked to see as many patients as possible but still provide quality healthcare.  We should have the properly configured tools to allow us to maximize our time interacting with our patients and fellow staff members,  not inputting data into the EMR. Futuristic Complex