What I Did Today…

A lot of people can’t imagine what a doctor spends her time doing.  Sometimes I wonder too…why don’t I just see patients and go home?  So today I tried to keep a list.  I thought I’d let you know what my (fairly normal) Monday looked like.  I know I left a bunch of random stuff out because I kept forgetting to list what I was doing, but at least you get the idea.  This is all the behind-the-scenes work that is invisible to people but has to be done at every doctor’s office across the country.

  • Saw patients (everyone knows about that).
  • Fought with my internet…why oh why does it choose such inconvenient times to not work?
  • Finished appointment notes, sent summaries to portals (except for one patient who always takes detailed notes)
  • Got paged twice from pharmacies about prescriptions
  • Hunted down an x-ray result I hadn’t received, called the radiologist to discuss the situation, and contacted the patient with next steps
  • Looked up a study a patient mentioned, reviewed it, looked up medication conversion (I’ve learned that even pharmacists have to do this!) and replied to her questions
  • Put in referrals to specialists for two different patients.  This requires faxing medical records, demographics, and a letter from me.  Oh, and I wrote those letters too.
  • Called and scheduled my kids’ well child checks…I finally remembered to do this before 5pm!!!
  • Called Medicaid to do a prior authorization (also a before 5pm task)
  • Reviewed labs several patients had drawn late last week and the results came in over the weekend.  One required additional testing, which necessitated contacting the patient to discuss, contacting the lab to add the labs (terrible hold music!), then receiving the paperwork from the lab to sign and return to them saying that yes, I really did say that I wanted the additional labs. One set of labs needed to be faxed to a specialist with a note from me.  Of course all the results needed to get to their owners.
  • Reviewed echocardiogram results on a patient, determined what additional testing was needed, contacted patient to discuss.
  • Discussed doing additional labwork for a patient who HATES needles, recommended the Buzzy to help with that.  (Here’s a great TED talk about the subject).  Wrote order, faxed.
  • Checked messages and found that I had received several phone calls from patients about various concerns, returned each call…imagine the amount of time I spend on the phone with you when I talk with you, then multiply that by 4-16 calls a day!  (Typical is about 8).  Sent emails with resources to a couple of the people I spoke with.
  • Called people to schedule follow up appointments.
  • Did messages on the portal.  They ranged from a quick “great, see you then” to several detailed treatises on complicated questions.
  • Called the lab again to order supplies.
  • Called again because you have to call different numbers for different supplies.
  • Tidied up office, cleaned instruments, watered plants.
  • Thought about looking at beginning of the month finances but just couldn’t bear doing anything more today.

In a typical office, some of this could have been easily handled by staff (such as faxing).  Some of it would have been a message to staff, “tell patient she needs an appointment to discuss” instead of replying to those questions, or “tell patient to work on lifestyle changes” instead of the long discussion.  Some of it may have been handled by a staff member without my knowledge (finances, scheduling appointments, refilling prescriptions…which can present a problem when a particular number of refills was done to make sure a patient came back in).  But many of these tasks are things doctors do every day and no one thinks about it.  Reviewing labs.  Reviewing imaging.  Determining next steps.  Calling radiologists.  Contacting specialists.  Replying to messages and phone calls.  The stuff someone else would have done is fast and easy, almost a break from the work of doctoring.  But I love the doctoring part…I am so happy this practice gives me the time to do it right!

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