Sunday, December 16, 2007


After that last post, I should give you an insight as to why doctors are always running late. Well, more precisely, this should be why I'm always a bit late because I can't speak for everyone.

Occasionally emergencies do occur. And as bothersome as your current medical condition may be, it is trumped by the patient who was just involved in a car accident, is actively bleeding to death, or needs immediate surgery. The majority of the time, the patient in the ER takes precedent over the patient in the office.

Now people understand this triage method and have abused the ER system by going there first for their medical care instead of their primary doctors. Of course, we're not stupid, so even if they're in the ER, if I don't think the condition is life threatening in any way, my clinic patients get to see me first and the patient in the ER sits and waits.

Sometimes the patient that's scheduled before you takes up more than their allotted time. They may need an unforeseen office procedure that takes up an additional 15 to 20 minutes more than what was scheduled. They may have a complex problem that takes longer to diagnose. (It's not easy picking the correct diagnosis from a infinite possibility of diseases, you know.) They may have a hard time understanding what's going on, and I have to take additional time to explain it to them. They may not speak English. They may come with 2 pages of typewritten questions to ask, to which I have to answer all of them. They may want me to talk to a family member over the phone. Or, like that last patient, they spend the first 5 minutes complaining about the wait, which does nothing but further delay everything.

Sometimes patient's charts go missing, and we have to send one of the staff out to look for it. Or their x-rays are missing. Or a pathologist's report. These all cause delays.

Sometimes I have to talk to another specialist in regards to a specific aspect of that patient's disease, and we have to wait for them to call me back.

And of course, there's the paperwork. Everything I do requires documentation in painful detail. My ballpoint pens usually last about 6 weeks before running out of ink. That's a lot of writing. Can you remember the last time your pen ran out of ink?

Lastly, I also field pages from nurses taking care of patients in the hospital and with consultation requests from other doctors. I have to stop and answer my pages, listen to them and talk to them, and even if a phone call only takes a minute, that's one more minute added to the overall delay.

We know nobody likes to sit around and wait. We hate that too. So I work as fast as I can, and many times I don't have time for lunch. I just grab a granola bar or some saltines. I laugh when I hear about other people taking 15-minute breaks because I rarely have that opportunity.

Contrary to what you might think, I'm never sitting in the break room drinking coffee with the nurses, or sitting on a computer doing on-line shopping while you're sitting in that freezing cold exam room wearing one of our fashionable paper gowns. I don't like delays any more than you do. If I'm running an hour late, that means I have to stay at work an hour longer to get everything done.

Doctors don't get to clock out at 5pm. After I'm finished seeing clinic patients, I have to go see and take care of my patients in the hospital. Only after everybody's been tucked in for the night can I go home. Sometimes it's 4pm. Sometimes it's 10pm. Sometimes, I stay up all night performing emergency surgery and never go home, only to start a new full workday in the morning. We only go home when the work is done.

I like what I do, it's a blessing to get paid for doing something I enjoy. But I hate having to sit and wait in the office as much as anybody. And as much as I like helping people get better, and as much as I like my job, I like being at home with my wife a lot more. A lot more.

I'm as aggravated as you are when things get backed up. So just bear with the doctors and the nurses, be patient, and find solace in knowing that we're working as fast as we can to get you out of the office so that we, too, can go home.