I've disappeared for a while again. A couple of reasons why. One is that BlogPress's iPad app isn't working. I'm not able to blog on the go like I used to be able to.
The bigger reason is that my practice is getting up and running. By running, I mean running over me while I desperately try to keep breathing, completely giving up on keeping up.
I expected that I would end up with a larger than usual number of patients with personality disorders. I've been shocked though at how many there are. Most of the time in our "meet and greet" appointment is spent putting their supplements, meds, and "medical problems" into my EMR.
Something I hadn't counted on, were the high number of patients who are incredibly unwell but haven't seen a doc in 20 years. These are patients who have had their illnesses slowly progressing so they didn't notice how unwell they were. Some come into my office stating they've never felt better, but I can hear water on their lungs from across the room. Determining the cause of their illness and treating it takes time and all my training.
I've been giving all my new patients questionnaires to fill in before we get started. It helps to guide our first meeting and has been really helpful IF the patient isn't coming in already broken. Rather than being able to be on top of what is happening right away, I've had to hire someone with some clinical smarts to enter all the answers to my questions for me so that I can spend our first appointments dealing with acute medical issues.
Something else I wasn't expecting was needing to put a hold on my new patients while I get the ones that I already have a solid plan. I don't know who half my patients are. I've met them, I have notes in the chart about them, but have no idea what face goes with what name. I wish there was a photo component to the chart to help me with that.
I still think I have the best job in the world, just surprised by how overwhelmed I've been.
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