It’s 10 p.m.
Seven days before Christmas.
I’m sitting at work “finishing” up some charts.
I am suddenly overcome with anger.
What am I doing here right now at this minute? I am helping no one.
This work I’m typing away at — trying so hard not to scream — it’s hoops. Fucki*g hoops … for insurance companies. So I can beg them to pay me. Pay me pennies for the hard, good, compassionate, humanitarian work I’m out here trying to do — but can’t because of this.
This deathtrap of notes.
I put quotations around “finished” because, at this moment, I know, no matter how diligently I try, no matter how much time I spend here typing — Instead of completing my shopping list for my five children. Instead of seeing my husband AT ALL today. Instead of eating a complete meal. Instead of enjoying the rest of the evening, after finishing clinic at 8 p.m. to provide walk-in hours for my sick patients. I will, quite literally, never be finished.
I am typing away.
Clicking box, after box, after box, after box, after box, after box, after box.
Reading reminders on each patient. Have they gotten their mammogram? Their pap? Their flu shot? Their colonoscopy? Have you checked their labs? Their HgA1c at least twice this year? Have you talked to them about their “health care goals”?
Did you order an X-ray within 30 days of their acute back pain? You did? OK — ding — you’re no longer a “quality” physician. So, we’re going to pay you less.
As quickly as I resolve them, new results come in. New documents. From specialists. Labs. Physical therapists. Insurance.
F—U—C—K—I—*—G insurance.
Under the guise that they “care.” That they are courteously reminding me of all the “missing” items for the “quality” care of my patients.
Do you know what quality care is?
I do. It’s my passion. I love speaking to people. Meeting them. Getting to know who they are. What makes them tick. What makes them enjoy life. Are they enjoying life? Are they not? What’s stopping them? Is it mental? Is it physical? Is it chemical? Is it biological? I have these answers. All of them … if I just had the time to dig a little bit. The time to help them trust me. To understand their communication style. The time to really, truly understand their health care goals.
If I were allowed to do it my way, I could help all of my patients.
But instead, I am in front of this horrid, white, glowing, screen typing away.
As I type, I’m neglecting something.
My patients can’t stand it. They confuse lack of time, with a lack of compassion.
We don’t care about them. We don’t return their calls. We don’t get their forms in on time. We don’t give their lab results until two weeks after they’re drawn. Their referral wasn’t sent. Their refill wasn’t sent.
I hate it more than they do.
I am a problem solver. I like solutions. I like to help.
Sitting here. Typing at 10:24 p.m. is the last thing on earth I ever wanted to be doing.
Yet — here I am.
Drowning.
In this, slow death by charting.
Erin O’Laughlin is a family physician who blogs at Cornucopia.
Image credit: Shutterstock.com
