Saturday, February 22, 2014

Changes in Practice Locations

Apparently, after I left my previous employer to go to Shand's Primary Care West in Lake City, I have been "just booked up, sick, or out of the office." 
I understand that the previous practice does not want to tell my patients where I went in order to try and keep them from following me. But it's pretty sad when they lie to patients and not just tell them that I've moved on. Don't they realize that it makes people mad and make them want to leave? 
I have always thought no compete clauses were stupid anyway. Adults will follow a provider if they can because they have built a relationship and trust. I can't make them follow if they don't want to. 
I will be glad when the new doctor joins the group so the advertising goes out and it all can be clarified. 
Otherwise, I've been on the longest vacation of my life?

Sunday, December 22, 2013

Cha Cha Cha Changes!

It's been a while since I've posted due to some changes in my career setting. I'm still a FNP but moved to an office closer to home with better hours. This was a sudden thing as the opportunity fell into my lap. 
This is the first chance I have had to blog in a bit that didn't feel like a complaint yet again. I had a wonderful weekend without my computer attached to my hip and wasn't quite sure what to so with myself. I'm sure the quiet timd will once again be few and far between but I'm catching up on some reading.
I plan to go through my links and clean those out and pop over to some of my old blogger haunts and say hello.
Hope to become more motivated to write! See you around after I catch up on some sleep!

Sunday, October 27, 2013

Should You Shadow At A Location Before Working There?

Some NP new graduates are asking whether or not to shadow at a location before accepting or talking terms with an employer. I say yes because it can give you an invaluable look at a practice and it's style before you commit.
I would not do it for more than a few days and be very specific about what constitutes shadowing. In my view, it means that you follow the different providers in the practice on their busiest days and see how they interact with patients and staff members. Don't pass up a chance to eat lunch with the nurses as they will usually give you the real lowdown.
If the provider wants to use your services, make sure that there is a legitimate offer on the table.
I also recommend that you use your preceptorship hours as a way to do the same thing. That's what I did and figured out really fast which offices I did not want to work. I definitely don't recommend working in an office setting where a spouse is the office manager. I won't expound on that subject but understand that I will work for Wal-mart before that EVER happens again.
What say you? Any experiences?

Sunday, October 13, 2013

Why A NP Thinks ObamaCare Will Not Work

Everyone is yelling and screaming about the government shutdown over the Democrat's and Republican's refusal to come to an agreement regarding the funding of ObamaCare. So.....what are we going to do about all of this. As a health care provider, I agree with some of the basic ideas. Patients should be covered by insurance regardless of previous medical conditions. I agree that everyone should be able to be covered by some form of medical coverage. We must make it affordable. How do we do this?

The problem universally is two fold.
1. Can and should we force people to be covered? Some say that we live in a free society and that to force us to pay for something we might not want is against our inherent rights. Some say that if they don't want to pay for insurance that they should not have to. When they get sick, they will pay for services then. Ideally, patients should be able to pay cash for services rendered but some provider's offices do not take cash pay patients. The worry is that if you accept them and they cannot pay, you are still obligated to take care of them. I don't believe this is true. If you give a patient 30 days of emergent care and a notarized letter stating that you will no longer accept them, it's a done deal. We don't live in a prison society where medical providers are forced to care for patients that they may not gel with just as patients have a right to change providers as well.
 In a utopian society, everyone would feel obligated to pay their debts. Years ago, people would feel severe shame for going to the hospital or a medical provider and not pay the bill. They would feel less of a human being and would make the effort as soon as possible. If they couldn't pay in money, it would be done in trade for goods. Ah the good old days! But that was the time when we didn't have such high costs for medical care. Medicine is big business. Why should we make it more affordable for people to be diagnosed and treated? I can see a treatment being more expensive when it first comes out. We have to pay for innovations. But years later, we are still paying thousands of dollars for technology that has been out such as CTs and MRIs. Why should it cost thousands of dollars now for those diagnostics? Because medical imaging is big business, because research is big business. What would happen if we cured the common cold? How many shelves of cold remedies would not be needed and how many pharm companies would lose millions of dollars? My gosh! Add any the other medical ailments that may actually be cured and we could almost have a conspiracy theory. But, I digress.....
Who will pay for this coverage?
Everyone who works at a legitimate job. Yes, this means you and me. People are telling me that the new plans are expensive and that they cannot afford them. Some are saying that they are going to opt out but are finding out that the penalties are too high. So they will be forced to buy the insurance in order not to be penalized. Great.
What about all the other patients who are below the poverty range and cannot afford to pay for their insurance. They get it for free. Wait! It's free to them but it's not to us who have to pay higher taxes in order to maintain the Medicaid system. So we're getting doubly slammed. We HAVE to pay for ours because we have a legitimate job.
My solution? Do away with the ability to walk into any ER and get care for free, ESPECIALLY when it's not an emergency. If they show up via private vehicle with a complaint that did not just happen within the last 24 hours, send them out to their new primary care providers who will take care of the regular issues that are not emergent. The same goes for the bogus EMS transports. If the patient is determined to be using the EMS system in order to get into the ER for quick issues that are not emergent, PENALIZE them by taking away some of their... Oh wait! They don't have a job so they have nothing to give as a penalty...BINGO! By Jove I think I've got it! If they have two legs and two arms and can follow directions, they can work on the side of the roads and in the fields right next to everyone else. Disability should only be given to those with HARDCORE, REAL medical problems!
If you can walk, talk, sit, stand, bend over and breath without oxygen support, you can do something. I know! They can be trained to be sitters and caregivers for our elderly so that their families can get back to their jobs and become productive in their own lives. They can be trained to help take care of animals in the shelters and the zoos and National Parks. They can be trained to work at the homeless shelters and to help with childcare for those who are out there working for a living.
What say you?

Monday, July 29, 2013

Getting A Second Wind

I have been dealing with some issues at work lately but I think that things are going to improve. It's amazing how tension can effect people and how both positivity and negativity can impact your life.

Most of my patients are very astute to my moods as well though I try to hide it. I have always been positive in the room and try not to bring outside influences into the exam room. Patients also try to hide when things are bothering them. Often, after a few minutes, I can pick up on it and some have broken down and admitted that there are pretty bad stressors in their lives.

A lot of medical providers don't care to ask a patient how their lives are doing. They just want herd them through like cattle and while the notes look good on paper, the patient didn't feel like they were listened to. I try really hard to interact with my patients and find out what the real issues are behind the headaches and the stomach problems.

Do you feel like your provider listens to you?