Vague.

Day 5 – National Blog Posting Month.

3D-man-stabbed-on-the-chest-with-a-knifeIt’s been on and off for a few weeks now, this sharp, stabbing pain in my left chest.  I know what it is and why it is and as much as I try to control it, I just can’t.  It’s work related and I can’t talk about it.

Wow, I think I just “vagueblogged”.  And yes, I just made that up.

I hate when people “vaguebook” – you know, someone posts a very vague message on Facebook which then prompts friends and followers to ask, “Are you okay?” or “Thinking of you!”  “Hope you are okay.” Suddenly whatever they are actually posting about really isn’t as important as how many friends actually noticed and are asking about it. That is what is really wanted by the original message.  Someone is feeling upset and alone and vulnerable – reaching out to social media is the way they can feel important again.

Which reminds me of a comedian my husband introduced me to recently.  He’s so funny and so NOT politically correct, it was actually quite refreshing to watch.  His name is Anthony Jeselnik.  One particular “bit” really struck home with me.

So today, I ask my blogging friends and readers not to forget about me.

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Full Steam Ahead to 2015.

Is it just me or did the last 365 days fly by?

Seriously! I blinked and it’s December 31st.  Where has the time gone?

It was an eventful year.  I started the year on maternity leave.  I struggled with one running injury after another and worried I might never run again.  Then I ran 10 km for the first time and managed to repeat that feat at least three more times thereafter. I shaved off almost a minute from my average running speed and ran almost 630 km this year.  WOW!

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I lost two patients to cancer, discovered another area of medicine I’d like to do more of in the future and welcomed 15 new babies to the practice.

I turned 40 and celebrated in style.

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I watched my daughter lose her first tooth and wiped away brave tears as she got her first cast.

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Our family lost a beloved pet (on the left) but we have another beauty amongst us (on the right) who still needs our love and affection more than ever now.

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I am blessed with beautiful friends and family who have consistently been there for me and have supported me this year. I am grateful to them (you know who you are) and am so very fortunate to have you in my life.

My husband is my knight in shining armor. We had so many amazing adventures this year; I can’t wait to see what’s ahead for us.

IMG_9920 IMG_9830 IMG_9697 IMG_1408 IMG_2961 IMG_3292IMG_3126IMG_1409 And finally to my readers and followers:  thank you for reading and contributing.  I look forward to another great year in the blogosphere!

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The Dollars and Cents of Running a Practice.

I am not business oriented at all, which is kind of ironic.  I pay rent for my office space, I have a staff and expenses to cover to run my family practice.  I have a small business, actually.  Except that I have no formal training in business, nor do I ever wish to be a “business woman”.  Yet, here I am, almost 10 years out of school and I’m running a small business.

To this I say,

 

Since I started my family practice, I have always felt weird about charging patients for services not covered by the government.  I’m not entirely sure why.  Most patients think health care is free and it isn’t.  We pay taxes, and while I get paid pretty well for what I do, there are certain things that the government will not pay for, so it’s reasonable that a patient is expected to cover the cost.  I’m talking about sick notes for work, prescriptions for massage therapy, prescription renewals via fax, etc.  Our medical association gives us guidelines on what to charge for these non-insured services, and it took me a few years to implement these fees into my practice.  Needless to say, I was losing quite a bit of money.

So I started by sending out a yearly letter to all of my patients reviewing the non-insured services and offered patients two options – to pay a “block fee” that covers everything for the year, or to pay on a “fee for service” basis.  Most patients opted on the latter, which was fine, but after a while I realized that only accepting cash or personal cheques was inconvenient for most people.  So, I looked into purchasing a terminal for credit/debit payments. Suddenly I needed a “business account”, a “business name”, and was going to be charged an extraordinary amount of processing fees.  Yeah, no thanks. So, another few years went by.

But now, after almost 7 years in family practice, I have built up over a thousand patients and often spend a ridiculous amount of time writing sick notes, massage notes and renewing prescriptions over the phone and I am not being compensated for it. I found myself getting really annoyed at the stack of prescription renewals on my desk every morning and started to refuse to do them unless the patient came in.  Well, you can imagine how that went over.  Normally I give patients prescriptions for 3-6 months and for certain conditions (ie. high blood pressure, diabetes, depression), I expect them to follow-up regularly but of course life sometimes gets in the way and patients can’t come in to see me.  Or they just get lazy and complacent and “run out” and need a re-fill immediately.  Well, sorry folks, but times are changing and that will now cost you $30.  But how to enforce this?  It’s not like they can just show up and pay me cash, otherwise they’d just come in for an appointment, and sending an invoice in the mail is just going to get ignored.

I looked into the terminal for credit/debit payments and the fees and hassle was just not worth it.  Then, a few months ago, my colleague told me about something called Square.  Her teenage son told her about it and said it’s an app on the phone and it takes credit card payments.  Hmm, I was skeptical. But the concept was brilliant!  Then it just so happened, I bought something at a comic book store downtown and the shop used Square for my debit purchase.

So, I did some research and after another month of hemming and hawing about it, I signed up with Square.  Within days, I received the card reader in the mail (for free) and was all set to go.

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I can’t believe it took me this long to get with the program.  It’s the best thing since sliced bread.  Thank you, Square!

Bad News Bear.

There’s an aspect of being a doctor that never gets easy and that is delivering bad news.

In medical school we take a course called “Breaking Bad News“, but nothing prepares you for actually having to do it.

I’ve had my family practice for 7 years and have been practicing medicine for almost 10. I can still remember every single time I’ve had to give bad news.

  • While working at a walk-in clinic, over the Christmas holidays, I had to tell a woman she had pancreatic cancer.
  • In my first year of family practice, I told a woman she had cervical cancer.
  • In my second year of family practice, I felt a pancreatic mass in a 55-year-old woman; she lived for 4 years after that. I attended her funeral.
  • Three years ago, I felt a very abnormal prostate gland and new instantly the patient had prostate cancer.
  • A young woman, believed to be about 3 months pregnant came in for an unrelated matter and asked if we could listen to the heartbeat. She’d seen her midwife the previous week and they couldn’t find it.  Neither could I.  An ultrasound a few hours later confirmed what I already knew.  She’d suffered a miscarriage but didn’t know it.
  • There was an older woman who came to see me for chest pain. She had been coughing from a cold and had a lot of chest wall pain. An x-ray showed multiple rib fractures. Spontaneous rib fractures.  A week later, after sending her for a series of blood tests, I diagnosed Mulitple Myeloma.
  • Sometimes a diagnosis of chlamydia can be devastating.  It certainly was in the 31-year-old married woman who came in for a routine Pap.  Sadly, my bad news was instrumental in her later ending her marriage.
  • My first week back to work, I told a man he most likely had kidney cancer.  Welcome back!

Every time I have to deliver bad news I am reminded how fortunate I am and how fortunate my patients are for living in a country where, when its required, they have access to timely health care.  None of the above patients waited for more than a week or two to see a specialist.  Sadly, not everyone survives after being given bad news. I haven’t had to do it very often, but when I do, it affects me personally.  Often I can’t sleep for a few days.  Sometimes I worry (often unnecessarily) that I missed the boat and should have caught the illness at an earlier stage.  Anything else going on in my life suddenly seems not to matter for a while.

Bad news bear.

Sometimes that’s me.

 

 

Thirty Days of Blogging.

Day 30. National Blog Posting Month.

I did it!!!  I wrote a post every day during the month of November.

[Extra points to anyone who can tell me where the “Grr Argh!” reference is from.]

But seriously folks, as today is the last day of the November,  I am going to reflect on this month of posting.  When I first read about the National Blog Posting Month, I immediately thought it was a great challenge and one I should embark on. I mean, what else have I got to do these days, you know, besides nursing my infant every 3 hours and changing a diaper almost as often? My brain needs the exercise, almost as much as my body needs the running. 

As I got started, the magnitude of what I was doing hit me, around day 4 or day 5.  Could I really find something to write about day in and day out?  Well, as it turns out, I can!  And even more surprising to me was that you fine folks were actually reading! It is such an honor to have your attention for a few minutes every day.

One of the goals I had this month was to increase the number of followers of my little blog.  At the beginning of the month, I had 86 followers.  Today, as I write this, I have 109 followers.  Astounding!  Thank you!!!!  When I read other blogs and see that some folks have hundreds of followers, I wonder how they got there.  Well, I kind of figured it out – you have to write often, you have to write about stuff that people are interested in and it doesn’t hurt to be a little funny and be willing to poke fun at yourself.

I also learned a few things while writing this month:

  • I can write every day, if I set my mind to it.
  • I need to get some decent sleep if I want to lose the baby weight
  • The best time to have that morning cup of coffee is around 9:30am, when cortisol levels start to fall.
  • There will always be parents who won’t vaccinate their children, but I will continue to educate those parents (in my medical practice especially) and if I can instill change in just one family, then I will have done my job well.
  • I’m going to continue to fill my house with music – the memories that are made are there for a lifetime.
  • I am so very blessed to have three beautiful, healthy children.
  • It’s okay to have a noisy household, especially during naps; in fact, it might actually improve neurodevelopment.
  • I am spending way too much money during this maternity leave (see “Costco” post).
  • I love running.

 

And with that, I bid November and the National Blog Posting Month, adieu.