Who Needs Stitches When There’s Crazy Glue!

It’s been a while since I’ve stitched someone up.  I used to do a few stitches a month when I worked at the University health clinics. Since starting my family practice though, I haven’t done a single suture in years.  There’s two reasons for this:  1) Patients generally don’t go to their family doctor for stitches, rather they head to the closest ER or WIC.  2) I don’t have suturing materials at the office.

Yesterday, my husband was putting together the bike trailer he recently purchased.  Daughter was at preschool, son was sleeping, so I took my bike out to the local gas station to fill up the tires.  I’m not very good at it, and proceeded to completely drain the tire of air.  For the life of me, I just couldn’t figure out how the air pump worked – I was having a “dumb” moment.  Anyway, so I walked the bike back home and I can see my husband at the end of the driveway.  Aw, isn’t that sweet, I think.  He was wondering why I took so long and was looking for me.

As he approached me, I could see he had a towel wrapped around his hand.  He unwraps the towel and says, “Does this need stitches?”  There, on the palm of his left hand, under the index finger, is a nice gash about an inch long.  “Yikes!”, I said.  “Yep, that’ll need stitches.” The wound looked deep but on closer inspection, it actually wasn’t bleeding all that much.  I started to problem solve quietly on how we could do this.  Daughter was due to be picked up from preschool in half an hour, son was sleeping and I was due at work in 2 hours.  Oh, and then I remembered that I don’t actually have any suture material at the office.  DOH!  And that’s when husband says, “I’ll just use crazy glue.”  Um .. come again?

Then he proceeds to show me about 4 different scars where he used crazy glue to put himself back together.  Better than sitting in an ER for hours on end, right?  I reminded him that we need to clean out the wound (it was caused by slippage of a screwdriver) to which he replied, “Get the Vodka”.  So, the first bottle I see is the Finlandia.  “No!” he says, “Not the good stuff. Get the cheap stuff in the other cupboard.”  Right. Of course, what was I thinking?  So we clean out the wound and I remind him it’s a good thing I gave him a tetanus booster a few years ago (when I also gave him the H1N1 vaccine).  10 minutes later, wound is crazy glued and bandages are applied.  Son is awake, I get ready for work and off we go to pick up daughter.

Who needs stitches when there’s crazy glue?!  My husband, that’s who!

After-Hours Rant

I am “on call” for the after-hours clinic tonight.  I am supposed to be available for 3 hours, from 5-8pm, to see patients in our call group.  It’s March Break, so I expected it to be kind of quiet.  But not this quiet!  I’ve seen one patient!  What a waste of time!  I feel bad because my husband is home alone all day with the kids and as I sit here catching up on work but not actually seeing any patients, he has to put the kidlets to bed without me. It is what it is and it only happens once every 6 weeks or so, but I wish it was busier.  At least then I wouldn’t feel guilty about not being home.  Instead, I feel guilty because I’m here, updating my blog.  (Don’t tell him, ‘k?)

After-hours care is important – I just wish patients would use it more wisely.  I know it’s easy to just go to the local walk-in-clinic (WIC) but what patients don’t realize is that their family doctor gets dinged for it by the government.  If I have rostered a patient to my practice, then that means that patient should see only me.  I get paid a certain amount of money per patient, per year.  If that patient that I am getting paid for, regardless if I see them or not, goes to a WIC, the government takes that money away from me.  It also makes our group’s numbers look bad.  We are supposed to be keeping our patients out of WICs.  We get a certain amount of money per year to keep our patients out of WICs.  When that money gets depleted, and it often does, our group goes into a negative balance and the government keeps track of this.  If we are constantly in a negative balance it means we aren’t doing our jobs right and the government can dissolve our group.  Patients need to be told this, and I make every effort to explain this, but I think something is getting lost in translation.  Patients either pretend they understand, then forget and just go to the local WIC becasue “it was convenient”, or they simply just don’t care.  I’m really not sure which it is.

As I sit here, tired and counting the minutes to when I can go home and hug my husband and tuck-in my kids, I wonder how many of my patients are at WICs right now.