THINGS PEOPLE CAME TO THE DOCTOR FOR ON BLACK FRIDAY
The Army mandated clinics stay open this year. It was still a holiday for active duty Soldiers but I was told to work anyway to meet "access to care." Only 7 of 15 appts got booked and of those, only 5 came to their scheduled appointment, and none were truly urgent from a triage standpoint. Let me be mad for a second for time wasted. 😡
- •SnoringTurns out the patient has pretty bad untreated allergies. Started on Zyrtec and Flonase. Screening questionnaire for sleep apnea was borderline. Patient will follow up in one month. If no improvement, will switch to Nasonex and obtain a sleep study to rule out sleep apnea.
- •Shortness of breath and dizzinessNo showed. Could've been legitimate. On review of the patient's medical record, she complained of the same a month ago but didn't also didn't show up for her cardiac ultrasound, to pick up her cardiac monitor, or get labs done as ordered. No idea why she called this morning to schedule an appointment for 1 hour later and then didn't show up.
- •Pinworms #15 year old kid with itchy butt for 5 days. Mom found a worm last night. Ew! Prescribed anti-parasitic medication for kid and whole family.
- •Pinworms #2Different family. What are the odds of this twice in one day? 3 year old girl with a sister who recent had pinworms. Mom found worms last night (checked after noticing lots of scratching). Treated whole family also.
- •"Opiate withdrawal" was the booking complaint.Active duty Soldier; 2 hours late. Multiple notes from addiction specialist in chart with red flags for medication abuse. He consumed an entire month's supply of chronic pain meds prescribed by someone else in the last 10 days. I politely told him I would not be caring for him as he was 1) 2 hours late, 2) in violation of his pain agreement and 3) would be given meds to manage his withdrawal only 4) would not be given any narcotics by me or anyone else in the clinic. Stormed out angrily.
- •Lab results.Female in early 20s who previously saw another doctor two months ago complaining of anxiety. Doctor ordered a diabetes screen due to obesity. Results showed prediabetes. Spent an hour counseling the patient on lifestyle modification, developing a plan to reverse prediabetes and to lose weight safely and effectively. Also entered referrals to diabetes nutritionist/counselor to reinforce what we covered today. Patient to follow up in 1 month to check progress.
- •Okay, I'm good now. Woosah.
- •The only thing that gave me job satisfaction today was stopping on the side of the road to assess the situation at a four car + dump truck accident.Don't get me wrong. I love primary care. I just would've really liked to spend time with my loved ones today, like the hospital leadership that made me work a holiday we are usually closed for (to take care of a whopping 5 patients with subacute issues). From a business standpoint (which is what they use to justify making us work), they probably lost money by opening.