A sign of the times

[N80]

I am a family physician in South Carolina. There are four doctors in our clinic. We are supposed to have 5 or 6. We are below 50% understaffed in terms of support staff, medical assistants, nurses, front office etc. In the last year there has not been a single application for a physicians and the head hunters can't find us any. None. For the last six months we have had virtually no applications for clinical staff or front desk except for ones that people do in order to stay on unemployment. They do not return our calls. Subsequently we can do less. I've had to cut my number of appointments by about 15% just so we don't run the remaining staff ragged. So yes, our typical level of service has decreased and there is a lot of burnout. I am now doing tons of clerical and non clinical stuff to help take the burden off the remaining staff. This on top of the mountains of administrative nonsense heaped on us by the Affordable Care Act. It is no real surprise that there are no physicians applying. It should be no surprise that our patients have to wait days to get an appointment.

 

[EddieWalker]

When my wife had her knee replaced 3 weeks ago, there where a lot of nurses there that she had taught in nursing school. Most have only been RN's for a few years. All of them said that they would never do it again.

 

[MossRoad]

I am a family physician in South Carolina. There are four doctors in our clinic. We are supposed to have 5 or 6. We are below 50% understaffed in terms of support staff, medical assistants, nurses, front office etc. In the last year there has not been a single application for a physicians and the head hunters can't find us any. None. For the last six months we have had virtually no applications for clinical staff or front desk except for ones that people do in order to stay on unemployment. They do not return our calls. Subsequently we can do less. I've had to cut my number of appointments by about 15% just so we don't run the remaining staff ragged. So yes, our typical level of service has decreased and there is a lot of burnout. I am now doing tons of clerical and non clinical stuff to help take the burden off the remaining staff. This on top of the mountains of administrative nonsense heaped on us by the Affordable Care Act. It is no real surprise that there are no physicians applying. It should be no surprise that our patients have to wait days to get an appointment.

You're a doctor? Hey, I have this bump on my....

Good luck out there.

 

[Jstpssng]

One of our kids worked at a Vet's office during high school and college. She got the employee discount (plus they liked her). One of our cats had kidney issues. We had to give it 100ml subcutaneous injections twice a day of fluids. Made him look like a hunchback for an hour or so. Anyhow, the 1L bag of the stuff was quite expensive. But she got it for less than half of the price they'd charge a regular customer. The markup was kind of shocking.

Also consider though, what percentage of the meds they keep in stock but have to throw out because it got old. Like any retail business they have shrinkage, and have to account for that somehow. That "somehow" is passed on to the customers in some way, otherwise they wouldn't be able to stay in business.

 

[bunyip]

Eldest daughter did some work experience with a vet when she was in high school, had to go to a vet 'trade' night and got back about 9pm, he dropped her off and came inside, saw her kitten and she picked it up and he asked if he could hold it, she gave it to him and he said what a pretty kitten and gave it back, two days later we got a consultation fee for $150 of the prick.
I refused to pay it.

 

[jyoutz]

Everybody/everything is positioning to take advantage of increased prices.

Examples in my case -

I can no longer call my doctor and ask a simple question - I must make an appointment - cost.....$175.

I can no longer simply order tick meds from Pet Smart. Must secure prescription confirmation from my vet. Cost of appointment - $75.

I can no longer drive to our local gravel pit and get a load of gravel. Must be secured and delivered by contractor. Delivery cost - $180.

Is this only in my area - ???

$175 for a doctor visit? Wow. That’s crazy. With my insurance, an office visit is $30 co-pay and teledoc visits are free.

 

[jyoutz]

TSC sells many vet meds, and Jeffers sells most online. Except for things like rabies vaccines that can only be obtained from a vet.

 

[Larry Caldwell]

Everybody/everything is positioning to take advantage of increased prices.

Examples in my case -

I can no longer call my doctor and ask a simple question - I must make an appointment - cost.....$175.

I can no longer simply order tick meds from Pet Smart. Must secure prescription confirmation from my vet. Cost of appointment - $75.

I can no longer drive to our local gravel pit and get a load of gravel. Must be secured and delivered by contractor. Delivery cost - $180.

Is this only in my area - ???

I use the online patient portal for my doc. I can post prescription needs and the clinic staff will respond. If my symptoms change, I can write a brief description and either get a referral or an appointment, as needed.

Our vet is pretty open. At the moment they are down to 9 vets working, and are thinking of going to a 24 hour schedule. They are both a large animal and small animal clinic, so 24 hour is their working life. I think they have two vets working nights in calving season anyway. We call them and they will either sell it to us directly or give us a prescription, our choice.

I don't have a dump truck, so don't know about the gravel.

 

[jigs_n_fixtures]

Our rural health clinic and the two ”big town” hospitals are part of an experimental rural health initiative. We have an app, which lets all the docs see your records. You can also send messages to you care team if you have questions or concerns. They usually get back to you in a working day.

I had a spider bite, which got redder and uglier over a couple of days. I smeared it with neosporen, and it comtinued to get worse. So, I took a picture and sent it to my doctor through the app.

Nurse called about 20-minutes later, asked me how long ago I’d gotten bitten. And then told me to go to the ER, because my normal doctor was out of town, and the PAs who staff the walk in clinic wouldn’t know what to do.

The ER scrubbed it out with a brush that had the finest little bristle, almost as fine as babies hair. Still was a bit past the uncomfortable level. Turns out some spider inject their digestive enzymes when they bite you and the wound proceeds to get digested, and get larger. Dr even ,laughed when he asked me what kind of spider it was, and I replied, “Smusshed”. Don’t know about you, but when something is biting me, my reflex reaction is to smack it with the flat of my hand, and then rub in a figure eight to be sure it is dead.

 

[Hay Dude]

Our rural health clinic and the two ”big town” hospitals are part of an experimental rural health initiative. We have an app, which lets all the docs see your records. You can also send messages to you care team if you have questions or concerns. They usually get back to you in a working day.

I had a spider bite, which got redder and uglier over a couple of days. I smeared it with neosporen, and it comtinued to get worse. So, I took a picture and sent it to my doctor through the app.

Nurse called about 20-minutes later, asked me how long ago I’d gotten bitten. And then told me to go to the ER, because my normal doctor was out of town, and the PAs who staff the walk in clinic wouldn’t know what to do.

The ER scrubbed it out with a brush that had the finest little bristle, almost as fine as babies hair. Still was a bit past the uncomfortable level. Turns out some spider inject their digestive enzymes when they bite you and the wound proceeds to get digested, and get larger. Dr even ,laughed when he asked me what kind of spider it was, and I replied, “Smusshed”. Don’t know about you, but when something is biting me, my reflex reaction is to smack it with the flat of my hand, and then rub in a figure eight to be sure it is dead.

Same recently happened to me. We were moving bales in a tight barn and a black widow got me. At first I went home and put some triple ani-biotic goop on it. It got worse. Did tele med. Doctor scolded me for using the triple anti-biotic! I told him that was the limit of my medical training and he laughed. He said he doesnt recommend the stuff? Anyway, a steroid and an anti biotic and 2 weeks I was healed.