You are currently browsing the daily archive for January 3, 2022.

The first fortnight of the new year at the office is always the same. Patients have their deductibles recommence. This leads to a lot of phone calls, requests to change meds to something cheaper, or hopes of finding ways to make prescriptions less expensive, like a higher-dose pill to cut in half. Many resolve this matter by skimping on doses – or stopping meds all together.* Patients will also find weasel-ways to get prescription renewals without having to have a check-up. “Oh, I’m fine, the same really” they say, “can’t I come in in six months – after my deductible is met?” I take it these sort of shenanigans are a USA matter only; Spo-fans outside of The States can tell me if insurance deductibles (and their consequences) apply to their countries.

January was the month I was told a prescribing nurse was to start, but I see no evidence of his arrival. The clerical staff, who usually know these things before I do, inform me a few folks (MDs and RNs) are provisionally hired but there’s no word when they start. If rumors are right, there are three or four new folks are coming onboard, which makes me wonder if this is the year I get sacked. Perhaps a few RNs would cost less than Urs Truly. Before the place was sold, I wouldn’t think such morbid thoughts, but now The Overlords are in charge, it’s possible. However, let’s not count our chickens. I’ve lost count of how many potential coworkers I have heard were coming only to have them never arrive.

This year is the year I buckle down and do rating scales. These are quick fill-in-the-blanks questionaries patients get and do after checking in and while waiting for their appointment. They are psychiatry’s equivalent to having your vitals taken whenever you visit the GP. Arguably, they are more objective means to monitor progress of depression, anxiety, well-being etc. It is also arguable if these rating scales really better treatment. Regardless, they are becoming standard of care; I might as well get the ball rolling before some outside agency steps in to tell me to do so or else.

Another matter seen every January is an upswing in pharmaceutical representatives. After a relative hiatus in November/December, they return en masse. I admire their perseverance, given there is only little-old-me to woo, and I badger them with questions they can’t answer. Perhaps there is a correlation to the deductibles and the return of pharm reps, who are flogging brand names. One of my medical new year’s resolutions is to not bear-bait them by poking holes in their presentations, but smile, nod, and listen. At least I always say thank you for their time, the food, and the samples they bring.

Otherwise my job is really no different day in and day out and each year is like the previous one. New patients show and old patients move away, drop out, or go elsewhere due to change of insurance. While it isn’t various, I take pride my work has meaning to it. ‘Burn out’ isn’t about working too much, it is about what you do feels to be of no meaning or value. By that definition I am certainly not burned out.

*Patients are picky about what they will buy/not buy. What makes something ‘too expensive” is subjective, and sometimes curiously at odds with other items. Outraged patients forgo their medication for cholesterol or depression, but not for anxiety. These are relatively not too expensive and insurance companies rightfully deduce if they are not covered the patients will pay for them themselves.

Brand names usually have

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