Wednesday, Wednesday!

Wednesday, July 22, 2009

Although today's patient load was middle of the road (41), the morning was the busiest part of my day.

Our office recently went online with e-Scripts and although it is currently slowing us down dramatically (as we continue to learn how to use it, and learn its idiosyncrasies), it will definitely save us time and effort in the long run.

Right now we are essentially "feeding" the system with each prescription we write. At some point we will be able to pull up the patient information and have the ability to view previous prescriptions and, with a few clicks of the mouse we will be able to refill that prescription instead of tedious task of searching the database for the correct drug, selecting it, choosing which dose, SIG, dispense and refills, etc., because we had previously "fed" that information into patient's profile.

e-Scripts is not just more efficient, it will also reduce the number of errors made when prescriptions are called in or faxed to the pharmacy.

I had the pleasure of working with two patients today, husband and wife, both in their 70's, that I had previously assisted around Thanksgiving. Not assisted as in they were my patients on that particular day, but physically assisted from the office to their car because the husband was so sick he was not able to walk and needed a wheelchair. The wife admitted to me today that she thinks about me often and how it was such a blessing I was there that day to help her and her husband and thanked me generously for my time. (It turns out her husband had a severe bacterial infection that took several months to resolve.)

Today they came in for their regular follow-up appointments which included determining their INR (coumadin/warfarin) levels. Being that coumadin/warfarin are blood thinners it is enormously important that these levels are checked on a regular basis.

The husband also received a B12 injection while the wife received a gynecological exam. I mention this specifically because I had both patients in the same room to do their intake and the husband cracked that he needed the "man's exam". The three of us really chuckled when I asked him if he meant the "finger wave?".

A third patient, female and 90 years-of-age, was clearly frustrated from the time she heard me call her name until I finished her intake. She was so distressed that her blood pressure was 186/92, when it usually falls within normal limits. Instead of waiting for the patient to tell me what was wrong I told her it was clear to me she was very frustrated. That broke the ice and she went on to explain how several phone calls had not been returned on the day she was admitted to the hospital ~ which was the same day as her last appointment, three weeks ago.

A fourth patient, who had been a patient of ours several years ago, had been referred back to our office by another doctor. During her intake she mentioned that 13 years ago one of our female doctors was the one who diagnosed her breast cancer.

I also had the opportunity of drawing blood on a new, younger patient, a 35 year-old man. (Our patient demographic leans heavily toward the over 65 crowd so it is refreshing to work with a patient near my own age.) I will be so brazen as to admit out loud that this patient was a quiet flirt, with amazing light blue eyes, and actually flirted with me.

Another young patient, a female around 30 years-of-age, also needed labs drawn today. Although she doesn't mind the needle itself, she hates the pain that the needle inflicts ~ which makes her loathe having her blood drawn. I told her I would do my absolute best to keep the pain minimal and set to work. I had already inserted the needle and was on my second tube of four when she asked me if that was all (the pain)? I told her it was and she said it was awesome and told me I was the best!

Recently our office changed the medication list (form) that is included in all of our patient charts (the list includes the medication, dosage, and instructions) so our intakes are taking longer than they used to. Any old medication lists (that are not on the new form) must be rewritten on the new form.

It's not a problem, per se, to do this, it's just that a generous amount of our patients are on more than a dozen prescriptions, from various physician's, and it is time consuming to translate all that information to the new form. For instance, a patient that was in our office today brought in a copy of his medication list that filled an entire 8 1/2 x 11 sheet of paper. It took me more than 20 minutes to copy all that information to the new form.

The afternoon was much more quiet and all the patients had been seen and checked-out by 3 p.m. so it was time to catch up on entering e-Scripts, pulling charts, and catching up on charting.