The morning was fairly slow and I was able to spend all the time I felt I needed with the patients and did not make anyone wait very long. This afternoon, however, everything fell apart. I saw more than twice as many people as I saw this morning so I was seeing everyone later than their scheduled time. Some times were double booked as two people had been mistakenly dropped from the schedule on Friday without them having cancelled so they showed up for their appointment time which had now already been taken by someone else. Since it was our front desk's mistake, I had to see them which put me even further behind. On days like this you want to take that front office person and ring their neck but you smile and say "no problem, I had nothing better to do than correct your mistake".

Then, the last patient of the day was taken back at 5:20 and I had finished seeing him at 5:40. He then went out front to make a return appointment in two weeks and ALL the front office people had gone home so he could not make a return appointment today. That's what happens when the corporation that owns the group I work for puts the front office people under control of the admitting department of the hospital so they are cross trained and can fill in in the hospital rather than being under the control of our own team leader. I don't like this particular setup and this is a major reason. The medical assistant who works with me cannot go home until I am finished seeing patients and I believe at least one front desk person should also stay, they do in the private world believe me. If they were more responsible to the team, maybe we could cut down on some of the scheduling mistakes.

Enough rant for one night. I did get finished in time to get to worship team practice on time at 7 PM and now am home finishing this update. Then I will get things ready for tomorrow and get a little sleep tonight before I have to be back at the hospital in the morning by 7 so I can round on my hospitalized patient then go to my 7:30 meeting. I'm getting tired of hearing myself whine about my long day so I will stop now and write something about computers.

The office was hopping this morning with one patient having an acute asthma attack while at the same time another had a kidney stone. I had to try and be in two places at once so my split personality was useful <g>. Both ended up doing well, the person with the asthma attack went home breathing normally and the person with the kidney stone went home with pain meds to try and pass the stone in the privacy of his own home. I told him I would admit him if the oral pain medication wasn't enough or if he changed his mind and did not want to try and pass it at home. He should be able to pass it within the next couple of days and will bring it in to us for analysis.

This afternoon was not quite as hectic but was busy. We made some patients feel better, some were disappointed because I could not cure them today. One man came in hoping I could cure him from his back pain which he had once every 3-5 years, I had to tell him that I could not guarantee that he would never have the pain again but to be thankful it only happens every 3-5 years. Another man was convinced that penicillin which he had gotten from a dentist years ago would cure his mouth ulcer which are normally caused by viruses or trauma. I had to inform him that penicillin was no better than placebo for curing it, his dentist had probably used it as placebo knowing it would not hurt him unless he was allergic to it. Another eight year old boy had jumped off a slide yesterday and his foot was still hurting today. X-rays showed he had three fractures in the bones of the foot. Luckily, this can be treated with crutches for a couple of weeks then careful weight bearing without jumping for another two weeks, then he should be fine, kids his age heal so quickly. He will now have to watch recess and karate practice for a month, tough on someone his age.

Now I am at home after mens meeting and worship team practice. Dan Bowman was kind enough to inform me that my redirector page was still pointing to last week's page, I know I changed it Sunday night on my local copy but forgot to FTP it up to the web site, obviously. Now you can see that I actually did post last night. Until tomorrow then....

My ophthalmology appointment went well. I finally got to meet one of the local ophthalmologists in person after being here for two years. He and I were lamenting the lack of a local medical society here where new physicians could meet the other physicians in the area. It seems there was a strong local medical society years ago but when Kaiser Permanente came to town it fragmented the local medical community and the local medical society was a victim of that fragmentation. I moved here from an area with a strong local medical society and everyone knew everyone and supported each other. When an HMO, like Kaiser, moves into an area bringing in their own physicians to directly compete with the local physicians instead of trying to work with the local physicians then fragmentation occurs. Local physicians become upset with the HMO physicians and physicians stop working together and become strangers to each other. I don't know that years of this can be changed but it is worth a try if there are enough physicians here who are willing to try and mend some fences.

Now, back to what I was talking about before that rant. I now have new contacts as my vision had changed in the past two years, which I knew and expected. Things are a little clearer now although there was not a lot of blurriness with the old contacts. The ophthalmologist did warn me that I would probably need reading glasses within two years AT MY AGE. He thought I would need them now with the new contacts but I do not, small type is still not a problem since my arms are still long enough. Still there will come a day when I have to wear reading glasses with my contacts, I do not want to try bifocals or bifocal contacts, at least for the foreseeable future. I am happy with my extended wear contacts especially for running and other physical activities. I have thought some about laser reshaping of my corneas to eliminate the need for contacts but that will not fix the eventual problem with reading. I will still, one day, need lenses of some type for reading so I will not do the laser reshaping, at least for the foreseeable future.

At home, we are getting closer to being able to put in new carpet downstairs and get everything moved back to its proper place so the house has wider walkways again. We are not going to show the house again until things are back in their proper place, the realtor agrees with this plan also. For more details about this saga check out Delanae's page.

I kind of like being able to write this update and have it posted before 5 PM in the afternoon. Now I will have time after church to get better prepared for tomorrow and still get to bed earlier than I have been the last few nights. I still need to check out the other Daynoters' pages but have time to do that before church. I will probably not have an update tomorrow unless it is something real quick tomorrow night. I will have some interesting things to tell you about Friday after being on call tomorrow night so see you later...

I am happy but tired. I was awake, on the telephone, every half hour to every hour all night last night. And to think I wanted to get back to that. I had three admissions last night, two at 4 AM this morning. Then I got up again at 5 AM to get ready to come in to hand over the patients to one of my associates and then go to a meeting beginning at 7 AM. After that, it was a busy morning at the office with the highlight being a less than five minute telephone consultation with an attorney about injuries suffered by his client in an auto accident. I have never been on the telephone less than five minutes with an attorney because they are trying to get me to say things more favorable to their client. This one did not.

When I finished the morning, Delanae and the kids came by to pick me up and go to the courthouse where we sat and waited for thirty minutes for our five minute "hearing". Then, it was back to the office where I was double booked for the afternoon. This means that there were two patients scheduled in every slot, rather than the usual one. By the time I finished this afternoon, I had seen in almost two less hours the usual number of patients I would have seen in a full day. Luckily, there were no hospital admissions since I will be at a review course all next week and would have had to transfer their care to one of my associates. The review course is in Portland and runs from 8 AM to 5:30 PM Monday through Friday. I will drive down every day and back every night. I checked today, and I will be able to park in a large lot north of Portland and ride to downtown Portland where the course is being held and return on the public transportation system for less than three dollars a day. I will be able to miss all the rush hour congestion this way and the cost for one day's round trip ticket will be less than half of what the parking downtown would be. This will be my first chance to experience an urban mass transit system several days in a row.

Tomorrow, I will be going to Seattle for the committee meeting I had told you about Sunday. After that, I will drive right back since Delanae is not going with me. She has a remote at a local cellular telephone store to help with tomorrow morning so she and the kids will stay here. Hopefully, through her contacts at the store, I will be able to get a new cellular phone there one day in the not so distant future. Her radio station is buying her a new one since her first one is no longer holding a charge or charging up correctly. Installing a new battery did not solve the problem so they will simply replace the telephone.

So now, I'm going to end this post and go to bed so I can get up and drive tomorrow morning. I'm looking forward to sleep uninterrupted by the telephone or the beeper tonight. See you tomorrow......