Last Week



Doc's Progress Notes

Week of February 5, 2001

Last Updated: 2/22/2001 at 9:12 PM PST

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Monday February 19, 2001

Things have slowed down some in the hospital. That means that the RSV epidemic here must be about over. I only have one patient in the hospital now and she should be discharged tomorrow. In the office I am not seeing near as many kids with cough and wheezing now as I did the last two weeks. We really haven't had an influenza outbreak here, just a few cases over the past couple of weeks also. Hopefully, the low hospital census for our group will continue through the weekend when I am on call.

The low hospital census does hurt us in one way however. Both the hospital and our medical group are owned by one corporation making us an integrated healthcare delivery system. The decision was made some years ago to use the ancillary services (x-ray, ultrasound, laboratory, etc)of the hospital rather than keeping them independently in our offices. That means that the traditionally profit making part of the clinics were taken away leaving only the income generated by us seeing patients. Since our margins are so thin, as they are in any medical practice these days, most of the time we barely break even or even lose money but the business we send to the hospital more than makes up for that. Now, if the hospital has a low census also that puts a double hit on our regional balance sheet. Amazingly, our medical group is managing to break even at the present time and our family practice team in particular is in the black. This is in stark contrast to a lot of large clinics across the country which are currently going broke and breaking up due to the effects of continuing lowered reimbursements and higher overhead costs. We know of one clinic in Olympia, which is about fifty miles north of here, which has been in business for fifty years but is in the midst of bankruptcy now. The individual doctors in the clinic can either take jobs with other groups like ours or try and borrow a few hundred thousand dollars to open their own office and try to make that way.

Our group is on very solid financial footing because it is a multiregional healthcare delivery system. If one region is not in the black then the others can support it until that region is back in the black again. Our region currently has the pressure of the debt service on our now one year old sixty million dollar building project. That will decrease over the next few years and we should return to the black again. It would also help if we could stop the migration of 15-20 hospital patients per month to Portland area hospitals. That would be enough to keep the hospital in the black every month and make our regional year end figures look better.

I called about my Compaq Pocket iPaq today. My order is in the top thirty orders waiting to be shipped as soon as they get their next shipment of iPaq's from Compaq. The customer support person could not tell me how many iPaq's were expected to come in shortly but it was anticipated to be very shortly. They did promise to call me if the shipment was delayed. I am hoping to have the iPaq within the next two weeks but that may be too optimistic. I see where Compaq is coming out with a 64mb version sometime this year. That model will probably ship right after I get my 32mb version.

I am still getting my tax information together and probably will be the rest of this week. I am trying to locate one record which I know we have but in moving offices may have been misplaced. I need it before we can send the information in. Hopefully, it will turn up later tonight. See you later.

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Tuesday February 20, 2001

No meetings today which meant I got some work done. My schedule was packed and I saw work-ins as well and still got finished fairly close to on time. Most of the patients today who were sick had upper respiratory infections. I did see three children from one family, only two of who had appointments. I didn't protest as they are all foster children and the total number of children in that family is eight, all but two foster children. The mother in the family is also going to college in Portland, I do not know where she gets the time. I asked today who does the dishes for the ten family members and she told me that the three oldest children do all the dishes. I did not ask how she kept up with all the laundry that crew must generate. I am only too happy to help them any way I can, even if it means fitting one of their children into an already overcrowded schedule.

I got home in time to watch the Arkansas Razorbacks beat South Carolina on a three pointer in the last fifteen seconds. The game was nationally televised on ESPN and will probably be the only game I get to see them play all year as I doubt I will get to see any of their games in the SEC tournament unless they make it to the final game of the tournament. I have kept up with them by reading the online editions of a couple of Arkansas newspapers. The current team does not have the talent that past Arkansas teams have had, including the one that won a national championship and played in the national championship game the next year, both early in the 1990's. It seems that their coaching staff cannot get the caliber of player that they used to recruit routinely. Here's hoping the basketball recruiting makes as big a comeback as the football recruiting is doing.

Tomorrow I have three meetings once again. One is by video teleconferencing and the other is by telephone call. Unfortunately, one is at 8 AM and the other at 2 PM so that means I have to make two trips to the office complex tomorrow. The other meeting is at noon and will be with our former pastor who remains a close friend. We get together once in awhile to just talk and find out how each other is doing.

Tomorrow night, I am going to Tigard again with Delanae to a meeting about Scheduled to be there is the founder of the company so I will get to meet him in person. That makes it an important meeting and the reason I am going. There may not be an update tomorrow, we shall see if I have time during the day.

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Wednesday February 21, 2001

A true day off, well, as true as mine get anyway. I had no patient contact today since I have no one in the hospital at the present time and had no appointments scheduled today. I did call a neighbor who is a patient about a medical problem that he has so I guess I did have patient contact today. Forget that I said anything earlier about a day off.

Two of my meetings happened, the lunch did not as he doesn't feel well. Technically, that is another patient contact I guess. Both meetings did generate e-mails that needed to be sent to various people in our organization so I ended up staying at the office longer than I had anticipated. I saw that the charts are already starting to stack up on my desk there so tomorrow will be busy from the start. I have an optional meeting in the morning which I believe I will option out of.

Delanae and I are headed to Tigard again tonight. That is just south of Portland and where the business meetings for are held. We will eat at a local restaurant first then head down that way. Stephen will once again be responsible for picking up his sister at church and getting her home later tonight. There are advantages to having another driver in the house.

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Thursday February 22, 2001

Today was a very uneven day. I had several no-shows again but at other times I was very busy. The morning began with no shows and as the morning got later I got more and more busy. Our hospital service is still rather small which hopefully means it will stay that way over the weekend. I have no one in the hospital although I was expecting to admit one patient today but he was a no-show also. Actually, it is a six month old baby who is not gaining weight and his mother reports that he is vomiting again. She was supposed to bring him in this morning but did not show. Hopefully, he will be brought in tomorrow. We tried to call them all day but there was no answer, a message was left on their answering machine.

Tomorrow begins with a meeting conducted over the internet. We will be looking a problems with our electronic medical records software package and trying to identify ways to fix them or how the company who wrote the software can fix them. This will be my first "Net Meeting" and I am looking forward to it. After that, I have a full office schedule then I am on call tomorrow night. Delanae and I are supposed to have dinner tomorrow night with a candidate for one of our empty family practice slots in our group. Hopefully, I can make it to the dinner and be able to stay long enough to eat. Then, Saturday I am supposed to give the candidate a tour of our hospital before working the rest of the day in our urgent care clinic. We have another candidate interviewing Monday for the same position, I will have lunch with that candidate.

Time to close this update now and FTP it to the website. Then, I need to get ready for tomorrow and get some rest tonight. See you sometime the next three days, I hope.

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Friday February 23, 2001


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Saturday February 17, 2001

No update.

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Sunday February 18, 2001


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