Mark's musings

My turn to “blog” again… is that truly a word? So more about medical practice here. I am still in my first posting at Central Medical, a 4 doc group here in Oamaru. They did a very nice job welcoming and orienting me to the practice, and the receptionists were kind in the first 2 weeks not to overbook me. They use an electronic medical record, Medtech, as does much of the rest of New Zealand. Their office is in an old limestone building in the center of town, 2 blocks from the small hospital, where most labs and x-rays are done. The day’s patients are booked into 15 minute appts with double-books common as well, especially when one doc is on holiday, as one is now. I have also been out to each of the four rest homes in town, grouped around lunch for travel time, for emergency and routine visits. (It made me really appreciate my nursing home rounders back home.)

It has been a real learning experience to spend less time with each patient, and to call them from the exam room, do their vitals, and take the history and examine them all in my single office/exam room. (There is not a nurse for each doc.) Amazingly I am able to type a note as we go and finish most in the allotted time. That is unless they come with a more difficult problem, like depression, or accident/time loss with all the attendant computerized forms to complete. Or like my last 60 year old patient yesterday who wanted “everything checked out” and had not been seen in 4 years, with a BP of 142/94, etc…
I marvel at how I can see patients every 15 minutes and usually stay on time, while back home my nurse does the vitals, I have 20 min per patient, and I still fall behind. Part of the reason is that patients here come in EVERY 3 months for refills (or “repeats” as they say) and seem to expect short, more frequent visits. And there are virtually no adult physical exams. There are well children visits, but on a much briefer schedule to get shots. All cervical smears (Paps) are done by the two RN’s in the group, and they do virtually all the female vaginal exams as well.
And then there are the different words patients use to describe their conditions:
There was a GI bug going around and the first patient talked about “spewing“- I was surprised and asked what that was… vomiting! At least I knew what he meant when he said “I took crook” (very sick). When patient has a prescription it is the “chemist” who will fill it.
And finally, there is the wonderful “tea time”- it’s in every day’s schedule at 10:30 AM and 3:30 PM. And most of the docs and the 2 nurses each day get to these tea times, even if a few minutes late. It could be a catch up time at your computer, but everyone leaves what they’re doing to go sit together for a few minutes and chat over tea, coffee, or a snack. And patients who are waiting see us go and never give me a look of dismay… Wow!