Home from Ohio!

I have not been able to blog for the last 10 days as I have been in Ohio helping my youngest daughter with her new baby!!  My seventh grandchild!!  I have had some time to think about a lot of subjects pertaining to medicine while I was not working daily at my clinic!  When one is rocking a baby there is time to think!!

I did have to do some work while I was gone.  It is always a struggle not to work when I am supposed to be on vacation!!  I tried very hard to limit it to just a few short hours and mostly did work when everyone was asleep.  But there is always work to do.  I often feel guilty for working too much and also for not getting work done!  It is a hard dilemma.

When a family physician, especially a solo practitioner as I am, decides to go on vacation, it can be a big job before and after the trip.  I am sure this may happen to anyone who owns their own business.  I have to make sure someone can cover for me when my patients need me and I can not physically go see them, especially at the nursing home.  Also, not being in the clinic daily, some activities cannot be performed by my nurse practitioners.  They cannot change some medications that are controlled substances.  There are tests to look at or a need for someone in my absence to look at the results because they may have been ordered before I have left for my trip.  There are papers to sign that only an MD can sign.  I am still always available by phone as long as I am in the country and I was called only a very few times while I was gone on this trip to Ohio.

Tomorrow I will go back to work and I look forward to being back at work.  The most difficult issue I have with being a physician is that I am always behind on clinic notes and I am working very hard to try to figure out how to keep this from happening.  I have struggled greatly with trying to keep up daily for as long as I have had my clinic.  When I am gone the notes also collect even more.  It is my responsibility to know what is going on with each of my patients so I look at every note my nurse practitioners do each day.  I am ultimately responsible for what happens in their care. I have to make sure each note is coded correctly, the diagnoses are in the right order, the education component is in the chart and the note is complete.  If anything is missing and Medicare comes in to audit our charts they will fine us or take back our earnings!!  Even though we have done the work, if we do not document correctly they will take back what we have earned.

One pare of my job that I really like is actually running my business.  Most physicians do not like this part.  So, I have also studied and read while I was gone about how to be a better leader/boss at my clinic.  It is something I am always thinking about.  Quality of life for everyone who works for me is important.    I also want to be an effective boss, teacher, business owner and physician to my patients.  On the plane I read a book called “Multipliers”.  I read about 3/4 of the book and it will hopefully, help me be a better leader.

We use a business model called SCRUM.  We started it about a year ago.  There are many business models out there but this one struck a chord with me as it helps us work together as a team.  We are working to be more efficient on a daily basis as well as have a much better flow throughout the day.  I hope to get the best work out of each and everyone of us so that we may help serve our community better.  But there is a balance between working hard and efficiently but also having purpose.  I don’t want to be a slave driver and I do want all my staff to feel happy and have purpose when they are working in our clinic.

So many ideas to think about!!  There were many other thoughts that went through my head this past 10 days that I will talk about as this week goes on.  I don’t want to make each blog post too long!


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