"In sixty-nine I was twenty-one and I called the road my own
I don't know when that road turned onto the road I'm on.
Running on, running on empty
Running on, running blind
Running on, running into the sun
But I'm running behind."
"We're stretched so thin, right now. No new hires in sight. Look at this list of patients: twenty-two of 'em, all over 70, eight "new's" among them, every one with tons of medical issues. Didn't get out of here until 10:30 last night. Then back at it at 8 (am) this morning. I'm telling you, I hate it. Hate it. There just doesn't ever seem to be an end in sight. We're just a bunch of "f**in' employees, and no one gives a damn."
I sat stunned. I knew him from before. His job had taken it's toll. This wasn't the guy I knew earlier. I really didn't know how to respond, but did suggest that maybe hospitalist medicine wasn't for him.
I had been there once. Like a fly buzzing against a pane of glass, persistently buzzing, buzzing, unable to escape, able to see the sun on the other side of the window, but no matter how hard I buzzed against that window, I could never make it outside. The forces against me were just too great. But it's right there! Can't you see it? If I just work a little harder. Hey, others can do this job, so I must just be doing something that I can fix. What can be so hard about this? Hell, I've got a medical degree! I'm smart enough to figure this out!
But only after the fly stopped buzzing against the window to noted that there was an open door right next to him, was he ever able to reach the great outdoors.
But woe to the fly that doesn't make the change...
... for if he keeps buzzing against the window, he'll die.
I've definitely been there -- having seen up to 19 patients in a half day at the clinic, with super complicated sick patients with poor access to care who come in when they are one step away from death's door at times. Our job as physicians is not an easy one. I feel his pain, and am pretty sure we all have been there at some point. You're not alone.
What's the door?
Who moved my cheese, comes to mind.
22 total patients, including 8 new ones that need H&Ps, is a 15-hour day for a good hospitalist. About a 10-hour day for a crappy one.
No one should have to do that five or more days in a row.
The doc doesn't necessarily need to get away from hospitalist work. He needs to find an employer who respects good physicians.
-Steve (hospitalist for 9 years)
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