Friday, March 27, 2009

wal mart mentality?

someone's gotta do it, right? actually, someone is already doing it. and more are joining in every year it seems. i'm talking about urgent care, after hours, etc. 
it's being done, so instead of fighting against it, i should use the aikido strategy and take the opponent's strength and turn it to my advantage, right? i cringe when a mom takes a baby or a child to an urgent care center. why? two reasons: 1) i'm not the one seeing them so i don't know what they really had and whether the treatment was correct/appropriate, and 2) it means i wasn't able to see them. both reasons show my control freak nature, and my insidious pride - like they would've been diagnosed and treated correctly if i had seen them because of course i always make the correct diagnosis and prescribe the correct treatment. right. that we've established that...i can't work 24/7 - at least not for long, and i have to trust that there are other physicians/np's/pa's who can take good care of my patients after hours - of course i trust cathy - hello - so why do i resist it?
1) it's really not necessary. ok, neither is it necessary to be able to buy eggs at 2 in the morning, but if someone offers it, someone will take them up on the offer. need is not the issue. this is a drive thru world and by gosh, my kid got a fever an hour ago and i want him seen now. truly i understand this with work/school/fears of serious disease/too much information available to make people worry, etc.
2) it's an extra expense. it costs more after hours. and then many parents bring the child in within hours to days of the after hours visit for me (or their pcp if they aren't mine) to see them and to confirm the diagnosis and treatment. 2 visits, one problem, could've waited but didn't have to (see #1).
the solution? an urgent care where a trustworthy person over whom i have at least some control in hiring/supervising/advising/backing up is going to see that patient after hours. someday, maybe. but i think i have to give up trying to buck the current mentality of parents and go with it. but doing what the people want is not always the best thing for the people. how does one convince the people of that? 

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