Friday, July 3, 2009

Community Health

Happy 4th.
Yeah I am working today. I called my bank and the power company and they told me the bills were still going to be coming and no they wouldn't hold off on sending the bills because of Independence Day....hence we work.

Man it is these kind of holidays that make me think about what I have.
I mean can you even see the greatness of this country. We can say what we want, we can have our own businesses, we can worship who we want, we can drive cars to the grocery store that is right downt the street and if we don't like that grocery store we can just go two more miles and go to another one.
I think about how blessed I am not live in China or North Korea or Iran (they could be beautiful places, I am talking about their government).
I try to sit down with my kids and explain to them the enormity of this blessing. And when we pray I always thank God for it. It is really hard to explain to children.

We are off to our friends house for the yearly July 3rd bash. See they live about a 10 minute walk from great fireworks. So they have a party and everyone walks to the show.
Saturday the party is at my dad's. See he lives on a lake that beyond it is downtown. So we can sit on his deck and see the downtown fireworks.

I haven't mentioned it in awhile but the pregnancy is going well. We are due October 11th. Hilda is a champ. Can you imagine having three rugrats to parent and and doing all this with a basketball in your gut? Then having to cook dinner and clean the house.

Okay with all that out of the way...
Now that I talked about how great our country is I want to tell you about a government run facility that is the community health center.
As I told you before I worked there for about 5 years. I think I was there two days a week to start then I went to one for the last 3 years or so.
I was an instructor and I was "the" dentist.
I think the center is a must. People have dental pain and they have no means to pay (or they don't have all of the means). So I think it is our governments responsibility to take care of its people (now I don't want to get into who is responsible. The people are responsible for their health so is the government and so am I. But I don't think we have figured how all three can work together).
Okay so the clinic is there. I use to see patients for an exam and then we would schedule for treatment. Basic dental flow. But the first hour of the day, like I alluded to on Wednesday, is set aside for three emergencies.
Now this was first come first serve, so you never know what you are going to get. You could have someone waiting for 3 hours since 5am. Sometimes you can have 5 emergencies.
You know me. I am a bleeding heart. I don't want to know the story. I don't want to know that the guy is driving a corvette but says he can't afford a dentist. I don't want to know that this person has a dentist and a year and a half ago the dentist told them that they needed a filling.
All I know is this person is in pain, and I mean in a lot of pain, and they are in my waiting room.
At my office we do not turn away people in pain. This is where my office and my "clinic" office differ.
The employees at the clinic do not necessarily have the same attitude as me. See at my office if the staff I have are paid to be an extension of me. Now the staff at the "clinic" office are being paid to follow rules. It is a job to them.
It is a nine to five. 15 minute break in the morning, one hour lunch, 15 minute break in the afternoon.
It seemed that the attitude was, people are in pain....not my problem.
I would think that if this clinic did not have to have regularly scheduled patients they could fill a day with just emergencies.
But why would they do this? There is no incentive to see patients. There is no reason to help the fourth and fifth emergency. If they see those people they are simply working harder for the same price.
I told you I am not the boss here. There were many of times I just shook my head at the "systems".
Now all five employees have been there for over 20 years. They are working for a government organization. How easy do you think it was to get rid of employees that are worthless? It was impossible.
The front desk person, who was very nice, didn't care that over 50% of the patients didn't show up.
She didn't care if people waited for 6 months to just get into the program. It was not in her job description to be responsible for people to show up.
Now you know that we all confirm our patients. Why then do they not confirm?
Now it is not the staff I blame, it is the bossman. He was too busy getting grants and filling out pages and pages of paper work to have this facility running. I like him, don't get me wrong, but his is a real wussy. He would never get on his staff for taking a smoke break in the middle of a crisis (which I have seen many a times).
So I would go in and they would pay me a bunch of money and I would sit and do nothing for almost half the day, because people wouldn't show up, meanwhile two hours ago they sent three people away that were in pain.
And don't forget I wasn't the only one standing around. Don't forget the three assistants and the front desk person.
So what got me ticked about this whole thing was that I read an article about someone trying to be a patient in a government facility.
See to be a patient you have to call on the first day of the month and this is the only day of the month that they make new patient appointments. All the other days the recording tells the helpless patient that they are booking 6 months in advance. So someone that is calling and they call all day there is about a 10% chance they are going to get someone on the phone and if they do the first available appointment is next March (can't imagine why people don't show up).
So this poor person in the article was lamenting about trying to call at the right time and waiting months just to get someone on the phone.
Now I started to think back about my time at the place she was trying to call.
If I ran my business like them I would be bankrupt in a jiffy and if they every ran their place like I run mine they would be able to serve their community so much better.
The only problem with them running their office like mine is that they would have a staff mutiny. They just don't work like that.
I really like the hygienist there. I had a hygiene opening in my office so I asked her to apply.
She kindly declined. I couldn't understand it. But after I thought about it for awhile I thought to myself why would she want to change her job? She sees about 5 patients a day on a tough day. Great benefits. A pension plan.
The staff use to always complain about the job. One of the staff kept asking me if I had any openings in my office. I would pretend I didn't here her.
They are always talking about leaving and going to work for a regular dental offices. Man that would have been a rude awakening. I would have loved to see this.

I don't know why this article hit me so hard. I felt so bad for this woman. It just made me mad thinking about how they won't allow someone to schedule for a new patient exam because it wasn't the first of the month, knowing good and well that they have 3 hours open on TODAY's schedule.

Got to run. Party starts in two hours.
Have a great weekend,


Connie said...

Reminds me of working at the VA in residency. One small example of many - I worked in the dermatology clinic every Wednesday afternoon in fellowship. It was a tiny space, and every 1 PM when I arrived, 50 patients would be milling around in the hall outside the clinic, trying to check in and cram inside. There were enough exam rooms to see 3 or 4 people at a time. As the afternoon wore on, each patient would get madder and madder and complain about how long the wait time was, until around 4 PM people were about to rip my head off. I thought, man, are we really always that behind? Come to find out the staff were too lazy to schedule appointments every 15 minutes or whatever, so they scheduled EVERYBODY for 1 PM. That was the only appointment time ever given out for afternoon clinic. Even though we were always seeing patients until about 6 PM. And, the staff all disappeared at 4 PM, leaving the residents to fend for themselves. You had to beg them to not lock up the supplies when they left so you could still have LIDOCAINE for your patients who needed biopsies!!! AGHHHH. And, when we figured out the scheduling thing, they REFUSED to change the system and schedule like a normal office.

I think people think doctors are all money-grubbing rich people and that's why we don't want government run healthcare. It's not that. I want everybody to have healthcare, of course. I just have SEEN government run healthcare in a lot of formats, and I'm not excited about seeing the government play an even bigger role. I have no faith in them to not screw it up even more.

Anonymous said...

John that is just the way the government works. They are all lazy. At my VA residency we would race to see who could read the paper first in the morning. Lots of coffee breaks. 30 min suture removal. Manditory 2 appointment RCT. I was told you have the time so use it and take your time or else you will make the rest of us look bad. The best is the budget, order whatever you want even if you don't need it. Because we have to use up our budget or else it will get cut next time around. And the kicker is work half day and get paid for a full day of work.


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