Notice, I omitted the several hours at the end of a long clinic day that I used to spend thinking it would be less painful to gouge my eyeballs out than to sign endless prescription refills, notes from specialists who have consulted on my patients, disability forms for people who don't really deserve disability benefits, forms for diabetic shoes, electric scooters, walkers, canes, prior-authorizations for drugs, FMLA forms, and nursing home orders. Of course, most of these forms require rumaging through the patient's chart for a few minutes to confirm diagnoses, last vist dates, current medications, blah, blah, BLAH! When that's all done after seeing 25-30 primary care patients a day (5 of whom typically break down crying in front of you), you get to sit down and call the 10 or so patients who demand your call before you get to head home to your family. When you get home at 7pm - 8pm, you get to answer your pager all night from patients who think they just might die by morning if they don't interrupt your dinner and bedtime with your wife and kids. Then, every two weeks you collect a check which is, in general, the lowest pay in the medical field. This is the life of the primary care provider.
My life went from that described above to...well...I call it Margaritaville.
Three years ago I left my primary care internal medicine job to join an academic specialty clinic. Now I know how Edison felt when the light bulb went on. Wait, you mean I actually get a raise, get to see fewer patients each day, and I don't have to do any primary care grunt work? Is this a joke? Come to office, see patients, go home? Where's the hidden camera? What's the catch? Are you going to make me vote for Hillary? Are you going to force me to be a card-carrying member of the ACLU? I don't get it.
People, please appreciate those that do the grunt work on the front lines all day, every day, for the lowest pay in our wonderful profession. I appreciate the fact that I don't have to do it anymore - and I have the utmost respect for them. I just happen to now thank God every day that I don't have to do it. And, while they are filling out endless forms, refiling prescriptions, and calling patients back from 5 pm to 7 pm every night, I get out my margarita mix and tequila, throw some ice in the blender, put my feet up, and mix up a margarita that Jose Cuervo himself would be proud of (off ivory tower grounds and on my own time, of course)
The whistle blows at my clinic now at 5:30 pm every day...a place I now refer to as 'Margaritaville'.