October 1, 2017 marks the one-year anniversary of my medical practice relocating from Tujunga to the Healthcare Partners/DaVita Verdugo site right next to Verdugo Hills Hospital. I’m asked by patients all the time how I like the move, so I thought I would share a few thoughts about the past year with everyone.
I must admit, life this year has been full of changes and therefore quite challenging. It was a bit like moving out of the home you’ve lived in for over 20 years into someone else’s house. Then finding out you’re throwing a dinner party the next night for 20 people. And that you aren’t allowed to cook with any spoons. Not that you know where the spoons are anyways. Everything was different… this traffic going to work, the rooms, the staff, the leadership. Stuff was in boxes (some of it still is) and I didn’t know the names of everyone in the office for a month. There has been a huge struggle in all the logistics of absorbing extra patients since we lost 2 doctors and a third one in the building retired. Patients were showing up at the wrong office or getting stuck in traffic or ending up at the wrong building. There weren’t enough appointments available. There weren’t enough doctors.
I think the biggest adjustment for me as a physician is the huge difference in mindset of taking care of patients in private practice versus taking care of patients in a corporate setting. During all the years I spent in Tujunga practicing as a country doctor, the things that I loved the most were the things that I did for patients that reflected love, relationship, and community. I remember going in on Saturdays to stitch someone up with no insurance. I remember staying until 7pm so that someone could get a breathing treatment instead of going to the ER. I remember sending my staff to the pharmacy to pick up medication for the patient because they were so sick. One of my husband’s patients had no family and was put in a board and care. We used to go to his apartment to get clothes for him and bring him his mail. We took his checks to the bank to deposit them for him. We went to see him on Christmas Day and brought him See’s candy because he had no one else. These are the things that I miss most about Tujunga.
Medicine has changed into a game of metrics and pseudo-efficiency. We now practice with administrators who time how long the staff are on phone calls and don’t allow Pap smear bottles or tubes of KY jelly to be in the rooms for fear that patients will drink the liquid or swallow the gel. Life is ruled by policy and procedure with no common sense to balance it out. I think we’ve lost the ability to think critically and as a result, made life too complicated and inconvenient.
The demoralization that I wrote about a couple of months ago stems largely from my grief in witnessing the slow death of the art of medicine. I feel like staff and patients are viewed as electric plugs that can be plugged in and pulled out. The HCPs of the world think that theoretically, all the plugs should work the same. But I know the truth. People want to be valued, loved, cared for, and inspired. People want to be recognized for their unique gifts. People want rich relationships and a deep sense of community.
At times I find myself tearing up with sadness. It seems that every few weeks I have a resignation crisis when something really soul-sucking happens at Verdugo. Some patients have just elected to pay cash and see me for their office visit in Tujunga where I have more time and I’m not bound by so many rules and regulations.
Where do I see this going? I don’t really know that answer. I don’t want to give up medicine because I love it so much. If I had enough money to live on and didn’t have any debt, I’d just see patients for free because it’s so fun. It’s all the other heavy stuff that goes with an insurance-based practice run by a huge corporate entity that’s so very hard to deal with.
Right now, I’m trying to find ways to ground myself. I’m trying to give feedback to our leadership in the hopes that they use the information to learn how to inspire confidence, trust, and loyalty amongst employees and patients. I’m trying to figure out how I can continue to treat each person as perfect and holy (including myself) while staying within the guidelines that dictate what I can and cannot do.
Yeah, it’s a tall order. But I guess that’s what life is all about, no?