At the Still Point of the Turning World
Residency is over, NOW what? (While I'm waiting for the answer, I'll get some spinning done....)

Tuesday, March 22, 2005


You may well be asking, "Why isn't Theresa updating her blog now that she's actually FINISHED residency and on easy street as a REAL doctor?" Well, the truth is, I've been too busy sleeping on the recliner by the pool to get near the computer and all these Shiatsu massages I've been getting impede my typing hand.

Or, if I'm honest....This real doctoring gig is not as easy as one might think. I started a full-time clinic job in January and have been seeing 80+ patients a week since then, which is not all that many in the scheme of things, but they've all been new to me, and that means familiarizing myself with their entire medical history, medication list, treatments tried and failed, etc. etc. This is the most difficult part of clinic doctoring: establishing care, getting to know the person within the patient, laying down the basic vocabulary of familiarity that will later serve as a kind of shorthand between the two of us. What will take only a couple of sentences to convey a year from now takes a half an hour of full paragraphs right now. I imagine we all go through this stage when getting to know people. It's just that I have to get to know about a HUNDRED people a week in this early stage of the new job, and for a fundamentally shy person like myself, this is truly exhausting.

I've also been learning a new system. In many ways, the services here in Humboldt County are much better than they were in Monterey--much more behavioral health and educational resources, and better access to specialists. The down side is learning the paperwork and how to get through all the hoops needed so that Joe Schmo can get into physical therapy or the MRI scanner. Luckily the clinic I work for has a fantastic staff and they do all the gruntwork for me. Having all this help is new to me--as a resident, I did everything myself--and takes some getting used to.

Then there's the joy of obtaining privileges and credentials with the local hospital and health plans...tons of forms to be filled out, a million copies of my medical license, diploma and board certification transmitted via FAX, modem and snail mail, all so that I, mere family doctor that I am, can order a simple mammogram or write admitting orders on a hospital patient. All of these things I used to do without any brouhaha at all, because I was a mere resident and my qualifications didn't matter.

Sometimes I miss being a resident...I miss working within a team, the security of knowing the attendings were standing behind us. I'm told these are mere growing pains, but I feel them nonetheless.