Too Sick to See Patients
Medical providers get sick, too. As a matter of fact, we often get sicker than the patients that we treat everyday. Our immune systems are constantly being challenged. People cough in our faces; they sneeze on us; little children whip "stuff" on us. Our immune systems work overtime when we are working. And, when germs do make it through our defense systems, we will become ill. Of course, that is happening to me right now.
A few minutes ago, I called my office to have them cancel my patients for today. I feel real bad about this, but we have other providers in the office that can see the ones that we were not able to contact. Last week, my PA wife was ill. When they called to cancel her patients, they simply informed them that she would not be in today and they would have to re-schedule. That is not enough information. Patients need to know the reason why we canceled their appointment. I told the medical assistant to tell them she was ill. People really do understand that we get sick, too, and will be much more sympathetic when they are inconvenienced.
I work 12-hour shifts and handle a large percentage of the acutely-ill people that call on the same day. Acutely-ill people are the most contagious, so it doesn't surprise me when this happens from time to time. I don't believe I have been sick for about a year.
So, why am I blogging? I am bored. I have a pile of tissues accumulating on my desk; I am coughing my head off, have a fever, body ache, headache, and basically, I feel like crap. I was up all last night doing the same; keeping the dogs awake. My wife decided to sleep in a different bedroom.
There is a good chance that I have influenza. I certainly saw enough laboratory-confirmed cases recently. This year's flu vaccine did not make the cut. Every year, a new vaccine is developed, anticipating the virulent strain. This is based on the flu strain the hits the Southern hemisphere about six months prior -- their flu season is opposite of ours. Most flu strains originate in China, like most of the stuff we purchase. Influenza typically comes from pigs or fowl (Pleasant, huh?), so agricultural societies that have a close, intimate relationship to these creatures are the first to get these mutated animal-to-human stains. Some years, the flu vaccine is right on, or at least the flu type was similar to a previous year. This year? Not.
Many people think they have "the flu", but most are probably wrong. Influenza is a respiratory disease; not diarrhea and vomiting. It causes high fevers, severe coughing spasms, body aches, headaches, sore throat, malaise, loss of appetite, etc. When you have the true flu, even your hair hurts. At first, you are concerned that you may die. At the height of the illness, you start hoping that you do. Of course, death from the flu is not a laughing matter. Every year in the U.S., tens of thousands of people die from influenza and its complications. About 90 years ago, during the Spanish Flu Pandemic, about 20 million people died. Visit an old cemetery sometime and look at the dates. You will see a lot of 1918's, involving people of all ages, including many, many children.
My first step today is to see if I have influenza or not. This requires a rapid test from a nasal swab. My wife will bring it home over lunch. If I have type A influenza, I will start Tamiflu today -- an effective antiviral medication that will shorten the course and severity, allowing me to get back to work and see the other people with flu. If my test is negative, I will just wing it. Based on the generalized symptoms that I have, the most likely culprit is a viral infection. Viruses do NOT respond to antibiotics.
Tomorrow is my normal day off, so I should (hopefully) be back to work the following day. Most people with viral illnesses are contagious a day before, and about two days later. I should be fine in that respect. Since I see many newborns and well children in my practice, too, I do not want to expose them. Viral illnesses are truly the Gift that Keeps on Giving.
Today, I will just do what I can. Get plenty of rest. Drink fluids. Eat some chicken soup. Take some anti-inflammatories for these body and headache. If I try and watch TV or read, I will fall asleep. Perhaps, my body is telling me something.
These winter months are brutal in a medical practice. It seems like someone is out sick every day, and the demand for appointment always exceed the availability. We have an "open access" policy in our practice. This means that anyone who would like to be seen today; can be seen today. The patients love it. We are not so enthusiastic some days when we get home at 10 PM. When you are ill, you need to have access to your medical provider. We signed on for that job when we picked the profession. It really ruffles my wrinkles when someone posts on the WebMD ENT board, that they are sick, but their doctor can't see them for two weeks! That's crazy.
Related Topics:
Technorati Tags: flu, fever, aches, influenza, vaccine
A few minutes ago, I called my office to have them cancel my patients for today. I feel real bad about this, but we have other providers in the office that can see the ones that we were not able to contact. Last week, my PA wife was ill. When they called to cancel her patients, they simply informed them that she would not be in today and they would have to re-schedule. That is not enough information. Patients need to know the reason why we canceled their appointment. I told the medical assistant to tell them she was ill. People really do understand that we get sick, too, and will be much more sympathetic when they are inconvenienced.
I work 12-hour shifts and handle a large percentage of the acutely-ill people that call on the same day. Acutely-ill people are the most contagious, so it doesn't surprise me when this happens from time to time. I don't believe I have been sick for about a year.
So, why am I blogging? I am bored. I have a pile of tissues accumulating on my desk; I am coughing my head off, have a fever, body ache, headache, and basically, I feel like crap. I was up all last night doing the same; keeping the dogs awake. My wife decided to sleep in a different bedroom.There is a good chance that I have influenza. I certainly saw enough laboratory-confirmed cases recently. This year's flu vaccine did not make the cut. Every year, a new vaccine is developed, anticipating the virulent strain. This is based on the flu strain the hits the Southern hemisphere about six months prior -- their flu season is opposite of ours. Most flu strains originate in China, like most of the stuff we purchase. Influenza typically comes from pigs or fowl (Pleasant, huh?), so agricultural societies that have a close, intimate relationship to these creatures are the first to get these mutated animal-to-human stains. Some years, the flu vaccine is right on, or at least the flu type was similar to a previous year. This year? Not.
Many people think they have "the flu", but most are probably wrong. Influenza is a respiratory disease; not diarrhea and vomiting. It causes high fevers, severe coughing spasms, body aches, headaches, sore throat, malaise, loss of appetite, etc. When you have the true flu, even your hair hurts. At first, you are concerned that you may die. At the height of the illness, you start hoping that you do. Of course, death from the flu is not a laughing matter. Every year in the U.S., tens of thousands of people die from influenza and its complications. About 90 years ago, during the Spanish Flu Pandemic, about 20 million people died. Visit an old cemetery sometime and look at the dates. You will see a lot of 1918's, involving people of all ages, including many, many children.
My first step today is to see if I have influenza or not. This requires a rapid test from a nasal swab. My wife will bring it home over lunch. If I have type A influenza, I will start Tamiflu today -- an effective antiviral medication that will shorten the course and severity, allowing me to get back to work and see the other people with flu. If my test is negative, I will just wing it. Based on the generalized symptoms that I have, the most likely culprit is a viral infection. Viruses do NOT respond to antibiotics.
Tomorrow is my normal day off, so I should (hopefully) be back to work the following day. Most people with viral illnesses are contagious a day before, and about two days later. I should be fine in that respect. Since I see many newborns and well children in my practice, too, I do not want to expose them. Viral illnesses are truly the Gift that Keeps on Giving.
Today, I will just do what I can. Get plenty of rest. Drink fluids. Eat some chicken soup. Take some anti-inflammatories for these body and headache. If I try and watch TV or read, I will fall asleep. Perhaps, my body is telling me something.
These winter months are brutal in a medical practice. It seems like someone is out sick every day, and the demand for appointment always exceed the availability. We have an "open access" policy in our practice. This means that anyone who would like to be seen today; can be seen today. The patients love it. We are not so enthusiastic some days when we get home at 10 PM. When you are ill, you need to have access to your medical provider. We signed on for that job when we picked the profession. It really ruffles my wrinkles when someone posts on the WebMD ENT board, that they are sick, but their doctor can't see them for two weeks! That's crazy.
Related Topics:
Technorati Tags: flu, fever, aches, influenza, vaccine
10 Comments:
I noticed you frequently refer to your "PA wife". What does PA stand for?
Get well soon!
A "PA" is a Physician Assistant -- a highly-trained medical professional that provides a wide-range of medical services, from primary to specialty care. There are over 80,000 licensed PAs in the U.S., and PAs are now being trained and employed in the United Kingdom, Canada, Australia, and some parts of Europe. My wife has nearly as many years in clinical practice as myself,and we work together in the same practice.
For more information, check out www.aapa.org or www.capanet.org
Oh, how I wish your practice were in my city. When I moved to my small town a few years ago, I realized I had taken my daughters' very large former pediatric practice for granted. I could always schedule same-day appts. for my kids if they were sick, even if we couldn't get in to see their regular dr. Where I live now, no pediatricians seem to run a practice with multiple drs., so I often end up in the walk-in clinic for things like strep.
I absolutely also love your insistence on letting patients know why doctors are out--little gestures of respect like that mean a lot.
Dr. Moser, I agree that sick patients should be seen when they are sick and not 3 weeks later.
If my doctor doesn't have any appointments available, I can usually see his PA. If there are absolutely no openings available at his group, my medical has 3 walk-in care offices I can use.
Although I wait longer at walk-in care, the doctors are all part of the same medical group and have access to my records electronically.
Also whenever my doctor has had to cancel appointments, I am told the reason.
Two weeks is nothing to wait. I had C. diff a few months ago and when I called to make an appointment with a gastroenterologist to see if there were any long-term problems I should be aware of, they scheduled me for an appointment TWO MONTHS away. I've found that when a patient calls to make the appointment, it's way off. If a doctor's office calls, it's the next day. I guess they figure patients are all making it up. A little respect would go a LONG way in these matters too.
Dr. Moser, I loved your blog. I work in Canada as a Charge RN, full-time nights, at a nursing home with around 200 residents. I get to field all of the last-minute call-ins from PSW/HCA who are sick, but seem to never get a sick day for myself. With the nursing shortage, I never have anyone to fill in for me, and if I call in, and they can't find anyone, they call me back begging. And yet, they post all these things around the facility that if you are sick, not to pass it along to others!! It's so nice not to feel alone!
PS - Feel better soon!
Giggle - LOVED your blog - I had the Auzzie flu a long time ago and believe me...I DID want to die!!!
My fever was 106 and STAYED there thru out that whole LONG 6-7 days!
I fianlly went back to bed (I sleep in the livingroom when I'm ill because going to bed is waiting to die - it's a "thing" with me), anyway, I told God to either heal me or KILL ME but I didn't CARE ANY LONGER!!!
My DH took me to the hospital, and they gave me meds that were the same, but in a stronger dose to help me thru it, but I still felt rotten.
I went to bed one night after the hospital visit, and awoke around 9 or 10 pm, soaking wet - even my HAIR was soaking wet as if someone had just pulled me out of the pool, but BOY! DID I ever feel GREAT!!!
I had to get up and change the sheets, blankets, my clothing and take a shower to get clean again - I will never forget that period in my life...
Drink your oj, take your meds, get some rest, and have some chicken soup - we call it Jewish penicillin at our home (I'm Jewish)
May you get well soon, and go ahead - watch the TV - you NEED the SLEEP!!!
I am better...still coughing, but certainly not feverish or contagious at this point. I would still like to take an afternoon nap. I am back to the clinic today seeing an on-going dance of sick people again. I hope I don't catch anything else....I need a break.
Thank you all for your kind comments and get well wishes.
I work for a pediatric group with 4 physicians in the front office. The winter is so hard, we are getting killed with all the flu and strep. Although we do not take appointments after 5, our last patient is scheduled at 4:15, we always have work in patients. On most days our entire schedule is full by 10am and as you know this does not make the other patient's parents happy that call after that. So the ones that get worked in put the entire schedule behind, so patients complain. Being at the front desk we get the brunt of the angry parents.
Personally I think during the winter we should not take any well checks except for newborns to 18 months, the others can wait until the winter is over.
Anyway, thanks for letting me vent.
Feel better, Jlea
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