The Vanishing Oath

If you're a complete medical internet dork like me, you've no doubt heard about The Vanishing Oath, a documentary put together over two years by an ER physician. I just ordered it. I just ordered it after I just watched this short clip

The path to patient care is lined with numerous obstacles

And then I just cried. Sure, our narrator is talking about the ER, but it's the same everywhere. Electronic charts, hospital administrators, forms, insurance companies, prior authorizations, Purell, CLIA-waived nonsense, 90-day prescriptions.....

How does this affect you? Every single doctor in these United States, unless they are cash-only (maybe), had to deal with about three of these before he or she walked into the room to see you, your child, your grandma, your sister, your husband. How distracted do you want your doctor to be? Medicine isn't easy. You're not easy. You want your doctor's full attention, or do you want 20%? The other 30% is going to the chart, 20% to racing mentally through the 50 things you have to do for other patients, 10% to the patient who just left whose electronic chart you didn't have a chance to finish because the computer crashed in the middle of your note, and 20% to just how pissed off you are....

New England Journal had an absorbing piece that resonated with moi about what keeps primary care docs to busy. It's free to read. Just skim it:

What's Keeping Us So Busy: A Snapshot from One Practice

You think your one or two little prescription refills handled over the phone add up to not much, and you're correct. Multiply that by 20 prescription refills, 10 consult letters to review, 5 xray reports, 3 pathology reports, 5 out of 20 appointments that ran over because the patient issues were so complicated, and it ain't nothing. It's the death of primary care.