The community of patients that our ophthalmology clinic serves is notorious for providing bogus contact information. This includes phone numbers, addresses, and sometimes even ages. This is likely not intentional–they travel back and forth from their home country frequently. Many of them do not have a permanent U.S. address and provide a relative’s, friend’s, or neighbor’s when asked. This is problematic when we have to contact them.

For missed clinic appointments that is usually not a problem. They can reschedule at their own leisure, and there are usually enough patients to be seen in clinic already. Our surgical numbers, however, are dependent on our ability to reach our patients.

I had 2 patients that I’ve been trying to schedule for pterygium surgery, and none of their provided telephone numbers work. How can I reach them? I have a listed address on the demographic sheet, but should I go to their house to ask them to return to clinic for surgery?

Imagine that your doctor shows up at your doorstep to get you to have surgery. How would that feel? I wonder if he’d be treated like any other annoying traveling salesman hocking his wares.

I guess I’ll find out soon enough…

medicine ophthalmology, rant

Some IT departments are simply bad. I have been struggling over the last few weeks to obtain login access to the computer I use in the clinic. Without access, I’m unable to view any of my patients’ medical records.

I called the helpline responsible for the computing systems (5-HELP). After several prompts and minutes of waiting, I explained to the support staff my problem. He replied, “Oh, that’s a hospital computer, you need to call 4-HELP.”

I subsequently dialed 4-HELP, and waited through a suspiciously similar system prompts. The support staff on 4-HELP explained to me that even though the computers in question were in the hospital, they were controlled by the university. Hence, I would need to dial 5-HELP for support.

I explained to him that I had already done that, and he retorted, “You’ll have to speak to you departmental administrator.” I asked my program director’s secretary what I needed to do, and she told me that she had done “everything possible to activate my accounts” (translate: I’ve done nothing). I would have to dial 5-HELP for help.

Painful.

computing, medicine computing

Those who have completed their ophthalmology residencies can vouch that it wasn’t easy. There is variability in the efficiency in which a resident clinic operates, but most of them are busy. You have an excessive number of scheduled patients along with walk-ins that consume your day. In addition, there are insurance and scheduling issues to consider. If you are in a small program, your call schedule will be packed.

My medicine counterparts whine to me how dermatology and ophthalmology consults are so lazy because our consult notes until the next day. Most of the time we do our non-emergent consults in the evenings. During the day we have clinic patients to see. The program I am in has a resident rotation dedicated to consults, but it is intermingled with surgical time. We run between clinic patients to see our inpatients, and many of our evenings and weekends are filled with lectures or clinic.

The most difficult adjustment that I’ve encountered in my two weeks of residency is that I am a PGY-2 with intern knowledge. Our medical education is geared toward training us to be internists, not surgeons or subspecialists. We have to relearn a dedicated physical exam for the eye. Right from the beginning, we are (in theory), the experts in our field.

Hopefully, it will be easier as the year progresses…

medicine ophthalmology

I recently started my PGY-2 year. The experience is intense, and I haven’t even finished the first week. I had been anxiously anticipating starting training as an ophthalmologist the last few weeks of internship, and there has been no disappointment thus far.

I feel like an intern all over again, only worse. As an intern in medicine or surgery, I still had an inkling of a differential diagnosis for abdominal pain or any other common complaint. Medical school was grounded on core medicine. But ophthalmology? A foreign language to most physicians. Physical exam? No idea. And the fact that we’re on call an average of Q3-Q4, things have been busy.

Sorry for the delayed updates folks! More to come!

medicine ophthalmology

I recently watched The Hangover, a hilarious comedy about a bachelor party gone awry. There was a scene in which Zach Galifianakis was ridiculed for carrying a satchel by his friends. “You’re carrying a man-purse!”

That brought back some memories of my experience during my family medicine rotation during internship. I had carried a nylon briefcase from the AAO 2008 meeting to work and one of the FM sub-i students remarked, “Is that a man-purse? Whoa!”

Mind you, the AAO briefcases do not even compare in quality or in metrosexuality as the Timbuk2 messenger bag above. If I had my way, she would have gotten an “F” for insight. Clearly the philistine doesn’t know the difference between a briefcase and a messenger bag.

medicine medicine, rant