Sunday, June 23, 2013
With many of the EMRs, docs are using Dragon software to dictate. Dragon is amazing but you "have to train your Dragon" and some dragons are not well trained. On top of it, there is now pressure to have a complete note for the patient to have when they check out, as this is another one of those "mandates". The result is that the note is made entirely of macros with a small Dragon dictated blurb at the bottom that you don't have time to proofread. As you can imagine, the notes are not very useful but can be quite funny. Some of my favorites are " the incision was opulent", (instead of purulent), "the patient was singularly pathetic", (the patient was on singular and patanase). The best is when someone is dictating and then answers the phone, so the Dragon starts typing what he said on the phone. I had one note that ended, "fine, love you too!"
I had to have a prescription filled at the local chain pharmacy. The pharmacist handed me the script and it was only for 30 days instead of 90 days. I asked why they altered the script for a smaller amount. He got a little nervous. I then said, my copay is 10 dollars for this generic, how much is the cost if I pay cash for all 90? He got more nervous then said $14. So, to get it straight they will break a 90 day script in to three 30 day scripts so they can triple the copay. At first, the people in the line behind me were annoyed because I was taking so much time, after hearing what had transpired it was game on with each of them checking to see if their scripts had been altered. This is the same chain pharmacy that is so determined on electronic scripts so that people cant call around to see who has the cheaper prices!
Tuesday, June 18, 2013
It is near the end of the year and the interns are a bit burned out. We had an avid medical student here on an audition clerkship and overheard two if the interns talking about which one of them was going to see which of the "artists" in the Emergency Department. After a few minutes he approached me and said something to the effect that there are a lot of artists here in this area. I didn't want to burst his idealist bubble of sculptors and painters but I finally had to let him in on the meaning of the term. I explained that "Artists" are those who are really good at drawing. They are good at drawing disability, social security, Medicare, Medicaid, food stamps, Obama phones and everything else while they sell drugs and sponge off society.