Tag Archives: Job

Work Environments

As many of you know,  I have been job hunting. My first job after residency was a complete nightmare, and I am terrified of getting into another situation like that.In my interviewing process, I’ve come to notice there are three types of work atmospheres- profit driven, patient centered, and physician friendly.

My first job was very profit-driven. My employers were so focused on the bottom line that  patient care and my physician well-being was suffering. The administration would make sure the schedule was double-booked and I would be pressured to order unnecessary tests and referrals. Medicine becomes like factory work, just putting forth product to pay the bills.Every day was a battle with my ethics and the miserable feeling of coming home knowing I was unable to care for my patients the way I wanted to.

In the completely patient centered environment, the focus is on the patients and providing the best care without regard to money or cost. A doctor could spend as long as the patient needed and handle all issues in one visit.The doctor would always be accessible. They would stay late, come in every weekend and holiday, and always be on-call. seems like an ideal practice model, but leaves a lot of room for a physician to be taken advantage of, and not be able to make the money necessary to run the practice.

In a physician friendly atmosphere, the doctor’s lifestyle takes priority. They would only have to see ten patients a day and still make enough money. They could choose only to see the friendly, compliant, and easy patients and refuse to see the demanding, untrusting, and challenging ones. They wouldn’t work weekends, or evenings, or ever be interrupted at home for a patient calls. A great situation for the doctors and their families, but not so great for the patients.

I think the ideal practice is a combination of all three. There has to be a drive to work harder and have the ability to earn more and be rewarded for going above and beyond.There also has to be an environment where a patient can have the access to quality care, and have the time to discuss most of their issues. And there has to be an environment where the doctor is not overworked or over stressed, and can focus on giving the best care possible. I truly hope I can find a balanced practice, and that wherever I go, I will be able to practice medicine the way I believe.

Moving

Well, I am moving in less than a week for my husband’s job, and I am starting to stress out big time. I’m not good with change, and this is a lot of change all at once. We are moving to a completely different city one hour away from where we were before. It’s taken the four years that we’ve lived here for me to finally get comfortable and make friends, and now we’re moving. There isn’t a bone in me that wants to move, and I’ve seriously been dreading moving day.

We will have a new home which I love, but I will admit I’m nervous about because of the stairs. Normally stairs aren’t a problem. I do the stair master at the gym, which, BTW ladies does wonders for the booty. But when I’m having joint pain, or a really bad flare, I worry about getting in and out of the house. It was a concern before I chose this place, but it was the best choice due to location and space.

Then there’s the job hunt. I’ve interviewed at a few places, but I haven’t signed a contract yet. I have this huge fear about about getting stuck in a miserable practice that is completely profit driven, instead of patient centered. I had a really horrible experience with my first job that I was at for two years. I’ll tell you the story sometime, and you’ll understand.

And the packing is making me crazy. It isn’t just that it’s physical labor but it’s emotionally taxing. I am very sentimental and I save everything. I’m talking receipts from a romantic dinner my husband took me too three years ago and clothes that I wore in high school (they will NEVER fit me again). Moving is the best time to de-clutter, and I’ve had to grudgingly throw away a lot of things that I’m seriously attached too.

With all the stress and change, I’m starting to worry about having a flare. And that’s when I realize, I just need to stop, take a deep breath, and know that everything is going to be OK. Life is going to be full of change, especially when I have lupus. I just have to have relax and have faith that I’m on the right track. God’s got a plan for me far better than I could even imagine.

My Story: Part 3- Residency Continued

Although I was glad to be able to finish residency, it was not easy. There were days when the pain in my knees would be so bad I would be limping from room to room. The fatigue had gotten better with the high dose of steroids sending me into a state of jittery high, but after I had spent all my energy, I would crash hard.

I remember one overnight call, where it was an especially busy night. I was stuck in the ER doing admissions. The floors were also busy with critical patients, and nonstop codes. Perhaps it was a full moon. I kept finishing one task, hoping to be able to sneak off to the call room , eat something, and take my meds, but only to have another urgent task awaiting me. I watched the clock, 10 o’clock, 11:30, midnight.

I eventually caught fifteen minutes to eat, but after that it was back to the grind. The work seemed endless, my body ached, and I could barely keep my eyes open.  I remember finishing up my admissions, and as I was walking out the ER at 4 AM, the ER attending tells me he’ll have another patient ready for admission in another hour. I went to lay down for the hour, and prayed that would be the last one before sign out.

There was also the time when my left eye vision became blurry. I was in the middle of interviewing a patient in the ER, and I didn’t want the patient to feel I was incompetent, so I finished the interview, squinting to write my notes. Twenty minutes later, after I finished the admission, I ran to the clinic to speak with my attending. She didn’t know what was wrong, and told me to call my rheumatologist.

I went to the ER at a different hospital, and after a neurology consult and MRI, it was determined that I was having migraine auras. It turns out the constant lack of sleep and stress was causing me to have these painless migraines. I left grateful that it wasn’t any serious problems with the blood vessels in my eyes, which is what my rheumatologist had feared.

There were several other incidents here and there, and sometimes I had to be seen in the ER I worked at. Many times, I’d lay in that ER bed, embarrassed as my colleagues and other attendings would walk past, catch a glimpse of me in a hospital gown, then ask what was wrong. I never looked sick, and I always feared they would think I was just trying to get out of work.

It was a tough journey, but I made it through with lots of prayers and the support of loved ones.

Job Hunting Tips

While we are the topic of work, I’d like to take a break from My Story, and talk about job hunting. I am moving in a couple months and I’m in the process of looking for a job. For those of us who are able to work, here are a few things to consider.

1. Flexibility- This is huge. As a patient with lupus, you need something that allows you to be able to take time for doctor’s visits and tests, as well as sick days.

2. Low stress- One of the causes of lupus flares is stress. You want to work in a drama free environment where you can work at your own pace.

3. Ease of work- You want to choose a job where you aren’t standing for hours of having to lift or push heavy things.

4. Good coverage- Emergencies happen. It helps to work in a place where you aren’t ‘t the only person who can do your work. Employers are less likely to be upset if you call out, if there is someone who can cover for you. Also if you have to be out of work for a longer amount of time, they are less likely to replace you because they have someone there to do your job, and may just hire temporary help if needed.

5. Health insurance- Health insurance is expensive, and as patients with chronic illness, we need health insurance. Frequent doctor’s visits, lab work, and costly medications are nearly impossible to pay out of pockets. If I had choose between a good health insurance plan, and a higher paying job, I would choose insurance.