One of the hardest things about leaving veterinary school (for me, anyway) is that there are no more concrete measures of success like grades. How do you tell if you are a good doctor? How do you measure improvement?
Is it the number of cases you see per day?
Financial measures like average client transaction amount or gross production?
The number of thank-you cards and gifts from clients?
The number of lives you save?
Getting corrected (or reprimanded) fewer (or zero) times?
The number of cases you can resolve with just one visit? Without referring?
Feeling satisfied at the end of the day, as though you made a difference?
The number of new procedures you learn?
The number of clients who ask for you specifically?
Having techs and support staff respect you? Like you?
I don't have a good answer right now - in all likelihood it is a combination of these factors and more. I *think* I'm doing a pretty good job, especially being out of school less than one year, but I can't prove it definitively. That's a difficult thing to deal with when you're a ridiculous goal-oriented Type A person.
Friday, April 26, 2013
Thursday, April 25, 2013
Good at death?
It seems as though the best compliments and thanks I get from clients are my euthanasia cases. I'm not sure why that is - maybe it's the same reason why oncologists seem to have very grateful and nice clients?
Perhaps the clients have accepted what is going to happen. Maybe they appreciate that I explain what is going to happen, explain again as it happens, and ask them if they're ready for each step. Maybe there's something about having gone through it myself as a client multiple times that makes me more empathetic - I'm not really sure. All I know is that I've received positive Yelp reviews, really nice thank-you cards, or profuse verbal thanks from just about all of my euthanasia cases.
It's a running joke with my friends from veterinary school now - that I'm "good at death."
Perhaps the clients have accepted what is going to happen. Maybe they appreciate that I explain what is going to happen, explain again as it happens, and ask them if they're ready for each step. Maybe there's something about having gone through it myself as a client multiple times that makes me more empathetic - I'm not really sure. All I know is that I've received positive Yelp reviews, really nice thank-you cards, or profuse verbal thanks from just about all of my euthanasia cases.
It's a running joke with my friends from veterinary school now - that I'm "good at death."
Sunday, April 14, 2013
Mistakes
It seems like at least once every week or two I make a mistake and get talked to by the management about it. I get it - it's your money and reputation on the line, it's a new hospital, and I need to be made aware of my mistakes so that I can improve. Frankly I WANTED a place where I could get some feedback (both positive and negative) so that I can become a better doctor!
The latest one was where I didn't explicitly spell something out in the medical record - essentially the client did not agree to the recommended plan so we compromised. We discussed the consequences and risks of said compromise and I put it in the discharge instructions but wasn't explicit enough in the rest of the medical record. Long story short, the thing I warned the client about happened and the client didn't want to pay. Since it wasn't documented super-well in the record (note: my record was NOT finalized because I wanted one of the doctors to review it first, but the client came back before I could get that done) the management comped about $200 worth of services for that client. Oh, and as it turns out the client didn't want to see me or the other doctor on duty that first day but her preferred doctor was off and it was an urgent issue. I'm expecting some more meetings next week to discuss it - sigh. Lesson learned.
D says it takes about 1000 "atta boys" to make up for 1 "oh shit." I need a helluva lot more atta girls ...
The latest one was where I didn't explicitly spell something out in the medical record - essentially the client did not agree to the recommended plan so we compromised. We discussed the consequences and risks of said compromise and I put it in the discharge instructions but wasn't explicit enough in the rest of the medical record. Long story short, the thing I warned the client about happened and the client didn't want to pay. Since it wasn't documented super-well in the record (note: my record was NOT finalized because I wanted one of the doctors to review it first, but the client came back before I could get that done) the management comped about $200 worth of services for that client. Oh, and as it turns out the client didn't want to see me or the other doctor on duty that first day but her preferred doctor was off and it was an urgent issue. I'm expecting some more meetings next week to discuss it - sigh. Lesson learned.
D says it takes about 1000 "atta boys" to make up for 1 "oh shit." I need a helluva lot more atta girls ...
Saturday, April 13, 2013
The emergency queen rides again
This week has been slightly crazy at work. We're a general practice open daytime-only and yet I've managed to have an emergency every day; the other doctors have had a few as well.
Here's what I saw:
Tuesday - foreign body ingestion
Wednesday - bee-sting allergic reaction
Thursday - urinary obstruction
Today - hit-by-car AND bit-by-dog
Good thing I renewed my membership to the emergency special interest group! I'm also planning to go to their conference this fall. If these things are literally going to walk in the door when I'm on duty I should keep learning how to best treat them, right?
Here's what I saw:
Tuesday - foreign body ingestion
Wednesday - bee-sting allergic reaction
Thursday - urinary obstruction
Today - hit-by-car AND bit-by-dog
Good thing I renewed my membership to the emergency special interest group! I'm also planning to go to their conference this fall. If these things are literally going to walk in the door when I'm on duty I should keep learning how to best treat them, right?
Monday, April 1, 2013
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