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<\/p>\nAt least for the moment, the polls seem to be leveling out a bit …<\/p>\n
<\/p>\n
… and I found myself able to think [briefly] about other things. And the other thing on the front burner was a decision I made last week After eight years volunteering at a rural charity <\/strike> clinic, I’ve decided to wind things down and retire for good. If it were for age or health considerations, I wouldn’t be mentioning it. But that’s not the reason.<\/p>\n
Our area has a number of retirement communities. At some point, a few retired physicians opened a free clinic for the uninsured, staffed by an army of retired volunteers with a wide variety of medical skills. They raised the money with golf tournaments and donations, and created something I thought was unique – an interface between the retirees [from the "1%" retirement communities] and the patients from the other end of the financial spectrum. But with the coming of the national effort for universal insurance, the powers-that-be decided to change the clinic. We would still see the remaining uninsured, but collect the insurance reimbursement from those who were insured. And so we have a new building replacing our old "trailers." It’s staffed now by employees<\/font><\/em> with far fewer volunteers. We have added Electronic Medical Records <\/font>[EMR<\/font>] and a jillion other trappings of a clinic that has been "certified" to receive the insurance "payments." <\/p>\n Working there was a major change from my urban referral psychotherapy practice – more back to basics. The patients often had grown up pillar to post, exposed to abusive situations, substance abuse, and other craziness. At first, I was horrified at the medicine regimens people were on [almost everyone was "on" something]. The focus of this blog arose out of my explorations of these alarming medication practices. So the first order of business was to deal with the medication quagmires. Since I was the only act in town, I was also a social worker, an addiction counselor, a "common sense" psychotherapist, a medication manager, a neurologist, a grief counselor, etc – literally, a jack of many trades. Over time, I got my rhythm and found that I was able to do a lot more for patients in this setting than I might have ever imagined – even with infrequent contact.<\/p>\n I guess I thought I could ignore the changes that came with our new status, but I can’t. Instead of a brief written note and handwritten prescriptions, I have to do it on a computer using a system designed by someone who cut class on the day they taught "user friendly." Apparently the system pays extra if there’s a vital signs recorded with every visit, and a waiting room PHQ-9. There are frequent knocks on the door for some procedural something-or-another. Absolutely everything is just so much harder, and I’m sure that I now spend more than half my time doing these administrative, documentation tasks. The long and short of it is, instead of doing what I know how to do, I spend my time doing things that I don’t know how to do [and see no reason to be doing].<\/p>\n At least for the moment, the polls seem to be leveling out a bit … … and I found myself able to think [briefly] about other things. And the other thing on the front burner was a decision I made last week After eight years volunteering at a rural charity clinic, I’ve decided to wind things down […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[5],"tags":[],"class_list":["post-69013","post","type-post","status-publish","format-standard","hentry","category-opinion"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/69013","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/comments?post=69013"}],"version-history":[{"count":13,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/69013\/revisions"}],"predecessor-version":[{"id":69024,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/69013\/revisions\/69024"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=69013"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=69013"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=69013"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}I could mount a reasonably convincing argument that the coming of "the system<\/font><\/em>" with its rules and procedures makes it impossible for me to do my job, but that’s not really why I decided to muster out. I just can’t find a way not to be constantly pissed off. At times I think things like "a leopard can’t change its spots<\/font><\/em>" or "you can’t teach an old dog new tricks<\/font><\/em>," but most of the time, I think they’ve really messed up something that was working just fine, and I just don’t want to do it "their way<\/font><\/em>" [whoever they<\/font><\/em> are]. It’s as simple as, if you’re willing to work for free, and you’re 75 years old, you ought to be able to do it "your way.<\/font><\/em>" Obviously, the other side of the coin is that I’ll be abandoning the patients and that has weighed heavily, so I’m sticking around for a while to give the clinic time to get something else in place. I feel sad, but also relieved..<\/div>\n","protected":false},"excerpt":{"rendered":"