Firstly, the doctor has appointments scheduled every 10 minutes, some (probably 1/4) are double-booked. AND THEY NEVER RUN BEHIND!!!
The nurse to doctor ratio is 3:1....let me repeat, the doctor has 3 nurses to herself, probably leading to why the first point above exists. Each nurse comes into the room with the doctor and performs the following duties:
- Getting all of the Chief Complaint, History of Present Illness, and Past Medical History from the patient without the doctor repeating the questions
- Writing prescriptions and if a patient needs refills, the nurse goes ahead and writes it
- Ripping the carbon copy off of the prescription (as in, today, the nurse handed a prescription to the doctor with its carbon copy on the back and the doctor handed it back to the nurse--I think, for the only purpose of the nurse ripping them apart and handing it back to the doctor)
- Numbing areas to biopsy
- Being at the beck and call of the doctor to run and get samples, etc.
- Doing all the teaching regarding wounds and dressing
My mind was boggled at what the doctor DIDN'T have to do...and how she billed for the visits.
One visit she called a "Level 4" (which, for those non-medical out there... pretty complicated but not the highest, Level 5) --the patient was on Accutane, she looked over his dry skin, suggested heavy mosturizer, asked him a few questions about mood, and looked at his lab work...that was it! Geeze, I'm sure in Family Medicine nobody would get away with calling at a Level 4.
And one last thing...all of the patients came in with an understanding that only their skin would be taken care of, that's it. It was so strange to not have them bringing up multiple, unrelated complaints...and very boring.
Lesson Learned: I'd be bored to tears and unable to sleep in peace at night if I did "medicine" this way.
What it's Worth: Seeing how "the other half" lives.