Category: Work Stuff

I got promoted! Actually, it was either get promoted or get laid off.

I chose the promotion.

I never, in my wildest dreams, ever even considered being a medical assistant. I did throw around either a medical transcriptionist or a paralegal in my lifetime, but never a medical assistant.

But when you stumble on an opportunity you might as well grab hold and hang on for dear life.

And I assure you, I’m hanging on for dear life.

It all started with a staff meeting back in … February? (Wow – seems longer – WAY longer. Like YEARS ago ...).

We knew changes were coming down the pike, we just didn’t know how that was going to ultimately affect us.

I admit, I was pretty cocky. I was good at my job. My bosses loved me. My shit didn’t stink. I was secure and quite confident that whatever happened, they would always need schedulers. Right?

Uh. Not so much.

We learned, in that meeting, that the scheduling positions were being eliminated. And they were going to make the existing medical assistants start scheduling. And the existing schedulers had the choice of either getting on board with this plan, i.e. become medical assistants, or adios, don’t let the door hit you in the ass on the way out.

I chose to stick around.

But after I got over my initial shock of NO LONGER HAVING A JOB, or at least, no longer having the job I’ve done for the past two years and am familiar/comfortable with, I started to get excited. Because I enjoy challenges. I enjoy stretching my abilities and adapting to new environments.

Alas. Not everyone felt the same way.

In fact, it’s safe to say there were two people who were ABSOLUTE BITCHES about the entire thing.

We will hereby dub them, “the mean girls.”

The head honcho over the clinic was pretty smart about this transition, if you want my opinion. First, he came up with the plan of converting the existing schedulers (i.e. me and two other girls – the fourth girl had already accepted a position at a different facility doing precertifications and BOY, I bet she thought she couldn’t have timed that move any better) into medical assistants, thereby effectively saving our jobs. And secondly, he gave us control over HOW we were going to redefine our jobs.

Sure. He could have simply come in and said, “this is how we’re doing things from now on – take it or lump it”, but he didn’t. He told us we had two goals: to come with ways 1. the nurses would be responsible for putting in the orders and 2. to bring our telephone scores up.

Apparently, the hospital employs an independent phone survey company to call patients and ask them a series of questions about how satisfied they are with our services. And the hospital does this to work on being a better facility for our patients AND to train employees to automatically give better service because good old O’bummerCare will only pay out depending on how satisfied the patients are with our service.

Assholes need not apply.

So. The meetings began. We got together, we brainstormed, we bitched, we came up with ideas, we bitched some more, and then we tried some our ideas out. It was a TRUE trial and error and It. Was. Not. Easy. But we stumbled through it and here’s what we came up with: we were each assigned to one doctor. (And I LOVE my doctor’s team, thank the good Lord above).

And we eliminated voicemail. We answer ALL calls live in what we “affectionately” call, THE PIT.

THE PIT is where everyone goes if we’re not in clinic with our doctors. And in THE PIT, everyone answers the calls as they come in and tries to help the patients with whatever needs they’re calling in for. And most times, we CAN help them. Patients have questions about post-op restrictions, or they want to reschedule, or they want a refill on their prescriptions (which I can now take care of providing I get permission from the doctor/nurse to do so – I can’t just make that call).

Patients love it. However – I. HATE. IT. WITH. EVERY. FIBER. OF. MY. BEING.

But I don’t like answering the phones anyway. Ever. I’ve always hated talking on the phone. But since patients love it and management is getting less complaints about phone calls not being returned, it’s not going away any time soon. I guess I’ll deal with it.

Two of the gals that have been with the clinic for years (like 19 years!!) got so fed up with the changes and couldn’t accept that they were now going to be expected to actually WORK for their paychecks (they would do their jobs, but when the last patient had been seen for the day, they would literally spend the last few hours of the day goofing off or updating their Facebook statuses on their phones (because sites like Facebook, Twitter, YouTube, etc. are blocked at work).

So. They quit. In fact, one was ASKED to go home and never return because she was such a diva/princess personality that she thought it was totally acceptable to leave the clinic for hours but only make it look like she had only been gone for a short time and have someone clock her in/out. Which we ALL KNOW is stealing time from your employer and a huge no-no.

But honestly, few tears were shed because they were the mean girls who were bringing everyone else down and just being difficult overall and now that they’re gone? We’re ALL happier. So it actually worked out for the best, to be honest.

We have not had formal training. I was a bit surprised that we weren’t required to take classes in order to become medical assistants. We were shown how to take someone’s blood pressure and how to start office notes and obtain pertinent medical information for the doctor but only on established patients – the doctor obtains all of that information on new patients. We will take CPR classes eventually, but since we’re surrounded by nurses and PA’s I guess my boss doesn’t think that’s a high priority right now. It’s not a hard job, but it’s a physically demanding job as I’m on my feet all day when I’m in clinic. I’ve been wearing a pedometer, just out of curiosity, and I’m walking, on average, three miles on the two days I’m in clinic. I’m not complaining – it’s NICE to not sit on my butt all day long anymore.

We have the option of taking the certified medical assistant test after two years of experience. We will then get a substantial raise and be able to do more than we’re doing now. I’m totally doing that – providing I’m around in two years. I have mixed feelings about taking the test. On one hand, if I’m around for that long, why wouldn’t I take the test and make more money?? But then again, if I invest the time and money (it’s about $100 to take the test), why would I quit and go somewhere else? So it’s almost like, if I take the test, then I’ll feel a bit trapped into being a medical assistant for the rest of my life.

I hate being locked into something like that, especially since I never really saw myself making a career out of the medical field to begin with, but those are the cards I’ve been dealt and to be honest, I enjoy what I’m doing and I’m good at what I do so … why not??

I have no interest in becoming a nurse. (Though don’t quote me on that – again – I never, EVER saw myself doing what I’m doing now). I highly doubt I ever do anything more than what I’m doing now. It’s sort of a nice mix of having responsibility, but not having THAT much responsibility. The nurse’s have A LOT of responsibility and quite honestly, I’m not sure I’m passionate enough about the industry to commit to anything more than what I’m doing now.

Here’s what my week looks like now:

Monday/Wednesday – CLINIC DAY: Get to work at 7:15 a.m. and start office notes for the patients that are coming in to see my doctor that day. Turn the lights on in our five exam rooms, pull fresh paper over the exam tables and boot up the computers and open up the medical records program. Print off four copies of the day’s schedule – one for me, the nurse, the PA and the doctor. I highlight all of the new patients on the doctor’s copy as he’ll be responsible for interviewing the new patients, diagnosing them and ordering further testing for them.

I then start calling the patients back that are in the waiting room. I weigh the patients, show them to an exam room, ask them questions about their pain (if they’ve been seen before), and take their blood pressures. Then I put the number of the exam room on their super bills, place their charts in the appropriate place (the PA sees first post-op appointment patients) and then go out and call another patient back to another exam room. I’m responsible for making sure the exam rooms are full at all times. And when the doctor, or the PA, are finished with the patient, then I schedule them for whatever is recommended, (if I have time – sometimes we move so fast I don’t have time to do that), and show them out of the clinic. If I get tied up with a patient (and there’s a certain “art” in keeping patients on track because I have one of those “tell me your life stories” faces), then the nurse and the PA step up and show patients back to rooms, providing they have time. The nurses are responsible for setting up surgeries by educating the patient on what to expect and calling the hospital to put them on the surgery schedules.

I also answer phone calls and pages for the nurses if they aren’t available to take calls when we’re in clinic. This includes the physician’s line, which is a dedicated cell phone JUST for physicians to call each other on. When that sucker rings, my heart drops to my feet because I know it’s another doctor wanting to speak to my doctor. It’s sort of an intimidating conversation, truth be known.

After the last patient has been shown out of the clinic for the day, (and our clinic days usually run between 25 – 32 people), I don a pair of surgical gloves, take a few packets of disinfectant into the rooms and thoroughly wipe them down. I then spray some clinical disinfectant in the rooms to make them smell nice once more. (People are truly stinky when they go to the doctor).

I usually have about an hour, to an hour and a half left of my day and I then go through my flags, return phone calls and go through the clinic to schedule the patients that either I didn’t have time to schedule while they were in clinic, or patients I didn’t see before they left the clinic.

Tuesday/Thursday/Friday – PIT DAYS: Yuk. These are my least favorite days, though they are ultimately more relaxing than clinic days. I have a “station”, in the old nursing area (which poor nurses, they don’t have a home now that we’ve gone through this transition and they use their doctor’s offices to work out of now) that I use as my working space. I put on a pair of headphones and answer calls as they come in. (Whenever someone calls, ALL of our phones rings, so the entire day phones are ringing in stereo and whoever is free to answer the phone, does so). In between phone calls, I answer flags (which is an interoffice message system between us and the nurses), return phone calls and schedule appointments. I also go through upcoming clinics to make sure the patients have done the testing that was recommended at the last visit and make sure the films from those tests are on our system for the doctor to pull up and look at when the patients arrive for clinic. If patients didn’t have their testing done, for whatever reason, then I call the patient and reschedule their testing and often times, their appointment with the doctor because nothing is more frustrating to the patient and the doctor for a patient to return and not have done what they needed to have done before coming back. It’s a waste of time and money for all concerned and it makes the doctors quite cranky.

Because the phones can get overwhelming at times and because the pit can be quite overstimulating with the phones ringing and everyone talking at once, we have instigated “quite time” where we go out to the old scheduling desks for an hour to clear our heads and get some stuff done we don’t otherwise have time to do in between phone calls on high volume days. (Mondays and Thursdays are the WORST in the pit). That quiet time is a GOD send sometimes, trust me.

Fridays, since we’re all in the pit together, it’s not so bad because we have more of us answering calls and we end up answering less calls because of the extra man power. We also restock the exam rooms and make sure they’re ready to go for another crazy week of clinics.

I also do one outlying clinic a month in Carthage. I pack up the van with our laptops and equipment. The receptionist that goes with us packs up all the paperwork and whatnot, and then I drive the van (because they elected me to drive – *GULP*) to the hospital where we pick up the doctor and the PA after they’ve done their rounds, and then the PA (thank God) drives us to Carthage. Me and the nurse unpack the laptops, set them up in the rooms, the receptionist checks the waiting patients in and BOOM, off I go again, rooming patients, asking them questions, getting their weight and blood pressures and setting the pace for the clinic.

The first few weeks of doing my “new job” were exhausting, to say the least. Not only because I was learning new duties, but the emotional stress of trying to keep everything straight for the doctors was mentally challenging. I came home DEAD TIRED. But I’ve been doing this for a few months now and I think I’m getting the hang of it – at least – I haven’t heard any “constructive criticism” in a while so I’m ASSUMING everything is going along smoothly.

I’m still tired when I get home, but it’s a good tired – I feel like I’m really making a difference in people’s lives and have gotten to know quite a few “repeat” patients. It’s honestly a very rewarding job and I’m having fun with it.

I suppose that’s all anyone can ask for in a job. That, and more money … but that’s not happening any time soon so … *sigh*

I’m hoping this will be my last day.

Not with this company, (though there are days … moments … seconds that that doesn’t cross my mind), but at my desk.

Since I sit at the first desk that patients come to as they’re exiting the clinic area, I naturally help the most patients. On a four doctor day, it’s not unusual for me to help 30 patients ON TOP of the 15 voicemails I receive and the 15 flags I receive from the doctors’ nurses that I’m responsible for taking care of as well.

I’m currently responsible for 3 doctors- it’s overwhelming. I can’t maintain this pace indefinitely and I’ve expressed my … frustrations to my management.

It wasn’t until recently that I felt like a light bulb went off in their heads and they finally understood what I’ve been telling them for the past month.

So. We had yet another meeting yesterday (*sigh*) and today should, SHOULD, be the last day I’m at this desk. And we have three doctors today. So I will still end the day more behind than when I started it.

But. I will be sitting in the peach pit tomorrow (i.e. Triage area) answering calls and training the other MA’s to do the job that me and the other schedulers have been doing, and they will train me, and the other schedulers, MA duties.

Then next week, I will either be with a doctor or in the peach pit.

I will be kissing my desk, and my old job, goodbye.

At least, that’s the plan.

Let’s hope we all stick to the plan.

When I get stressed, my back goes out. There’s a direct correlation between my having anxiety attacks (and when I say that, I don’t have attacks where I’m feeling like I’m having a heart attack, but I get so overwhelmed I just shudder and cry. And I’m not a crier – so if I get to that stage, BACK OFF) and my back going out.

I have no idea if this is normal for other people, but it’s normal for me.

I’ve been so stressed out these past three weeks that I’ve barely made it past 8:00 o’clock at night before my brain simply shuts down. I simply cease to think or feel anything.

It’s kind of scary, if you want the truth.

We lost a girl at work. Which means we are short handed. I’ve been responsible for taking care of three doctors these past three weeks and I’m nearly to my breaking point. In addition to the extra work load, we’ve been trying to figure out how we can schedule diagnostic testing in the exam rooms without disrupting the clinic flow for the doctors. We’ve trialed this before and it was successful, not to mention patients really seemed to like it, too. But that was when we trialed it with one MA, (medical assistant), and one scheduler. Now we’re trialing it with one MA doing both jobs because they are eliminating the scheduling position.

The problem is the time factor. If one person, the MA rooms the patient, goes over the medical history with the patient and then schedules the patient, other exam rooms become available while we’re busy with a patient and that delays the doctors – who have more important things to do than wait on us.

So. We’ve been trialing some things to see one, if it’s possible, and two, to make it as efficient as possible.

I’m not saying these experiments don’t need to be done, they’re necessary, in fact, to try and offer better patient care, but when it causes me to end up being four days behind and I start having patients calling me back, not necessarily angry (though there are those), wondering why they haven’t been scheduled for their tests, it stresses me out. And management, for whatever reason, looks to me to sort of spear head the experiment, which puts additional pressure on me.

I snapped on Friday.

I had just gotten to my desk, was putting my purse down, when reception allowed a patient through to my desk. He wanted to know why he hadn’t been scheduled for a procedure and well, I told him the truth, we were short handed and I hadn’t been available to call the hospital and set it up for him. He was surprisingly understanding and I promised to call him later in the day (which I did), but for whatever reason, my co-worker went completely berserk on me. She expressed her … disagreement with my decision to be honest with the patient. In fact, she got our boss involved. Which was really the straw that broke the camel’s back for me. My co-worker sensed I was angry and confronted me.

MISTAKE.

So I vented. And when I say I vented, I got in her face and started yelling. And she responded by yelling back. And I finally had to say, “If you don’t get out of my space right now, I’m going to say something I regret.”

I think we were both surprised.

But that’s an example of how stressed we ALL are. We have resorted to yelling at each other.

When another one of my co-workers asked me what happened and I tried to explain to her the series of unfortunate events and that I was losing my mind because I was being buried by an unreasonable work load, my voice shook and before I even knew what happened, I started crying. My co-worker hugged me and advised me to hole up in an exam room until I could get myself together.

I did just that.

I don’t get paid enough to have this much stress. I just don’t. And yet, I’m not ready to wave the white flag yet, either. It’s a matter of pride, I guess, to stick this out and MAKE this work, damn it.

We had a meeting later in the day. The head nurse (who is now my boss), called all of the schedulers (soon to be MA’s) and the current MA’s together for lunch. She bought us pizza and we had a pow-wow. My old supervisor was there and I’m glad she came – she was our advocate and after we finished the meeting, I started to feel better. I think management FINALLY understands where we’re coming from. It’s like a light bulb went off in their heads and they realized that the world doesn’t stop for us when we’re working the clinics with the doctors – we’re still getting flags from the nurses and we’re still getting voicemails. In fact, when I checked my voice mails on Friday, the mechanical voice simply said, “you have over 20 voicemails.” I didn’t even get a number, that’s how many I had.

It’s all so overwhelming.

I cooled off. The girl who yelled at me cooled off and we apologized to each other. In addition to work stress, she has a lot of personal stuff going on and we both just sort of lost it. But I’ll admit, it sort of felt good to clear the air.

I’ve been losing sleep over this work situation. And I told my bosses that yesterday at our meeting. This has gotten to the point where it’s just ridiculous now. There are four MA’s who are being severely underutilized (their words, by the way), and three schedulers who are being WORKED TO DEATH. This has got to stop. In fact, one of my co-workers threatened to quit. She’s working Monday’s clinic and she said that if she got back to her desk on Tuesday only to find 15 voicemails and 20 flags waiting for her, she was gone. She couldn’t take it anymore.

I think management finally gets it. We worked it out so that her voicemails and flags would be worked by someone else while she was in the clinic.

It won’t always be this way. When we’re assigned our doctor, we’ll be responsible for one doctor. Not three, like I’m responsible for now. And I’m going to ROCK this new MA gig.

Anyhoo – I woke up this morning with the tell-tale back pain. I knew what that meant. So I did a bunch of squats, took some ibuprofen, and I think I have a handle on it.

I’ve also discovered how to keep my back from going out – squats. Which also produces tight buns – BONUS.

So yeah. Just when I got a handle on my job, felt comfortable with it and didn’t feel quite so stressed, the rules completely changed and now I’m trying to juggle my regular work while trying to learn another job AND collect data for management so they can figure out how we’re going to do our jobs. Though I appreciate management giving us the opportunity to come with our own work model, as opposed to just stnading there and saying, “this is how it’s going to be done,” it’s all too much too fast.

Honestly, I can handle stress. I even thrive on it. But it’s hard to stomach this much stress when I’m being paid pennies on the dollar to find ways to cope with it.

It could be worse, I could have lost my job. Then my family would be without health insurance and though at any other time this wouldn’t have bothered me overly much because I could have gotten another job fairly quickly? That’s not the case is today’s socialist society.

So yes. I will put up with the stress, find ways to combat it and keep my mind and body healthy while coping with it and be thankful that I still have a job and health insurance at the end of the day.

A girl I work has to wear a mask to work everyday – at least, until the CDC (Center for Disease Control) deems “flu season” over.

She’s allergic to the flu shot, which means she’s exempt from having to have it. I’d say lucky girl, but I wouldn’t want to have to wear a mask every day. That would royally suck rocks.

And it does for her. She hates it. In fact, she’s cashing in some of her vacation time so she can give herself a break from the dreaded mask until the “flu season” is over.

I put “flu season” in quotation marks because I distrust the CDC perhaps even more so than I distrust our government and ya’ll KNOW how much I LOATHE our government, especially right now. I think this whole “flu season” fiasco is just a scam to wring more money out of people by making them get injected with God knows what sort of drugs to line the drug companies pockets with cash.

And to top off my angry sundae, it’s perfectly legal, in the state of Missouri, to MAKE employees get the flu shot whether they want it or not. All under the guise of protecting patients and other employees.

Now don’t get me wrong, I’m not against protecting patients, especially the patients that have weak immune systems anyway, of course not, I’m not a monster, however, I’m not completely convinced, actually, I’m not convinced AT ALL, that the flu shot, in any way, deters the flu. Do you know how many strains of flu there are?

Exactly.

The odds of actually getting a vaccine for the type of strain that happens to cross your immune system in the year you happen to have God knows what injected into you is slim at best.

And if you’re honest with me, and yourself, you know I’m right. How many times have you heard people, express in genuine disbelief mind you, how surprised and shocked they are they actually came down with the flu after receiving a flu shot.

“But I don’t understand,” they whine while coughing up a lung and sneezing the tops of their heads off, “I GOT the flu shot. Why am I sick?”

Indeed. That’s the BILLION dollar question, isn’t it.

This flu shot thing is a deal breaker for me. The first year they made it mandatory that we either get the flu shot or lose our job, I sat down with Kevin and we seriously discussed my next step. I wanted to quit. I almost quit. I still want to quit. But (and there’s always a but, isn’t there), since Kevin is self-employed, that leaves it up to me to provide my family with health insurance.

And quite honestly, we can’t afford to be without it now – not just because we’re gambling on the fact that none of us either get sick or have an accident, but because we’re now required to pay a penalty if we don’t have it.

Anyway. I’ve bitched and moaned about this topic for years now – it’s old news – you know how I feel about it. Blah-blah-blah.

I’m bringing this up now because we’re now in “flu season” and I mentioned to Kevin the other day that if the CDC felt like the bottom line was too low and needed to up their profits, they may decide to declare a “pandemic” (remember H1N1?) and if that happens, I’ll once again be REQUIRED to get another bogus injection full of poisons.

Is this job really worth that? What if the long-term repercussions is Alzheimer’s? Or Dementia? Or something else just as bad?

No job is worth my health.

It’s time to get serious about a new job again. I can’t make the change over night – it will take time to ease my way out. I hate to brag (*ahem*) but my co-workers rely on me. I even have my manager coming up to me asking for advice on things now.

Whoa. Super flattering but also super stressful. I’ve become the poster child for scheduling, I guess.

I’m not taking this lightly – I’m very grateful for my job and I truly love the people I work with, but I can’t stick around and continue to participate in something I feel very strongly against.

So. What to do? I can’t quit without another job lined up for my family’s sake. And I would never walk out on the other girls – I couldn’t forgive myself. So it’s time to suck it up and start building my portfolio again. And I have my eye on one particular company that I think I would be a shoe-in for, AND, I’m my college degree is my ticket in the door. But they won’t take a serious look at me until I can show them what I can do. I have a few ideas on how I can do that – it’s just finding the time to do it. I’ll need to take screen shots from the programs I use at work. And I think I can do that as long as I use the dummy account they’ve created for training purposes. Obviously, I have to be very careful not to violate anyone’s privacy.

That would be bad. Very bad – especially with all the strict HIPPA laws in place. (Which is actually a good thing – people need their privacy protected – too bad the government doesn’t agree with that, but whatev).

Wow. I hadn’t planned on writing this much. I just wanted to mention that I feel sorry for my co-worker for having to wear a surgical mask all day. I don’t know how she doesn’t run screaming from the clinic tearing her hair out. But this issue is never far from my mind and I guess I needed to purge my frustrations. I sort of feel trapped and I resent the fact that the company has taken one of my choices away from me – but I need to stop complaining about it and take steps to do something about it.

It’s time to be pro-active.

(I need to bookmark this post and refer back to it from time-to-time to keep myself motivated to move forward with this get-a-new-job thing. It’s just soooo much easier to stay put and keep doing what I’m doing. Change is hard, doing nothing is easy).

By the by, we drove by the hospital yesterday and noticed that the construction guys are finally building up the foundation. We saw several concrete pillars, I think we’re finally making progress on the tower. (The’re building a tower onto the main hospital and my doctors will be moving their practice to that tower – I’d like to stick around at least that long and make the move because HOW COOL IS THAT?!? A brand-spanking new office. Sweet!)

I’ve been trying something new – I’m trying to …

Make your first meal the biggest and your last meal the smallest. Eat breakfast like a king, lunch like a prince and dinner like a college kid with a maxed out charge card.

Because I get tired of eating a big dinner, then sitting around either reading or watching TV, then going to bed and feeling like a whale in muddy water – fat and sluggish.

So. Even though I have NO APPETITE in the morning (never have, really), I force myself to eat two scrambled eggs and a buttered bagel and then drink some orange juice every morning.

Sometimes I shake things up and eat a bowl of oatmeal instead of eggs. Then I usually take leftovers from the previous night’s dinner for lunch and eat really late (like around 2:30ish in the afternoon) so that by the time dinner rolls around, I’m not hungry – at all.

Or if I’m a little hungry, I’ll eat another bagel.

This plan seems to be working – I’ve lost a little weight and I’m training my body to eat at different times.

I woke up this morning, had my breakfast and went to work. But I started to feel funny by the time I drove into the parking lot. I felt like a fist was pressing into my stomach and before long, I felt nauseous and ran to the bathroom to promptly lose my breakfast. I couldn’t figure it out. I’m NEVER SICK. Like, EVER. And this was a really strange thing for me and it happened so fast.

I felt a little better after tossing my breakfast, but before long, I felt that pressure again and my co-worker said my face turned white. She could tell I was trying not to vomit. I finally threw in the towel and came home. I chewed four extra-strength Tums and slept for about two hours.

I left work at 11:00 and by 1:30, I was feeling 100% better and considering there were several hours left in the day, I went back to work.

You can imagine everyone’s surprise when they saw I was back. But I honestly felt better. I left work at 11:00, came home, chewed some Tums, slept for a bit, woke up around 1:30ish and thought, “I feel fine.” I couldn’t, in good conscience, NOT go back to work. What was I going to do for the remainder of the day? (Oh sure, there is always something to do at home, but I would rather spend my time making money, if at all possible).

So I put my scrubs back on and went back to work. And I got quite a bit done in the remaining hours – and I’m pretty sure I scored brownie points with my boss. (Which wasn’t why I went back to work – I just have a VERY STRONG work ethic – but BONUS!)

Everyone was more than a little surprised to see me back. (My co-worker had sent out an email stating I had gone home sick). And I’m sure they were thinking, “Damn it, Karen. You’re making the rest of us look bad by putting on this super employee suit” but I’m being honest when I say, if I ever call in sick to work, it’s because I’m near death.

And that’s the God-honest truth.

And yes, I realize I’m super weird, especially nowadays when “work ethic” is an alien term to most Americans. I hate to be snarky, but there it is.

I have a few patients that call me every five or six months trying to get an appointment with one of my doctors. I’ve come to recognize their names but somehow, or at least they act like, they don’t recognize me.

Nice try.

These patients have been black balled. Yes. It happens in health care, too.

Here’s why: The doctors have spent a GOOD PORTION of their clinic day, (and documented this time spent), trying to help the patients mentioned above. They go over (and over) test results and explain (over and over) what they see and what they recommend. Most times, the patients are not surgical candidates but because my (and I call them “mine” because I’ve grown fond of all of the doctors and it’s my job to try and make their jobs just a little easier so I’m protective of that responsibility), are nice doctors, they offer suggestions on what the patient can do to try and help themselves. They don’t immediately jump on the surgery bandwagon, even though that’s what they love to do and get paid well to do, and they WILL NOT prescribe any sort of pain medications unless they performed surgery on the patient.

Fair enough, right?

They will often recommended diet changes, exercise and sometimes injections – and sometimes, these things help, if the patients will take that advice to heart and make an honest effort toward feeling better.

But that’s not good enough for a small percentage of people. They want a quick fix – they want a pill or they want surgery so that the pain will go away. And to be fair, I get that. Sometimes you have so much pain that you just can’t get away from it. It’s utterly miserable and it affects the way you live your life. But that’s the point – it’s time to change the way you live your life. Often times, people have made bad choices and they now have to live with those bad choices. It’s time to step up and make better choices.

I’m in a unique situation because I truly see both sides of the story. And I empathize with those people who are truly hurting and for whatever reason, our doctors don’t recommend surgery so that leaves the patient … where exactly? Having to learn to live with it. People who receive this type of news break down at my desk and I feel so bad for them – I can see they are in pain, frustrated and not sure what to do next. We often refer these patients to a rehabilitation doctor who might offer them non-surgical pain management options, or to a pain clinic to help manage their pain. It’s heart breaking and I feel so helpless because I can’t help offer them anything but that referral.

But once in a while, and to be fair, it doesn’t happen very often, in fact, I can only think of four patients off the top of my head, who won’t take no for an answer. Not only do they not take no for an answer, they won’t even try what the doctor recommended. To be fair, if patients have tried the recommendations and another doctor has taken more films and thinks the patient needs to come back and see my surgeons, my doctors will see that patient, again, and re-assess their situation, again. (Eight times out of ten, a patient who has been sent back to our office by another doctor gets the same news – no surgery recommended).

But the patients who haven’t even tried the recommendations and want to get back in, nay, DEMAND to be seen, burn their bridge. Doctors are human and their time is valuable. They will bend over backwards to help patients (and I’ve seen all of them do that several times), they are human – they get tired of beating their heads against a brick wall and they will black-ball patients.

These are the patients who have been hateful, demeaning, insulting and downright nasty to either the doctor himself (it happens and it always amazes me that people even take that attitude with another human being, let alone someone they want to help them), or they are extremely rude, hateful, nasty to the staff.

(So yes, be nice to the staff. Because like I’m protective of my doctors, a lot of doctors grow fond of their staff – it goes both ways.)

Black balling means they put a pop-up on the patients chart to either check with the nurse first before scheduling (the nurse will call the patient and gauge the situation), or to simply not schedule them at all.

End of discussion.

Sometimes, if a patient has been black balled, another doctor in the same clinic will see the patient. Another doctor will look at the patient’s clinical information and if he feels like he can help that patient, he will agree to see that patient. Again, it’s not as cold blooded as I make it out to be. But if another doctor sees that the patient was non-compliant and refuses to heed advice or to even be civil – all bets are off. The patient will not be seen and will be forced to seek treatment with another specialist with another hospital.

So be careful, my friends. Doctors CAN and DO refuse to see patients if they are rude, nasty or simply refuse to meet the doctor halfway when it comes to his/her treatment.

And now with this disaster called Obamacare, I predict this will be even more common – not on a patient’s attitude or non-compliance, but because the patient’s insurance prevents the doctor from getting paid for his time and talents.

It happens. It’s happening now. Be nice to your doctor. Hell, be nice to everyone. Your attitude DOES matter in the grand scheme of things.