Like I suppose I should have put a "this patient will have to see ortho" referral in but see there are different orthopedists on in the hospital day to day so....

Anyways, #primarycareishard #thankgodforweekends

(c) furious - because people with devastating TBIs or all-encompassing developmental disorders and the people who take care of them do not deserve these headaches & inevitable delays

anyways, #primarycareishard

I laughed aloud when I saw this in my mailbox 😭😂 - it’s almost always a mistake to ask for outside records ! #primarycareishard

dear psychiatric hospital,
WHAT IS THE POINT of hospitalizing patient x weeks to stabilize them, and getting patient a hospital discharge appointment, IF YOU DON'T GIVE THEM ENOUGH MEDS TO BRIDGE THEM TO THAT APPOINTMENT?!?!?
#primarycareishard
grrrr,
me

in related news (and #primarycareishard) trying to figure out someone's meds without records and a patient who can't give full history is really wild. why is patient on all the cardiac/stroke stroke meds but not a statin? IT'S A MYSTERY

Cleaning out some paperwork and came across this reminder of #primarycareishard. I mean, if my patient can’t leave the house because of an illness, aren’t they homebound? Jeeez Louise
I shall continue my efforts to detect A1cs and TSHs via telepathy 😂

it is REDONKULOUS that *technically* the 2hrs I am spending this evening reviewing records for a complex new patient who has a 15 min appt tomorrow (and trying to translate them into something easily digestible in clinic EMR) .... are not billable
#primarycareishard

dear radiology, i ❤️ you but also when you tell me to get an MRI but don't tell me what to do re: contrast, it makes me sad. love, #primarycareishard

big fan of ACR Appropriateness Criteria but oy takes time and also in this situation both MRI types are 'may be appropriate' so🤷‍♀️

The number of messages, prescription bounce-backs, etc. about asthma/COPD meds (which inhaler for which insurance? which spacer & will pharmacy have? nebs ok or not?) that I have received in the two weeks is... disproportionate. #PrimaryCareIsHard

When you forgot to sign in to UpToDate when at the hospital and then had a clinical question in evening clinic that you couldn’t look up 😬🫣😭 #primarycareishard

Five phone calls and 1 “care everywhere” inquiry later, no closer to finding out what antibiotic regimen my patient who came here from out of state is supposed to be on #primarycareishard

I thought I was gonna be done early today but #primarycareishard

Did I just get a PA request for something GINA says should be my first line asthma treatment? 🤨 #primarycareishard

I don’t know if the genuine excitement I feel when someone accepts a flu shot is nerdy, or appropriate, or sad 🙃 #GetYourFluShot #SaveOurHospitalBeds #PrimaryCareIsHard

I’d just like to say that 2020 has been hard enough without a metformin ER recall and un/undertreated DM2 is bad news and life isn’t fair and #primarycareishard

my most complex patients are certainly keeping me busy & learning as I wrap up residency 😁 #ManyVNACallsToMake #PrimaryCareIsHard #ButReallyIWillMissThem 🙁

Me: "It was untender..."
Preceptor:
Me:
Preceptor: "Nontender?"
Me:

🤣 #TripleClinicDay #PrimaryCareIsHard #Tired #Residency
Also y'all I saw 6 people in clinic today with (or recovering from) influenza #GetYourFluShot

I apparently won some kind of lottery b/c I have 5 hospital discharge visits scheduled into my clinics tomorrow, none are patients I've met before, only one of them has a hospital discharge summary available #OyVeyGonnaBeADay #PrimaryCareIsHard

Today was checking the chart of a patient I've never met - but I've learned & worried about via worklist, & recently reached out to - & realized pt died earlier this month. It's difficult to explain but I Have Feelings & but am not sure I'm supposed to? & sigh #PrimaryCareIsHard!

I don't understand - how are E0990, K0046, K0047, K0053, K0195 all "elevating leg rests" & how am I supposed to know which one & does my note or script need to say which one, or can it just say "elevating leg rests"?! god help me #wheelchairs #medicare #DME #primarycareishard

An A1c of 11% is better than an A1c of 14%.
#SmallVictories #PocoAPoco #PrimaryCareIsHard

today was one of those days where one bad thing after another came to my EMR inbox
and I am just so sad for / worried about my patients
and frustrated about the failings of our system/society
so it's hard to go to sleep
but that will make clinic harder tomorrow
#primarycareishard

on one hand my EMR worklist is making me hate primary care today but on the other hand i did a really good job cajoling a lot of people into #flushots this morning so🤷🏽‍♀️ #primarycareishard

I DON'T UNDERSTAND does pregabalin exist under some kind of exception that requires me to call a new rx in so patients can get a generic med if my rx says "Lyrica"? did I fill out a PA for the second time this year for no reason at all? #Grrrrr #PrimaryCareIsHard

by 3rd consecutive week of inpatient service, my continuity inbox starts to feel like an overwhelming burden. trying to get records from another state so Sick pt can see a specialist, trying to figure out which basal insurance will cover just... sigh 😫 #primarycareishard

One of my patients has an appointment today for much-needed, long-anticipated, took-a-lot-of-work-to-make-it-happen imaging, and I am legit distracted waiting to see if it actually works #Eeks #PleaseShowUp #IWorried #PrimaryCareIsHard

I have spent many many hours trying to figure out how to get a ex-SGA baby who failed a car seat test a new car seat trial & I have asked for help every way I can possibly imagine to ask for help & basically I give up kid may have to just grow out of car bed ☹️ #PrimaryCareIsHard

Today I called a specialist office during lunch to ask about how urgently I needed to get my patient seen by them & they called me back THE SAME DAY (at a time I WAS ABLE TO ANSWER THE PHONE) and now I feel much better 🙌🥳 #primarycareishard

The amount of time and perseverance it takes to get inpt info about a complex patient who has moved from a different state/system is staggering & unacceptable #primarycareishard #30minutesandcountingonhold

Approaching 30 minutes trying to figure out how to get a patient with likely idiopathic intracranial hypertension (per ophtho exam) imaging that everyone agrees she needs because of EMR/insurance/order confusion 😬Still. On. Hold. I #primarycareishard