Sunday, January 27, 2013

My Job as a Pediatrician

Ever wonder what your pediatrician does all day? Ever wonder why you sometimes have to wait to be seen (or, in my case, many times)? Doesn't she just spend 8 hours a day at the office and then go home? Why does she sometimes seem a little tired? How can she be tired if she only works 4 to 5 days a week in the office?

If you have ever wondered about those things, I am going to give you a peek into what my typical work day looks like.

4:00 a.m. – Get up and get ready for the day. (If I am really disciplined, I will get up at 3:00 or 3:30 so I can exercise.)
5:45 – Leave for the hospital
6:05 – Arrive at first hospital, make rounds in newborn nursery, then move on to the pediatric ward to round on inpatients.
7:00 – Leave first hospital and go to second hospital. Repeat the above.
8:45 – Leave second hospital and drive to office.
Note: I do not always have patients at both nurseries and both pediatric wards. I do often have to go to both hospitals, though. If I don’t have patients at both hospitals, I go get some coffee and spend some quiet time before the office.
9:00 – Arrive at the office to start the office day. I am usually met with multiple questions that relate to patients who might need to come in immediately but don’t want to, or who must have this form now or they won’t be able to go to football practice (but they didn't bring it in until this morning), or I find out that a staff member won’t be at work today because they are sick or something urgent happened. Or, if it is winter, “The schedule is full already, where do you want to add sick patients?”.
9:05 – Start seeing morning patients. I will generally see an average of 4 patients per hour. In winter I may see 6 per hour. In summer, I may see 3 per hour, depending on the type of visits. Between patients, I am usually greeted with more questions about where to fit someone in, presented with more forms to sign, forced to be cordial to the drug rep who is bringing in the samples that we need and has her boss with her, have to call back to the hospital about a patient, or have to argue with an insurance company about approving the MRI that our patient desperately needs to prove she does not have a brain tumor or spinal injury.
Along the way, I do have the great privilege of conversing and playing with lots of fun little kids while making the best medical decisions for them that I am able. The relationship with the kids and their parents is what makes all the other hassles worthwhile.
1:30 – I finish my “morning” after 7 1/2 hours of work. I then move on to my lunch “hour”, which is usually less than 30 minutes and is spent reviewing labs, returning phone calls, and signing forms while shoveling in whatever I happen to have available for lunch that day.
2:00 – I start the afternoon and do more of what I did from 9:00-1:30. The after school phone calls begin and we work to try to fit in those kids who got picked up from school sick. If our schedule for the afternoon is already full, we usually add those kids on anyway and stay late to see them, unless I have a firm evening commitment that requires me to leave by a certain time. Right before closing is when the asthmatic in severe respiratory distress walks in and must be urgently treated in the office while arranging for admission to the pediatric ward.
5:00-7:00 – I will finish seeing patients somewhere between 5:00 and 7:00, depending on the time of year and day of the week. Once all patients have left the office, I will usually still be at the office for another hour or two finishing documentation and making phone calls. If I admitted someone, I will also dictate the admission note and follow up on any admission orders that I have done.
6:00-8:30 –  I  finally make it to the gym work out if I do not get stuck returning to the hospital for something. It has been sometimes 11pm to 12am before I can get home at night. 
So there you have it. A typical pediatric work day for me. Some pediatricians will work longer hours than I work. Some will work fewer days and fewer hours than I do. Most will have a similar set of responsibilities that they must somehow manage while seeing patients in the office, making the right medical decisions, and not getting too far behind schedule.
Despite how hectic things can sometimes be, I am glad to be a pediatrician and I don’t know what else I would do with my life. 


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