As I finished the endless clicking, the clinic day came to a close. Clicking to begin and end phone visits. Clicking to get on and off Zoom visits. The endless video game clicking that is life as a physician documenting electronic health records. Too bad I have never been a gamer; maybe some who are can imagine amidst all of this they are in a scene from a Nintendo or Playstation classic. Clicking boxes to satisfy coders, billers. Clicking to verify my RVUs and my worth as a cog in the health system machine. Clicking to keep insurance companies from refusing to pay. Clicking to help my patients? Not sure. I sighed with exhaustion. 100 percent show rate. Again. I whisper, “I miss the no-shows from pre-COVID,” hoping that Hippocrates doesn’t hear me. (If a well-intentioned, all-alone pandemic physician whispers this in the woods, does the tree that falls actually make a sound?) In primary care, those no-shows gave us a chance to catch our breath. They afforded us a break from all the clicking. A chance to rush to the bathroom or say hi to a colleague. Now, there is no such reprieve. We sit and see one after another. Often, a day in the clinic goes by without even a conversation with anyone beyond my medical assistant. I barely move, mustering a few hundred steps in a full workday. I try to convince ourselves that we are doing “real” medicine, having a “real” connection. The only thing “real,” at least at the end of this day, is two hands tired from clicking. You know, it is not no-shows that I really miss. I miss seeing real people, including that tense excitement before entering the patient room, neither doctor nor patient quite sure what to expect. I miss real in-person moments with my patients – tears of joy and sadness shed together. Tears just don’t happen the same in virtual visits. I miss the chance to gently place the stethoscope bell on the elder’s chest. I miss checking the infant’s rash to then reassure parents it isn’t life-threatening like Google had told them it was. I wonder if my patients miss seeing me nearly as much as I miss seeing them. Anthony Fleg is a family physician who blogs at Writing to Heal. Source
