Today’s medicine is not the medicine I signed up for. I am a Xennial. Sandwiched between generation X and millennials, I don’t really belong to either. I didn’t grow up with the technological advancements that the millennial generation enjoy. I grew up with corded telephones, large box televisions, and without a computer in the house. We played in the streets until dark with the neighborhood kids and played board games instead of video games. I didn’t grow up with social media or Wikipedia, although in my later teenage years was quick to adapt to the technology that is now commonplace. I have enjoyed an analog childhood and a digital adulthood. I am also from a Xennial generation of medicine. Medicine was different when I started. I entered medicine in a world where providers were respected, when the majority of physicians were in private practice and had autonomy over their schedule and their practice. I entered medicine when the electronic medical record wasn’t even a phrase. I have witnessed an evolution in medicine. I have watched medicine change. The majority of health care providers are now employed by organizations instead of private practice. Schedule autonomy is almost non-existent. My day is no longer taken up by patients, but 40 percent of my time is spent documenting. I have less time with patients during my workday and more time with my computer screen, which even follows me home at night, long after my workday is done. During my time away from work, I am following up on labs, doing prescription refills, returning phone calls and contacting pharmacies because it isn’t possible to complete the mass volumes of these tasks during normally scheduled work hours. My time is spent trying to find billing codes, trying to convince insurance companies that my patients need what I ordered, trying to figure out how to input medications into an EMR system that doesn’t have my patient’s medications or dosages and no option to free text. It is spent going from one computer program and flipping between five screens to document on my patient, a separate program to order their medications, yet another program to view their X-rays. My schedule is not mine. I don’t have the ability to block my schedule if I need time to complete continuing education, hospital-required e-learning, or even if I have an appointment of my own. Requesting time off has to go through two to three different people in order to gain approval, and is frequently denied due to lack of coverage. My clinic schedule is often double-booked, sometimes triple-booked for a 15-minute time slot based on the premise that some of them might not show up, only to have all of them show up and be irate with me for “running late.” I remember a time in medicine when EMRs did not exist, when burnout wasn’t so high. Today’s medicine is not the medicine I signed up for. Today’s medicine is filled with overburdened and overworked providers who are trying to stay afloat. Today’s medicine is plagued with health care workers who entered medicine with good hearts, vowing to be different, vowing to take time with their patients … only to be swallowed up by the system. Talia Sierra is a physician assistant. Source
