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On Box-Making By Caroline Giroux, MD Memories of odd schools, these bodies, cold and rigid My white coat was for days the chosen territory of formaldehyde The interview needs dissection So needs, we’re so told, our every action Our Hippocrates’ oath is shaken By the rolling of boulders from Adminland We’ve just entered the torture chamber 93011, 90899C, 99214… To figure out which lucky number to pick Make sure you count the “bullet” points, quick In this gun culture, my hands shake, uneasy About being the target of invisible auditors, Almighty… Queen Mother Likes to keep her MDs Even buzzier than can be Now our charts must justify the time for vitals The signs of life or the signs of declining health I feel like shouting, “Let me through, the SYSTEM needs to breathe… I am a doctor!” I want to help people Where is the way to this safe temple? I am not a very skilled acrobat To satisfy the fancies of bureaucrats Not enough that our brains are useless without companies’ seal of approval For diagnostic tests, medication choices or doses… I am so appalled! “Beware, these codes will expire July 1st, please use more granular ones” Not sure why, some words just make my teeth grind more And July 1st is tomorrow, with my documentation habits in gore But hey, by the way Also… Canada Day! O! Beloved universal health care, with not as many bullet points... or wounds!

“Add-on psychotherapy”: scroll down very far, click a check box “Interactive Complexity”: (implicit…) but you still have to click! Check another box 95510, one note if a patient is dysregulated And then a separate one… when crisis has finally dissipated A manager told me that an MD Is now a glorified secretary From eight to five, the flat screen eats me alive What about all this wisdom, in my soft drive? Better set the chicken timer for med management Drrrrrrriiiiiiinnnnng! Now time to set it for psychotherapy, No more medical questions allowed, sorry Scrutiny is this insidious shadow upon us, dictating without trust Will our skills disintegrate, to the stage of dust? I hate moving, I hate packing Boxes segregate my treasures, I always forget where all went Patients have so many beautiful complexities But how to intervene when our thinking is in chronic agranulocytosis Remember? I once studied for many years to become a doctor I believed in the path of recovery through relationship Have I espoused a now sinking ship? This trusting, continuous process is hard to decorticate Yet I hope impossible to desecrate Remember: I am not a box-filler, I am doctor With growing knowledge, competency made of aware ignorance Already tired of this click-click-click dance And whose 10 min each visit it would take extra to be a coder Could be used in a way much better… cgiroux@ucdavis.edu

September/October 2015

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2015-Sep/Oct - SSV Medicine  

Sierra Sacramento Valley Medicine is the official journal of the Sierra Sacramento Valley Medical Society (SSVMS) and promotes the history,...

2015-Sep/Oct - SSV Medicine  

Sierra Sacramento Valley Medicine is the official journal of the Sierra Sacramento Valley Medical Society (SSVMS) and promotes the history,...