Work-since I spend most of my time working I can let you know how that is going. I just worked today from 9am til 12:30 and than had a 1.5 hour tea break before returning to work from 2-5:30. I saw 37 patients!! That is not too out of the ordinary. A typical day were I am not seeing walk in patients I will see 17 patients between 8-12 and than another 13 patients from 1:30 to 4:30. So a typical day is 30 patients and a busy day may be up to 40-45 patients. In the USA I was seeing probably 20 patients a day. Much busier here but much less documentation to bottle you down. I like it. There is a lot less administrative oversight and management here which I like-I spend time seeing patients and helping the sick. It is without a doubt better than the States that way. I have to admit most of the time I don't feel that rushed seeing all those people-if I saw that many in the States I would have been making big dough!! Maybe as much as Chris Balgobin!
The downside is that specialty care is very strange-today I tried to call radiology to ask about what would be the best test to order and I couldn't talk to them-the receptionist was giving me a hard time. At home I would have no problem talking to them. It seems like specialist have a huge wall of protection around them-they don't educate patients or there primary doctors well about the plan yet toss them back to primary care for all there follow up. Today I asked a guy with adenocarcinoma of lung with mets to his brain if they had ever told him what his prognosis was and he said "no" but was planning to ask at the next consult. Wouldn't you as a Cancer Doc think the patient would want to know that!! Common sense should tell you yes. Also-say you see a specialist and they do some surgery or procedure and you have questions or concern about what happened-you can't just ring them up-you would have to come to primary care and get re-referred and they will see you in maybe 6 weeks. Here was another great example-I saw a guy with previous knee replacement by a local orthopedic a number of years prior who came in complaining of wanting his other knee evaluated by the local orthopod. He said the orthopod had tried to convince him to do the other knee as well but the patient said he wanted to hold out. He held out for like 7 years and when I referred him back to local orthopod because he could barely function on that leg the orthopod wrote me back a note-it said it doesn't sound like it is that bad and he can wait. I just about cracked a nut. It seems to be a game to deny first referral cause than if you really want them to be seen you re-refer them back. Nothing like needless paperwork. So-not all is great in a national health care system. But-I still think it is probably better than what we got.
Another thing that bothers me about healthcare that Kelly and I were talking about the other night is how to get insurance. I come to New Zealand and pay the taxes with my 2 year visa and I don't have to worry about if I get sick or have any unfortunate accident/illness. Yet when we go back home I will have to worry about getting insurance and likely if I get insurance I will still worry about how much it will cost if I get hurt/ill or whatever. I just the quality of life in the US with all people would be so much better if insurance wasn't such a burden-affordable comprehensive health insurance. I just wonder how many of us work for insurance, not the money!! You can't retire early cause we worry about insurance. I can't take my family on a long holiday cause I have to worry about insurance. I wanna come home and take a big road trip for 3-6 weeks and see the US but will I be able to afford insurance to allow me to do this? New Zealanders get I believe 4 weeks mandatory holiday plus there are 12 holidays/year. What is it like at home-2 weeks and you better not get sick cause that comes out of holiday/vacation time. Plus-is there really a holiday in the States anymore where things are closed. I just wish the people would come up with a plan for affordable health care-it is so nice to not have to worry about if my family will be taken care of! It is such BS that this is a political debate-I don't care what your beliefs are politically-I just think Americans deserve AFFORDABLE COMPREHENSIVE CARE and if you have to be patient to get that care-LEARN to LIVE with IT. It is better for all. In New Zealand you can buy insurance as well that gives you first class service and access but it costs extra.
All right, on to other things. Surfing. Although I have not been surfing as much during the winter-I could still get out there and surf if I wanted too. It is not that cold. First off surfing is a tough thing to learn. You see those individuals cut up the waves and think that looks easy-well get out there and try. It is tough. Kelly was in Hawaii and took some lessons to learn to surf and I was giving her soo much crap about the size of the waves-well I should eat my words-I was on the same size waves learning. I have gotten lots better but there is also bigger and stronger waves to catch. I am able to ride some green waves and am still working on riding the face of a wave/turning on the wave. I ride a long board currently and most of the surfing people see is on short boards-i doubt I will ever get to a short board but hope to ride a mini-mal board(short long board). It wasn't that long ago that the thought of swimming in open water much less the ocean terrified me. I am so proud of myself that I can now swim for miles in the open water without panicking and that I can go out in the ocean on my surfboard and not be terrified of sharks/fish/creatures getting me. I am really hoping Liam will do some white water surfing on my board this summer. I have done some surfing with an old North Memorial colleague-Bob Levine. That has been really fun cause we are of similar ability.
Weather-I can only saw the weather here is awesome. I don't know how I can live in Minnesota again-I don't want to move to San Diego or anything but something a little more reasonable than Minny.
Venison Wars-one of the most fascinating things I have heard about here is the Venison Wars of the 80's. A patient of mine was a part of this fascinating history where hunters would riding in helicopters with loaded semi-automatic rifles shooting deer out of the side of copters. They would have AK 47's with 20 round magazines taped together so he could pop one out and put the other in to shoot venison-he once shot 47 deer in 47 minutes. They were getting big money for the deer dead. Later they could get more for a live deer so they started shooting net guns on the deer-they could get 4-5000 for a deer. Can you imagine riding a chopper down over a deer and shooting a net gun onto the deer-jumping out wrapping up the deer and hauling it out alive to sell to farmers to raise more deer cause the meat was worth soo much. Needless to say the guy said it was very dangerous-choppers were going down frequently and the lifestyle was one of work hard/party hard. He is a very fascinating man-I am a little jealous. He brought me some venison this week-I hope to hunt with him as well.
Mail delivery-a job I kind of want here is to deliver the mail. they ride bikes everyday to deliver the mail. Probably not paid as well as I would want but I am envious.
It's November 15 here in Minnesota, and I was just thinking a week or so ago, that I hear about Kelly and the kids adventures and daily life, but what does Brett think and feel about his work life, and his interests in New Zealand?
ReplyDeleteSo I decided to check the blog and was glad I did. Thanks for posting this, Brett! It's really interesting what you have to say about the health care systems.
I can see how the waiting for specialists and inter-doctor communications is frustrating. Do you think that could be a result of a different mode of operation in general? I mean, it's a different culture, slower, and the system was set up under different conditions originally. Do you feel that in the US, a switch to a national health care system would suddenly mean that doctors would not communicate (these systems/practices are already set up), and that the wait would suddenly become weeks or months longer than they are now - which is not bad here?
I think because the US has fast service (by comparison) that that would continue, and that Americans and American physicians would make sure they remained that way. I mean, it's the method of payment/insurance that will change ultimately, not the method of care. No? Would National Health care put us back into the dark ages?
I think you and I really agree on this, but are both frustrated that the real conversations are not taking place in Washington DC. (Don't worry. Michelle Bachmann WILL NOT BE THE NEXT PRESIDENT! Haha.)
Hope to see you all in May sometime. You'll have to come back to the hood for a visit. We still miss you guys.
Tell Phoebe I hope her finger is healing nicely.
Oh, and we've just had the most long and beautiful fall I've ever seen in all my XX years in Minnesota (and that's a lot of years)! There are still golden leaves on many of the maple and other trees. Imagine that - on November 15!
Kate Vichich