I'm a trainee in an internal medicine subspecialty. I've been working clinics for a few years now since the beginning of residency. I've probably worked ~300 clinic half-days by now: I've hated every single one.
I see 5-7 patients per half day (a 4-hour period). This seems reasonable enough, but I always feel rushed and stressed. I think a big part of it is that, due to the nature of training programs, the vast majority of these patients are new to me and they often have problems that I don't know how to solve.
Therefore, I have a ~30 minute period to learn the patient's history, talk to them, examine them, read on their condition, discuss with the attending, write my note and take care of any paperwork (orders, sign something, schedule some test, etc.). Then I need to completely switch gears and do this for a new patient (who is already cranky from waiting around).
Usually how it works out is that after a full day of clinic I end up absolutely spent, feeling like I left loose ends with each patient, with my notes half-done and then need to go home and finish notes and review results from the prior day's clinic. It's pretty exhausting and depressing.
I've tried reviewing the patient's chart the day before and pre-writing my notes. This definitely helps make the clinic run smoother. However, our no-show rate is about 30% (I'm usually scheduled for 9 and 5-7 show up). Additionally, even if they do show up, they often have a new problem that was impossible for me to expect and so all my preparation is fairly useless. Therefore, it's hard to motivate myself to spend 2 hours preparing for a clinic the night before knowing that about half of that effort will be wasted and it will be at least moderately stressful anyways.
To be clear, I'm not lazy. I happily work in the ICU, wards, procedure suites, and enjoy my work despite long hours and sick patients. It's strictly a problem I have with the clinic setting.
I'd appreciate any tips on how to make clinic more bearable!
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