Hospital Billing and Insurance

The prompt for this next clinical reflection meeting at school was the following: To what extent are physicians' values and decisions responsible for the cost of health care, and what responsibility do we have to control costs? How cost-conscious have the physicians you have worked with been, and what rolled does financial stewardship have in the professional responsibilities of physicians? 

But like so many other things, I was still angry about dropping $175 at Walgreens the other day for 3 vials of lantus and two boxes of test strips, so I had trouble focusing:

I think it is fundamentally irresponsible to be a physician unaware of the costs of medicine and health care services. That being said, a lot of physicians don't want to worry themselves with the details. Have I ever worked with a physician who seemed to understand how much things cost for patients? Not really. No. But consider this: how many physicians actually have chronic illnesses? How many doctors are on a ton of prescriptions at any one time?

On the Eve of ERAS (applying to residency programs)

I'm on the floor with my head cradled into my pillow. I'm dragging in slow but shallow breaths, smelling the scent of leave-in hair conditioner that has diffused into the pillow cover since last washing it several weeks ago.

There's a bottle of extra strength Excedrin and a bottle of antacids sitting on the table that I was previously sitting at. They've done nothing. My head hurts and my stomach hurts and I don't know why. Or rather, I either gave myself food poisoning via homemade balsamic vinaigrette for a delicious salad eaten midday or I am so stressed out that my body is forcing me to give up on what was previously a fun challenge:

Write the Great American Personal Statement.

I believe my psychogenic pain is telling me it's impossible.

Tomorrow I will have to submit 28 to 30 applications (depending on if I delete/add any new programs in the next 24 hours) to family medicine residency programs that are literally all around the country. Or maybe I'll splurge and apply to 75 programs, like some people I know who are applying to more difficult specialties. They will shell out more than $3,000. But the common motto is: "It's cheaper than having to apply next year." Implying that many of us won't get interviews and ultimately match unless we apply far and wide and broadly because we're.... what? Not motivated? Not dedicated? Not humane? No the answer is "less competitive." But what the hell is competitive? I don't know. I really don't. It's different for every specialty and every program within that specialty.

Each application will include a copy of my personal statement. The Great American Personal Statement.

Oh hell. And then there's the added anxiety that is trying to end up in the same location as my significant other who is also going to attempt to match this year. The likelihood of us matching in the same geographic location is so... unlikely that honestly we should probably just break-up right now and stop prolonging a fantasy that is doomed to fail.

Unless I can write the Great American Personal Statement.

Because then maybe I'll get interviews everywhere.

And then all my dreams will come true. I'll become an awesome resident who will have an awesome career, and despite it being "impossible" to have a private practice, I will have one. I will have it all.

But literally, only if I write the Great American Personal Statement.

So I'm whimpering through and over-analyzing every sentence, every paragraph, every idea, every phrase.  This is impossible. Everything's impossible. What is medicine? Why am I doing this?

Because I'm a smart young adult willing to dedicate my life to years like this last one. With days like this one. Spent over analyzing the smallest of details. Because I want to improve the lives of those around me. Because I want to serve communities in a way that will make lives healthier, happier, and more productive.

Because I want to be happy with the life I've lived. I want to die knowing that what I have accomplished has made a difference in this world, if only for a moment in the grand scheme of things. But that I've effected change. That I've made others happy.

Oh my god. I'm crying. I'm literally crying right now. Because all I want is to help people. Which sounds so stupid and has been said so many goddamn times. But it's true. Why can't I just write that? Why can't I just put that in my personal statement? The Great f***ing American Personal Statement. I want to help people. My name is Elora Apantaku and I will literally do everything I can to help people until the day I die.

Socially Valuable

"Remember that competitiveness does not equate to what is rewarding or socially valuable. The least competitive specialties, Family Medicine and Internal Medicine, are highly rewarding and are perhaps in the greatest social demand." - Dean of Students in an E-mail to fourth year students

A comment from an article from io9.com: "The Herd Mentality of the Anti-Vaxxer Movement"

Pediatrician: Will you be vaccinating your children?
Parent: No.
Pediatrician: Please leave my office.

He then goes on to explain himself -
I often wonder why a parent who believes vaccines are harmful would want to bring their children to a medical doctor at all. After all, for immunizations to be as malign as their detractors claim, my colleagues and I would have to be staggeringly incompetent, negligent or malicious to keep administering them.

If vaccines caused the harms Jenny McCarthy and her ilk claim they do, then my persistence in giving them must say something horrifying about me. Why would you then want to bring your children to me when you're worried about their illnesses? As a parent myself, I wouldn't trust my children's care to someone I secretly thought was a fool or a monster.

probably something guys don't have to think about

While I was at the National Conference for Family Physicians, I had the opportunity to walk around and meet residents from over 400 family medicine residency programs. It was... awkward.

I am a socially awkward person. Put me in a room of a 1000+ people who I have to present my best features to and well... yea. Not so much fun.

But definitely interesting. I remarked to someone that had this been a conference for any other type of physician and I would probably be crying in a corner. Family practitioners are usually pretty funny or at least try to appear friendly. So that's.... something to comfort the social anxiety.

A strange thought occurred, however, when I was talking at length about a program with one resident. I think he was flirting with me. Which would be inappropriate so he probably wasn't... but what if he was? I mean--I'm also terrible at telling if a person is attracted to me and everyone was earnestly trying to be friendly. My face always hurt from awkward smiling once I returned to my hotel room. But seriously... what if he was? Could I use that? Could I take advantage of that to get into a residency program?

Sick, right?

Strange.

This is probably something most guys don't have to think about.