A Day in the Life...

Now that I've been working for over a month, life has settled into something of a comfortable routine. In some way, since the hospitalists work independently of each other (unless we're on call), I am my own boss. I set my own hours, decide when to come to the hospital and which patients to see first, and leave when my work is done. Most days I come to work between 6:30am - 7:00am in hopes of finishing earlier (so that I can get out of the hospital sooner), but if I worked a 5-10pm call shift the night before and didn't leave the hospital until 11:30pm, then I'll usually come to work later, like 7:30a.m. (try to give myself at least 5.5-6 hrs of sleep a night). Or if I need to be somewhere by 4 pm and I have 15 patients to see, I'll come at 6:00 a.m. to give me plenty of time to work. No one ever yells at me for being late, and no one tells me how to practice medicine. I just hope that I know what I'm doing.

In the mornings, depending on how high or low my census is, I can usually expect to get some extra patients who were admitted overnight. Or, if one or two of my partners has decided to take the day off, their patient lists are split amongst the rest of us. The only rule regarding taking days off is that 10 hospitalists have to be present on any given day, so some partners use this to their advantage (i.e. take every Friday off). I once took a day off to attend hospital orientation, but since I got out in 4 hours, I ended up taking back my patients and working a regular day anyway. This is why I try to come to the hospital early; yesterday I ended up with four new patients on top of the others I already had. My "desired" patient cap is 15, so as long as my census is less than 15, I can almost always expect to get new patients every morning.

The general rule is to see the ICU and IMC patients first, and since the IMC is on the top floor of the hospital, proceed with gravity rounds. I usually stick to this rule, but there are times where I will skip a floor (i.e. if the patient's a rock) and go to a different floor where I know I have pending discharges to do. We try to discharge patients as early as possible, and those take up a LOT of time (paperwork plus dictations). I once spent almost an hour dictating a patient who'd been here for a month and miraculously survived everything that got thrown at him (GI bleed with simultaneous MI, gastrectomy, post-op CVA, etc), and that delayed time in seeing other patients. On a good day I can see 4-5 patients in an hour if they're not too complicated. The ICU/IMC patients usually take up a good 30-40 minutes per visit.

Food is free for physicians in the hospital (awesome perk!), and is usually not that bad. I've even stopped making my own breakfast of oatmeal and eggs b/c I can get the same at the hospital (plus extra fruit and bacon I wouldn't otherwise eat....) The menu has both healthy and greasy options, though my biggest weakness so far is helping myself to a chocolate chip cookie for dessert at lunch. I never ate cookies in residency b/c I had to pay for them (which I refused to do), but when the cookie is free, then all that goes out the window. So needless to say I've gained some weight. =P

Overall, more good days than bad on this job. Can't complain about that one =)