Tuesday, July 26, 2011

Tongue Depressors

Ever since my partners and I decided to go it on our own and start our own practice I have had this image of stocking drawers in exam rooms with tongue depressors. In reality it is one of a million things that needs to happen before a medical practice is open and is frankly on the bottom of any sort of order of importance. But tongue depressors are one of those omnipresent images that a medical exam room brings to mind. Have you ever been in an office that didn't have a neat glass container of the wooden sticks or a drawer dedicated to holding them? They are, in a way a symbolic and universal tool of all physicians.


This morning, after months of preparation, I finally got to fill drawers with tongue depressors. It wasn't anything ceremonial. It wasn't what I set out to do this morning. It just happened. After stocking exam rooms with diapers, wipes, wheeled stools and sharps boxes, speculums and alcohol swabs, barf buckets and reflex hammers I came to the bottom box in the pile and pulled out the little wooden sticks.


It made me stop and think about everything that went into those little sticks and everything that had to happen before they ended up in those drawers.


For instance: First we had to dream up our practice and decide to take the plunge, the leap of faith that it takes to go out on our own. We had to decide that those tongue depressors would exist in the first place.


Then we needed to write a business plan and get a business loan to pay for tongue depressors as well as pay the nurse and medical assistants to make sure that they are in the drawer when I need them. Pay the receptionist to talk to the patient and arrange that they will be sitting in this room when I decide I need a tongue depressor. Then we had to advertise for, interview and hire all those people.


We had to find a building, pick out the cabinets, choose the walls to put them on not to mention the carpet, electrical outlets, flooring and ceiling, even where to put the walls in the first place. Then we hired a contractor to install all of it so that I would have a place to put the tongue depressors.


Much time and energy went into choosing, contracting and installing the computers, printers and electronic medical records so that when I used a tongue depressor I could document what I found and what I decided to do about it.


We bought a refrigerator and installed temperature controls as well as an alarm system for those controls. We bought coolers so that if the controls failed we could save the contents of the refrigerators. We stocked the fridge with thousands of dollars worth of vaccines and stocked the nurses station with syringes, needles, alcohol swabs and band aides, (not to mention the nurses themselves). Then we brought in the health department to inspect our fridge, vaccines, coolers, needles and sharps containers and nurses. All this so that our patients would stay healthy and I wouldn't need as many tongue depressors.


Then we installed an alarm system so that nobody would steal our tongue depressors (or the computers, phones, cash or the giant TV that we use to distract kids while they are waiting for their date with my tongue depressor).


We put ads in the paper, built a website, a facebook page, wrote letters and printed fliers and business cards so that more people would come see us. Because if people came to see us I would get a chance to use and therefore pay for the tongue depressors.


We filled out pages and pages of paperwork for dozens of insurance companies, government agencies and community programs so that our patients can afford a visit to the room with the tongue depressors.


We obtained our own insurance so that if I do a lousy job with the tongue depressor I don't put my partners out of business. More insurance so that if a nurse gets a sliver from a tongue depressor or a patient crams one into his ear and sues us we can still afford to practice medicine with the remaining wooden throat inspectors.


We hired someone to make us a sign, wash our windows, clean our carpet, install blinds, configure our computers, organize our phones, keep track of our numbers, review our contracts, mow our grass, seal our driveway, bill various insurance companies, plow our driveway, call our patients and remind them about their appointments and many more I can't remember off hand. We bought exam tables and diapers, waiting room chairs and automatic paper towel dispensers, pens and ipads. All so that we can do what we do.... well you get it.


There have been a lot of hours, a lot of thought, planning and effort that has gone into starting our practice. It has been stressful and I have felt like I was neglecting my family on multiple occasions. But it is indeed a dream come true. It is a goal I never thought I would obtain so early in life, starting my own practice and stocking drawers with tongue depressors.








4 comments:

Marni said...

ipads? thats awesome....what EMR did you choose?

Sadie said...

Congratulations, Sarah. This is truly monumental and I wish you the best of luck as your doors open and you start flying through those tongue depressors!

Dora said...

So inspiring, Sarah!! I love the way you laid out all the steps it took you to get here- what an undertaking, and all while being mom to one, then two little ones! You are starting a legacy for yourself, your family, and the community you are serving.

Lora said...

This is fantastic!