The following example of family doctor is quite real, written by John Gérvas (village doctor, the most combustible and media jgervasc@meditex.es).
A typical day, Monday, from a general practitioner for 60 years great professional:
4:00 a.m. .- At four foot (without alarm) hoping to end the chapter on clinical governance practitioner, for a book that coordinates Vicente Ortún; me a text is very hard for clinicians but no light in him, I talk about the cynicism of the medical and political carnival and managers who want to transform parrarayos physicians from their mistakes and Abandonment, I am excited about writing it, full control literature and
5:00 a.m. .- I continue with the correction of a letter to the editor of a resident who passed this summer, for the journal Primary Care, on "versatility rural physician "needs changes, but the structure is correct.
5:45 a.m. .- Some email
loose .- 6:00 a.m. Breakfast, organization of the week (the deputy medical Buitrago del Lozoya no comes to replace him this week, you owe the money to the substitution of summer is to organize everything)
7:30 a.m. .- Clean snow and ice from the car, nearly fifteen degrees below zero, and in the street because are blocked access to the garage at home, with snow and ice accumulated, tear them without problems
8:30 a.m. .- In the center, Buitrago, half an hour before opening, the guard well, nothing outstanding; leave written instructions to administrative and physicians about a week at the health center Buitrago, to meet the doctor on vacation, I see two doctors and a clerk, called the deputy chief medical officer and gives me a laugh (have not paid since the summer to two doctors, although to claim a thousand ways !...) and I do not get (a good person, secondly ...); give a notice home to Buitrago call to value and I am to do it before eating
9:00 AM .- Salgo Canencia escaped the Sierra, to sign the death certificate
Irene (end of 92 years, heart failure, that I care two weeks last visit last night, Sunday, before dinner, I gave morphine to relief from the agony; two hours after the son called home to give notice of his death) refers to sacred drink coffee with the family, give their condolences and congratulations to Irene's daughter has taken him so well in front of several neighbors and family, with the pride and do not know how to thank the support that his mother died with dignity on the table, copy of health supplement of El Pais on Saturday January 10 with my picture and comments (which brought a niece and show him my appreciation)
10:00 a.m. .- In the run Garganta de los Montes, there is ice on the road and the car fucks (I have the worst for this, the Mazda MX5 as I let the Audi- 3 with four-wheel drive to my wife, also rural doctor) I eposición material than used in the statement on the last day (dissecting forceps with teeth and wearing of the exrtirpación a cutaneous horn, and oxygen marcarilla of an asthma attack) came with delay on usual, but my time, I escape, I have to pass query Buitrago at lunchtime, the holiday companion, without water, the cold, they set up in the morning and the sheriff comes to me say happy having solved the problem, "the doctor" I've been washing my hands with the alcohol solution that breaks my skin, I take the colors without love a Romanian girl who comes to the floor of her mother (excellent worker and person, two elderly care) because he slipped and broke his ankle (the little girl told him that it is not you older people is not known); consultation with the family sacred and the teenager who became pregnant and miscarried (contraception with the girl, unemployment and marital separation with the mother, the crisis in vivo in the query), I'm worried about an elderly woman with back pain, 34 patients in total. Uff!.
called a journalist Telemadrid, they want to do an interview with me about it in El País, I give the house phone and call this afternoon. At the end call center to confirm that no more notices, not only that you took this morning.
13:30 AM .- I go without problems accumulated snow Buitrago at the bus stop is the Romanian girl, stop and ask if you Buitrago (yes) and if you want to take her (yes). Mounts happy, working in the hospitality and speaks English very well, but has not been studied, in their country only studied up to 14 years, we cross a fox out of town, stop and enjoy the spectacle of seeing him get on snow up high. What's your name? Monica. How old are you? 20. And you, he asks. I tell him something about my life, why I this car, what you like to have grandchildren automatic convertible metal roof ... He tells me how different it is to make the bed here (in the hotel where she works) and in Romania, I remember a similar assessment when 40 years ago I first traveled to the Anglo-Saxon countries. Buitrago to leave it go out to open the door. To restart play the trumpet, he turns and says to me gently waving goodbye.
13:45 AM .- At the prompt, in Buitrago, Sheltered Houses (elderly patients);
I get the concierge, and I passed the office of the director who explains that the girls are concerned because the mother does not eat , vomit and do not know whether to wait to review its operation of 29 breast cancer, I came to the apartment of the elderly, is determined not to go to hospital, exploration bland, watery vomiting following a binge at Christmas; prescribe metoclorpropamida and omeprazole and pray, promise
back on Friday 14:00 (PM) .- In the center, to begin the consultation, there is another notice, given at 10, in Sheltered Houses (of which I have just come!). Wear eye and face of fierce wild and let things clear with the administrative and the guard, who were not well coordinated. Yes nurses are well coordinated, which on Friday called for guidance after we learned that there was no substitute for make it clear they did not want to be alone with no doctor. I put new face of fierce eyes and to ask that in such cases talk to me first, the coordinator, and to ask you what if today at 09.00 to the Department had called to say that there was no nurse, that would I say idiot because
are always on time, and before, for that which should not be idiots. I have arranged for the center header always has a doctor, of course. I attend to 20 patients aged Buitrago, a sacred consultation with a mother with two children can do no more with children's colds and the burden of life. Uff!. The second notice has Sheltered Houses Indeed my wife phoned me to tell me that was not the patient, who had called 112 and had sent two ambulances and a helicopter (fever with suspected tuberculosis). This is the mismatch in the extreme. I have to talk to the director of Sheltered Houses.
16:00 (PM) .- At four in the afternoon came the mate on watch and I'm going home
16:30 (PM) .- Snack; call Telemadrid journalist, tomorrow will come to Canencia to the report, I send material (publications and text for new patients) about my work in Canencia.
17:00 (PM) .- I light the fireplace, reading newspaper (Public) The mother who gave birth to Israel!
18:00 (PM) .- With the e-mail, full of friends and acquaintances who discussed it in El País, one dear to move me, for example, photographs that told me to Paco Sanchez Sevilla, extra classes -working kids from a marginal neighborhood on the art of photography (some rooms reminiscent of elícula "Gomorra"); draft of the introduction of ethical guidelines that coordinates Diego Gracia and in which I participate (ethics and incentives); new version of the letter to the editor of the resident (almost final version, very good); final one-day program organized by Rafael Cofino, in Oviedo, February 17, on prevention in the healthcare system (I will use and abuse prevention and put the sample of mammography screening for breast cancer); news items in various international lists, for example, the impact of the appointment Ralph Nader on the FDA
20:30 (pm) - Cena deliciosa (pinto beans widows, almost buttery, and a pork tenderloin fillets, grapes and polvorones).
21:30 (PM) .- I decide to write to the list MEDFAM on discrediting the hero (the general practitioner / family). I do not know if it will look like an exercise in narcissism and / or exhibitionism, but someone has to say that negative images primary are only part of reality.
22:30 (PM) .- The command, close to bed, which is half-past ten at night.
