A snowflake rolling down a hill will have less and less sense of rotation and movement over time the bigger the snowball. Eventually it may not know it’s rolling or moving at all. That to me is many of us in healthcare.

We still know we’re rolling and bouncing, just not sure where to.

This image came to me after I got a Pre-R call from someone with pink eye requesting antibiotics. We talked. I said most of these are viral, especially if someone else in the family has a cold. His wife had a cold and a pinkish eye too. He said thanks and a few days later got better. He knew he could call me if he got worse. I knew that checking vital signs, visual acuity, extra-ocular movements and pupillary activity would all be upsell and wheel spinning. That was the end of it. No bill. No coders. No EMR. No payment. Just a bit of advice.

In this Judeo-Christian wannabe country of ours, that medical exchange shouldn’t cost anything. If he wants to make a contribution to Pre-R to say thanks or drop off some eggs, that’s just great. But shaking down someone with a medical question, or chasing their insurance company, just wasn’t my target when I went to med school.

Another story… I recently received over four separate emails regarding a kid I saw briefly when he came back to the ER, as instructed, to have two staples removed. While I’d circled the location of his wound on my chart, they wanted the wound location written, and whether it was above the hairline. I said I’d get the chart sorted on my next shift. That wasn’t good enough. It had to be completed ASAP to close out the chart for billing. Over an hour of life lost just figuring out how to modify and sign this chart from home. I asked what would be the bill… $250! I now send patients home with scissors and staple removers with good instructions.

Beam me up Scotty! This snowball is crazy.