My Turn to Present

To keep retirement from becoming too unstructured, I've enrolled in the Osher Lifelong Learning Institute, acronym OLLI, where I take classes two mornings a week and learn to play Mah Jongg late Wednesday afternoons.  One class, which I also took last semester, has the title Of Minds and Men.  At one time it was for men, but not wanting to jeopardize any access to funding, it has been co-ed for a while.  The enrollment is restricted to as many people as there are weeks in a semester so that each person leads the discussion one time.  I wanted to learn about Echo Chambers, but the sign up sheet got to me last.  Procrastinators being what they are, people captured their date from latest to earliest, leaving me with date at the beginning, which means picking a topic that already has familiarity.  Last time I chose exorbitant drug pricing.  This semester it's Electronic Medical Records.

It's one of those subjects that divides emotion and intellect.  It is hard to overlook the potential of maintaining data in an organized retrievable way.  With little effort I can see lab trends over years, know exactly which xrays are on file and review the reports easily and the images with a little more effort.  Calling up the notes, I know who saw each patient when, though the reputation of the note writer often screams Ignore this One.  Handwriting problems disappear.  Spelling is left incorrect so that future readers can figure out what I typed myself and what falsehoods were generated by the computer which performed better in spelling bee than I did.  Since most people have most of the elements of their exams normal and I pretty much examine everyone the same way, I can create a generic exam, leave what's normal, change what's not, and delete those things I did not examine on that individual.  I should be a great enthusiast, but like most clinicians, I am not.

It's tedious.  And since work is generally task based, the time distribution of the individual tasks that comprises with work day has redistributed in a less satisfying way.  I generally do not like telephone sessions for going over lab work or revising medicines.  The computer requires use of a template to document the call, expanding a one minute telephone encounter to a four minute telephone encounter, most of it filling out the template.  That means call time has to be more scheduled than previously, where a 1-2 minute span on the telephone could be squeezed into an odd moment, to say nothing of expanding the time that I like doing the least.  My records are not adequately maintained, particularly among shared users.  It is common to have a medicine list with three different doses of the same medicine.  The medicine list works on the Roach Motel principal, the pills check in but they don't check out.  Huge amounts of data to tease out successful from unsuccessful processes should capture my professional imagination, but that task and the design to do it goes to somebody else.

I do not know how much credibility I will have among the class, when the other doctor will not be there.  But I will convey the good, bad and ugly in its the most objective way that a person who sees himself as victim can overcome.