settling in-

My first day of work was spent meeting people, driving to the nearby town to meet a supervisor doc in private practice, viewing the electronic medical record with another supervising doc, touring the Hawera hospital (10 beds and a nice ER) and viewing forms.  Second - fifth days were patients spaced mostly 30 minutes apart. I shadowed my supervisor on a few of his patients.

Kiwi people have a birthright of universal healthcare and income assistance. Accident coverage can be provided for everyone, (even self-inflicted snowboarding) and disability/work income. Most of the Work/Income (WINZ) forms I have done for pts this week have been appropriate- more appropriate than most of what docs are asked to complete in the US.  Very few requests for pain meds- most folks take panadol (our tylenol) or ibuprofen. I finally feel like I'm getting the hang of the EMR- much more user friendly than anything I've seen in the States. The biggest challenge is just learning the referral system and the meds. Furosemide (Lasix) is frusemide. -yeh- sounds alike but when spelling in an EMR on a 15 minute visit for a heart failure, hypertensive, constipated, high cholesterol, diabetic, etc. patient- frustrating to go through all the f and l lists of drugs to find it.

This week I'll move from a temporary room to my own for the year. The docs in our practice stay in the "consult room" and retrieve the triaged patient. No room hopping. Procedures and EKGs are done in the "theatre". No exam tables with stirrups, but there are abundant sheets and pillows for each room. (I could never find a pillow in any previous practice.) The Maori people have an opening prayer at 8:30 to start their day, and a closing one around 4. I'm usually working during that time, but I did get to participate in the opening on Friday. I can hear them singing down the hall. It's very peaceful. Most of them are very spiritual and nature respecting. Most are Catholic/ Christian and very focused on their family. They are all kind and respectful.

I finished electronic tasks at 8pm on Friday, but hope that I am getting faster. We currently have to print all Rxs, letters and labs, but most forms and radiology requests are electronic. They do not screen for colon cancer here. Cervical paps are done by the nurses with the patient lying on their side. Ending flu season here, but a flu swab is a 2 day send out. No rapid strep tests- just throat cultures (which is fine with me). They use a lot of chloramphenicol for antibiotic eye drops. Well child checks are all done by a nurse practitioner, but I still get to do a few, and do 10 minute walk in visits on sick kids. Most GPs here do not do prenatal or obstetric care. There is one private guy in town that does but I haven't met him yet. Midwives do all routine deliveries and OBs do the C sections and complicated pregnancies.