Wednesday, July 30, 2008


Over the past 2-3 weeks I have seen maybe 40-50 patients. It's really hard for a girl who actually likes to work and use her degree. I've been known to see up to 30 patients a day during flu season. Needless to say, I'm bored.

Plus with our new compensation plan, I completely freaked out that come October 1st (beginning of the new fiscal year) I won't have a job. (They are going to add up all the RVUs from the year and see if I can keep my salary or if I haven't seen enough patients have the potential to lower my salary. See why I freaked?) See they (the crazy administrative people) started a new compensation plan that was supposed to start April 1st. It actually started January 1st. Instead of being based on visits and cash receipts, our new plan is based on RVUs. That stands for Relative Value Units. Something Medicare came up with therefore must be good. (Wrong)

I need to make 2500 RVUs in one year. To make benchmark, or 80%, that's 2000 RVUs. That's 167 per month or about 8-9 per day.

Each level 3 visit is 0.67 RVUs. A level 3 visit is pretty much what I see. If you go to the doctor and have a problem, he/she does an exam and prescribes you medication then you are charged a level 3. If he/she does less then you get charged a level 2, less RVUs. If you have more problems or the doc/PA takes longer with you, he/she can charge a level 4 or even a level 5.

All that groundwork is needed because the doc I work with doesn't like to do Sports Physicals. And you know how many RVUs I get for a Sports Physical? 0.17. That's right. Do you know how many kids I would need to see to come close to my 8-9 RVUs per day? A LOT.

So this time of year, what do kids need? Sports Physicals. But herein lies the issue, I feel like I do a lot more than 0.17 RVUs for each Sports Physical. I'm not going to sign off on a form and have something happen to a kid.

Anyway, it's been a real struggle at work. Problem is, I was being moved around last year around this time, working with docs who wouldn't let me see patients. So I really don't know if this is common this time of year. Or if the docs are so stressed out about the compensation plan that they are seeing all the patients. And I want them to stay busy. I just want both of us busy.

And my office staff hates it when I'm not busy. I start organizing stuff. Usually it's the drug sample closet. Then I start 'going off' on the staff because all the drugs are out of date. These past two weeks I've been helping our manager get the ordering stuff organized into 'kanban.' An interesting "lean" ordering system based on a similar system at Toyota.

I've been going into every room in our clinic and writing down everything we could ever need to order. Like every suture, we have 12, every bandaid, we have 4 types in two versions--latex free and fabric, and it goes on and on. I actually finished the project today. So what lies in store for tomorrow I don't know.

I've never been in a place in my life where I have nothing to do. First it was high school, always doing homework or working or studying for AP tests. In college I was always studying. And after college, studying for the GRE so I could get into PA school. And then I was always studying in PA school and felt guilty if I even turned on the tv. I only saw 3 movies while I was in PA school--in the theater. Then I graduated and was studying for my Certification Exam. See, I'm just a busy body. I always need things to do. I don't do well with boredom.


jeff said...

well, you could come to the ville and watch my kids anytime...i have a million things to do and no time to do them (or money).

Nise(Denise) said...

Sarah I love your blogs...they are so honest and real. BE STILL AND KNOW THAT I AM GOD is what came to mind as I read your blog. God is in control and He will work for your good. He may not swoop down and save the day, but He has a plan and you know that it's trustworthy. He loves you so much. With the drive time and now the job crud He is really working hard in your life. I am praying for you to hear Him and be still...and be ok with it. Love you so!

rachel white said...

time to start looking for jobs in colorado. : )