The Flow Stopper
With fairly straightforward patients who can communicate well, this is an achievable goal. Tell me your problem and I'll fix it, or I'll find someone who can. That's what I do.
Unfortunately, far too often traffic jams occur. One slow driver in the left lane, a poorly-timed trainwreck, or someone giving grandpa a phenergan will all have the same effect. The laminar flow trickles to a halt, and once it stops it takes a while to get it started again.
These flow stoppers may present in various forms which have been well-described previously on this blog and many others. Any patient who requires an interpreter, any time-consuming procedure, patients who are overly demanding, patients with numerous concerned and annoying relatives, patients who want to be admitted but don't need to be, patients who need to be admitted but don't want to be, patients requiring more than one or two calls to other physicians, and so on.
The challenge is to deal with the traffic jam and resume the previous pace, which is easier said than done (for me anyway).
I sometimes wish I had a REJECT button to use once per shift in a situation that is unnecessarily slowing me down. When Mrs. Jones asks me to talk to her (Pediatric resident) nephew in Iowa to discuss her current condition, I could just press the button and move on to the next patient.
Before I spend a painful 20 minutes on the interpreter phone trying to get a history from Mrs. Xiang, who is almost as deaf as the interpreter, I could just hit REJECT and see three other patients instead.
When I've already arranged an admission for Mr. Stewart's chest pain, and then he wants me to talk to his son's Cardiologist across town and try to transfer him to another facility, I'd be all over that button like I was on Jeopardy and the category was The Human Body.
If grandma's feeling a little bloated because she can't poop, I'd be hitting that button like a fibromyalgia patient on a PCA pump.