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My receptionist came back last Monday.

Hooray! Half days only, tired. But we started catching up. Yesterday she stayed in the afternoon and worked on the pile of scanning. The scanning is boring deliberate work. If the lab or echocardiogram or cardiology consult or prior authorization is not labelled correctly going in to each chart, I will not be able to find it. It is true that we could set the fax to send the documents directly into the computer, but they still have to be sorted, prioritized and signed off. Oh! This person is going into kidney failure, that goes at the top of the pile, closely followed by the Veteran whose labs were not done because the lab doesn't understand Veteran's Choice. And so forth. The normal labs or pap smear get signed off and scanned and either go into a file to be handed over at the next visit, or I send a copy with a short letter.

Clinic is going well. I am finally back to the work level from before I got the second round of strep A, June of 2014. So it has been 3.5 years. The clinic is slowly starting to pay me back for the money that I put in to it. That is not profit, of course, it's loan being paid back.

I still have to keep work to 40 hours. With the "median" family doc reporting working 60-70 hours a week, I am seeing patients a little more than half days and the rest is spent in the paper hive. We no longer look like paper hoarders by this Friday. Part of it is that 77% of our patients are over 50 and 48% are over 65. And some are really really complicated.

Medicare has a new billing code for "chronic care". A care coordinator can spend twenty minutes a month calling the patient to check on them. The requirement is that they have two or more chronic diseases. I started laughing when I read it, because the first two patients I've picked are in the 9 or more category. I think 95% of my patients would fit in that category.

We are going to hire someone to scan a few days a week. After an hour or two it's hard to do it right. We've gotten another printer so we will have three going: one for scanning and prescriptions (special paper). One to receive faxes. One for outgoing faxes and for me to print lab and radiology orders and notes and patient instructions and consult letters and so forth.

Blessings on everyone.

Any brilliant advice on how to arrange back up for a two person office? Bit tricky, isn't it. When I was lightening the schedule a week ago, I could truthfully say that 50% of my staff was out sick....

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