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New exam table in clinic, bought in Seattle and brought back in my Scion. I tried to figure out how to get it out, but it weighs 250 pounds. Hired local movers. They took the old 1970s one to the metal recycling, since I couldn't get anyone interested. I thought about a skeleton/exam table Halloween installation, but moving it once is enough.

Also two more new computers. One has arrived. We had a computer update to version 10 of Amazing Charts yesterday so today will be stumbling around in a changed program. Hopefully this is not as big a jump as our jump from version 7 to version 9. Chain chain change, sigh. The tower for the second computer has not arrived yet, so that has to be fit in too.

Apparently I have presented 55 patients to the telemedicine since 2011. I hold some sort of record. I will hope that is a positive, though maybe not. I think the specialists talk down on it, and lots of the rural docs never ever present a patient. (Those two things can't be connected, can they?) I find it annoying that I feel talked down to, but I mostly use them to keep my patients out of the Pain Specialist offices (and off evil methadone) and also to outrank me. If the patient wants something inappropriate/dangerous/crazy and puts enough pressure on me, I present the case. Then I can say that the panel: Pain Specialist, psychiatrist, psychologist, pharmacist, rehab doctor and addiction doctor have made this set of recommendations and domine domine domine I cannot do what you, patient, have pressured me to do. I suppose it's a reasonable trade: they humiliate me and I use them.

It's not really that bad. They are helpful sometimes. I wish one of them would do a week in a primary care clinic. I think it would be eye opening. I did present one patient where by the end none of the specialists would look at the camera. One said, "So do you ever say to a patient, you are too complicated and send them so someone else?" The addiction specialist is also a family practice doc. She and I started laughing and I said, "No, we are primary care. This patient is a LITTLE more complicated than my usual, but the buck stops here. We are it. We are one that the specialist sends the person back and says, yeah, this isn't one I can do anything about."

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