"Doc Hollywood chimes in"

Well now it is my turn. On the work side of things, just getting started as I am finishing my mandatory orientation as dictated by the Medical Council of New Zealand. Mostly getting used to the "system" here in terms of access and insurance etc. Of course no system is perfect but it is interesting here. Most have some access to care here, public and/or private. Public is slower in terms of waiting for big ticket items as they are done according to need. If you have private insurance or are willing to pay then you can get in quicker. Interestingly all "accidents" are covered by something called ACC which is separate from insurance. The stereotype of the tough Kiwi also seems mostly true. However, I am struck by the mostly true truism, "the more things change the more they stay the same." 


The practice itself is scary...in the sense it is as if I have fallen thru the rabbit hole and emerged in a parallel universe with my practice here to greet me. Small, rural, excellent nurses and staff, with lots of urgent care related to a rural lifestyle. There are nurses here who are lifetime members of the community, know everyone and are involved to the nth degree. They all love a 'cuppa' and good story but when the day is done they are ready to 'flick off' for the night. A small town approach towards care. I have already been called out to an emergency car accident. My new 'partner' had to call a helicopter as a farmer amputated several fingers and any hope of restoring them laid in a timely trip to the acute care hospital capable of handling this. He is a US family doc/sport medicine/surfer from San Diego and he will share the practice with me until May then he returns to the US. We are getting along well already. You have met his wife and sons on the previous blog entries.


As most of you who know me will not be surprised, I am already analyzing things and seeing what can I bring back to my practice at home from here and vice versa. This particular practice has been without regular care for so long, somewhat in crisis mode taking care of patients' primary need as opposed to the health care maintenance stuff. That plus the long waits, a colonoscopy on the public system is 1-2 yrs for pure screening, makes it hard to focus on it at all. But being me, starting to add to the long waiting lists for colonoscopies much to the dismay of my patients I am sure...2 yrs from now they will get a call to show up for their colonoscopy never remembering it was that crazy American doctor who did this to him...it is kind of like hit and run primary care! HA! 


The wonderful thing about doctoring here is that the ACC thing. As mentioned above, it was enacted in the 1970's as their answer to eliminating malpractice lawsuits...basically in exchange for fault free accident insurance Kiwis gave up the right to sue for damages. They can still file for criminal negligence etc. So the incentive to sue is 'nil. So, where I come in is that my notes are not fodder for the medicolegal system, that I write a note that is for transmitting info to myself or a colleague not to defend myself. So, I get my notes done before the next patient (mostly) and come home with no notes to complete, if I behave myself. I am having to type them as I have not tried to use my voice recognition system yet. However,  if the desire is there, there are a lot of screening recalls I can use to make sure patients are coming back for things that they do need so I am falling a bit behind but only as much as I easily catch up over the lunch hour or during morning or afternoon tea which is scheduled in. We will see how I do as my workload increases and I have been here awhile longer.  The take home message is when I am home I am home and available for spouse and kids and myself to surf, exercise, read, etc. 


For their system as a whole, it is not all milk and honey as they are losing primary care docs at an alarming rate, which is why many of us locums are here, due to aging/retirement and the loss of young docs to other countries notably Australia, and in the politics and bureaucracy behind the scenes as docs have lost more and more say in how health care is administered. At least it is my interpretation at this early stage thru the eyes of a few I have spoken to thus far.

Peter's new office...nope this is the Rotorua Museum...our camera drowned and so no pics of the office as of yet.

Well that is the boring 'Peter's work-life entry' for now. Just to remind everyone that it is not all vacation and beach and surf. Oh, boo hoo for Peter! HA! I am already glad, happy and convinced this was the right thing to do for me as I already feel refreshed and have a new view towards medicine. A new appreciation of what I had, what I currently have and what I will return to. Thanks to all who have made this possible. Much love and appreciation, Peter