You probably already know this, but....

I love my job.  I'm lucky that I don't have to DO ANYTHING TO the people I visit.  I don't have to take their blood pressure, I don't have to ask to see their skin on their butt, I don't have to watch them get up out of a chair and walk across the room.  I get to visit people in their homes and offer a listening ear and an open heart as they talk about whatever they are willing to share about how things are going for them.  So much of what I hear has to do with how they feel in the "health care machine."  So much of what we do as health care providers has pretty much nothing to do with what the patient actually wants or feels.

This week I took a new patient who has no regular family doctor to a "transitional" clinic which sees patients temporarily while they seek a regular provider.  I had to take her, because she is just that impaired and frail that she would never have been able to get there on her own....and she lives one-quarter of a mile from the clinic.

 P.S. the reason she had to go to the clinic AND HURRY UP AND DO IT THIS WEEK is because without a doctor's order, the home care clinicians cannot make any visits -- well, they can't make any BILLABLE visits.

 The questions on the health history forms!!!  "Do you feel safe at home?"  "In your relationships?"  CHECK YES OR NO!!!

How about this.....when you first sit with a patient, during your CONVERSATION with them -- no, not an interview, not a session where you mostly look at the computer screen as you input answers (alot of times incorrectly -- believe me)....how about this....sometime during your conversation, let them know that if something is awry in their lives, in their home, in their relationships or family, you are open to hearing about it and brainstorming with them about what they'd like your help with.  Explain that you know that what goes on in their lives affects their medical condition and whether they feel like taking care of themselves.  Explain that that is why you are checking in with them about this seemingly extraneous topic.

BUT don't put a check box on a history form and call yourself open to hearing about family violence.

OK end of rant one.