Duty · Fun With Suits! · Pains in my Fifth Point of Contact · Pre Planning Your Scene

FPC: Phenomenal Phone Company

A long, long time ago, in a state capitol city not so very far from here, I was seated in the basement of The Enormous Hospital System Mothership, where She Who Would Become TDW-Mark II was undergoing surgery of some sort. I was seated next to, well, let’s simply call him my father in law.

At this point in the celebrations, the divorce from The Plaintiff had concluded, and she and I had a week-on-and-week-off child custody arrangement. My adolescent children had cell phones, and had both me and their mother on speed dial.

So, Number Three Son had occasion to call me, but I could not make out what he had to say, and my attempts to re connect with him were for naught.

I did not know if this was generic adolescent ‘gotta call dad’, or something emergent. That latter was very unlikely, but, after all, I have kinda spent my life in the “this is sort of an emergency” business, and therefore considering that possibility is an occupational hazard. Therefore, since I was NOT at home, and, should my children need me, their ability to communicate that to me in a timely manner was mission critical, well, The Phone Company, and their inability to connect a freaking call something like 12 blocks from the freaking state freaking capitol, well, to understate the thing, I found it unsatisfactory.

Father In Law offered the use of his phone, on Another Carrier. I entered the number of my son, hit “connect”, and, par miracle’!, just like that, I was speaking to my son!

We concluded our conversation, since it was a generic “ought to call dad” call, and I asked Father In Law if I could make one more call. He assented.

I then called “customer service” (spit!) of The Phone Company. I explained my problem, and how this was not acceptable. Phone Company Minion asked my location, and I described myself as being one floor down from street level, in waiting lounge of Enormous Hospital System Mothership. Minion then regaled me with a bit of RF theory, to wit: “You cannot reasonably expect a cell phone to have a reliable signal when you are underground!”

I asked Minion, do you have caller id?

Affirmative.

Could you tell me the originating telephone number for this call we are having, right now?

He read back Father In Law’s phone number.

Is that a Phone Company number? If not, what carrier services that number.

Why do you ask?, responded the Minion.

“Because, that is the carrier who is henceforth going to be receiving checks from me approximating $200/month, because my phone, my childrens’ phones, and the phone of every mo$%#r f@!%&er who will stand still long enough to hear this story, will be giving their business to this carrier, whose phone I presently hold in my hand, in this basement, as you and I converse!”

Having said that, I realized that there is no satisfying way to slam down a cell phone. I miss plain old wired phones.

Duty · Fun And Games · Fun With Suits! · Pains in my Fifth Point of Contact

Moar! Random Thoughts!

The other day, I saw some soul, who was vexed by an itchy rash. I interviewed said soul, examined, and prescribed a steroid cream to soothe the rash. My instructions, in the prescription, were “Apply thin layer to rash twice a day”

Later that day, my MA fielded a call from the pharmacy inquiring where the rash was? (as in, I suppose, where on the patient’s body). I therefore had to complete the thought that I was charting on a completely different patient, find the chart for the patient, open that chart, review my note from several hours ago, and answer the query.

Foolishly, I had assumed (…yeah, I know. AssU-ME.) that “the rash” was specific enough, but, it seems, no…

In a similar vein, I continue to receive prior authorization requests. This is maddening, because (a) I typically attempt to prescribe the exact same thing previously prescribed. For, say, asthmatics, that means I attempt to prescribe the-flavor-of-the-month of albuterol inhalers. In addition, (b) years and years ago our Fly Over State Legislature passed legislation mandating substitution of generic, equivalent, medications unless the brand is specified, with the specific instruction of “dispense as written”. Silly me, I had supposed that when I prescribed albuterol, which is the generic name, that this generic substitution law would allow the pharmacist, who has access to the “menu special of the day” that the insurance company will subsidize, could then think, so to speak, “Hmm. McFee wants albuterol, but the insurance company will only subsidize Youcallwehaul brand of albuterol inhaler. Howzabout I simply fix that, and dispense the Youcallwehaul inhaler, just as if it were not a BRAND of ALBUTEROL, but, indeed could be considered equivalent to the generic albuterol inhaler that Our Hero had indeed prescribed?”

Had that occurred, I would not get a paper note spending pages and pages to tell me that the Useless Insurance Company Inc., would not pay for the generic inhaler, but would, rather, pay for the Youcallwehaul inhaler, no doubt reflecting the proud legacy of pharmaceutical excellence that has characterized the Pashmir Valley since January of 2022!

And receive that note several days AFTER my patient encounter.

All the while telling me that they would not pay for a non preferred inhaler until two other inhalers had been employed, and had failed.

So, that means that my patient has NOT had their freaking inhaler for (lessee, now: Friday visit, Monday denial, Thursday, if they are attentive (scoff!), mailing date for the voluminous tutorial on the pharmaceutical excellence of Bagwan’s Pharmacy And Weapons Factory, which I finally see, perhaps as soon as a full week after my patient encounter.) So, something like 8 days, more or less.

Let’s paw through the old chart, and review previous prescribed inhalers, shan’t we? Lessee, there is Ventolin, and then there was that time this soul received…Ventolin, and, of course, the last time when one of my colleagues prescribed…..er, Ventolin. So, imagine my surprise when I prescribed (lessee: what was that stuff?)…Oh, yes. Ventolin!

And I receive the previously described voluminous correspondence detailing why the Behemoth Insurance Company would not pay for the prescription of….er, Ventolin.

I really try to embrace the suck, but geez, ya know…

Fun And Games · Fun With Suits! · School Fun And Games

Nursing School Lessons

NURSING SCHOOL LESSONS

So, TINS, TIWFDASL, years and years and years ago. I was in nursing school clinicals, and working for EMS in Da City. This was so long ago, that HIV/AIDS was not even on the horizon.

One day in clinicals, I was cleaning up an incontinent patient, and my instructor motioned me outside once I was done and the patient tucked in to a nice clean bed, and he, himself, was clean and dry and in a clean gown.

She began: “Mr. McFee, You did very well keeping the patient covered so that he would not get chilled as you bathed him. There is, however, one item I ought to call to your attention.”

“Yes, ma’am? What is that?”

“I noticed that you were wearing gloves. That concerns me, because your patient might feel insulted at your wearing gloves for personal care.”

I responded, “So, you are telling me that the fact that I am wearing gloves to clean a patient who has been incontinent, of stool at that, might be seen as insulting?”

“Yes, Mr. McFee, that is exactly what I am telling you.”

“Well, ma’am, I worked last night, on the ambulance. I spent the night crawling in and out of cars, and over broken glass, removing injured people. I probably have a thousand little cuts on my hands alone. I am pretty certain that any patient of mine will get over their hurt feelings way before I recover from Hepatitis B. But, you are the instructor, and I am the student. Let’s write down your directions for me in this matter, and make a couple of copies. We’ll both sign each copy. That way you will have a copy, establishing what you directed me to do, I will have a copy and therefore cannot claim that you never told me to do what you told me, and there will be no questions moving forward what I am to do.”

She looked aghast. “I am not going to write that down! No way!”

I smiled. “Thanks for the counseling session. I will certainly keep your words in mind, moving forward!”

Duty · Fun With Suits! · Pains in my Fifth Point of Contact

Going Solo

There I was, Fighting Disease And Saving Lives, one weekend day, and I was soloing. Generally, our agency’s practice is to have two providers on duty at a time. On this particular day, I was “It!”, with no partner. The floor staff was sympathetic. I was all “Meh?” about things.

I was reminded of an old joke. It seems this fellow had had his fill of driving a lengthy distance, and elected to stop for the night. He stopped at one hotel, and was told that there were no vacancies.

He stopped at another, and yet another, only to be told, again and again, that there were no vacancies.

Finally, in response, he asked, “If the president of The United States was standing here, telling you that he needed a room for the night, are you telling me that you would turn him away?”

The desk clerk declaimed, “Of course not! Of course, we would make accommodations for The President!”

The traveler squinted at the clerk. “Well, I just read in The Daily Tattler that The President is in Bagwanistan this week. Since he will not be arriving, I’ll take his room!”

The application to my situation was to ask administration if there was anybody else working with me on that day. Of course, as reflected in the fact that there was, you know, nobody else there with me to fight disease and save lives, they would tell me that, no, there was nobody else to work with me that day.

In this imaginary conversation, I would next ask, “Suppose I got hit by a bus on the way in to work today? What would you do, then?”

The reply likely would be that “In that event, we would do (xyz)!”

Which, of course, would elicit the response, “Surprise! I did NOT get hit by a bus! Hey, howzabout (do xyz), and get me some freaking help, eh?”

Duty · Fun And Games Off Duty · Fun With Suits! · Gratitude · Life in Da City!

Snippets Part III

I have a flexible spending account at work, so as to be able to pay my copays, deductibles, and suchlike with pre tax dollars. Late last year, I noticed that the card by which such expenditures were paid for, was getting declined. I assumed that I had spent all the money and thought no further of it.

Then, I began to get messages from the administrators of the account. Finally rousing myself to speak to them, I learned that the card had been frozen, because, I was informed, they required hard copy receipts for 3 or 4 of my expenditures. This included purchases from my optometrist for, oh, gosh, GLASSES, as well as at the podiatrist, for TDW-Mark II’s ingrown toenail.

It puzzled me, Visa, nor Mastercard never had such issues. I assumed that, just like the commercial banks, that the electronic billing that led to the vendor of, say, my gasoline, getting paid, had all the information required, kind of like a grocery store receipt.

Perhaps I was wrong. Or, perhaps, somewhere in this favoured land, folks go to their podiatrist, or their optometrist, when they feel the need for hookers and blow. (I wouldn’t know, myself, and Hunter Biden was not available to comment on that possibility) So, I guess, I will have to remain puzzled.

@@

Occasionally, I am humbled. Just the other day, I had such an opportunity. The lady bringing the pre school aged children in for whatever their complaint that day, was approximately my age (and, I am by no means of child rearing age. Hell, my youngest grandchild is already in primary school!) She reported, in the course of the conversation, that “My husband and I both got them when they were very, very young.”

Just, matter of fact. No inflection, dry fact.

As I was charting later, I noted that the parent was identified as the grandparent.

So, let’s contemplate that. Some of us are anticipating retirement, with few responsibilities, plenty of free time, and no pressing concerns.

Others, around us, are raising a SECOND family, at our ages, and not flinching.

Some of us are facing demands of duty, and stepping up to those demands, and in doing so are protecting, and nurturing, the most vulnerable among us.

@@

So This Is No Shit (TINS), There I was Fighting Disease And Saving Lives (FDASL), long, long ago and far, far away.

Well, okay. REEEAAALLLLYYYY!, I was shopping in Farmer Jack, in Da City, on one of my off duty from EMS days. I was pushing my shopping cart down one aisle or another, occasionally consulting my shopping list, and a fellow approached me.

He greeted me. “Hey! I know you!”

I did not just recently develop my aversion to Humanity. I spent years perfecting it. “Uh, no, you don’t, sir.”

He, on the other hand, was undeterred. “No, I know you! You work for the fire department!”

“You have the wrong guy!”

“No, really! I remember you  You saved my brother’s life!”

“Yep! That’s me! That’s how I spend my days! How is your brother?”

Fun With Suits! · Life in Da City! · Pains in my Fifth Point of Contact

Snippets, again

@@ Please, do NOT tell me that Bonine is 125 (or 12.5: she was not speaking clearly) milligrams, over the counter. I happen to know that OTC Bonine is Meclizine 25 mg, the same strength anti vertigo medication I prescribe as Antivert, and I know this for reasons. These reasons include (a) I kinda went to school for this stuff, (b) I prescribe Antivert/Meclizine several times a week, (c) TDW and I enjoy taking cruises, and she is somewhat susceptible to seasickness. Therefore, I am familiar with Bonine in it’s seasickness/motion sickness indication. Therefore I purchase it, OTC. Ya know, like last week. (d) When I acquire a medication, I (pay attention now! This one weird trick will help you manage your medicines!) RTFL. (Read The Freaking Label). (e) I have a functioning memory, not blown out by continuous applications of high serum levels of cannabinoids. Therefore I can remember this stuff, along with other stuff I find useful.

Finally, please, Please, PLEASE! Consider the possibility that I, indeed, am trying to both help you, as well as make your life easier.

The above is my internal monologue, which is considerably lengthier than my first pass response, also stifled, of “Hmm. Weird. Ok, then, don’t take it. Good talk. Have a nice day! Buh-bye, now!”

@@ So, TINS, TIWFDASL, as an ED nurse, long ago and far away. It came to pass that my manager invited me to join her in her office, where she told me that several of my colleagues had come to her, concerned with what they esteemed to be my taking overly long to triage patients.

For those in the studio audience who do not know, “triage”, in the ED setting, is the process wherein a nurse interviews the patient to elicit chief complaint (“What motivated you to come to ER tonight?”), history of present illness (“How long have you been ill? What have you done to address it? How did that work for you?”), allergies/medications/history, and vital signs. In the course of that conversation, the goal is to identify unstable folks, and truck them right back to care, and differentiate them from stable folks (like a broken limb with intact downstream circulation), and invite those folks to be patient.

I asked my manager how long I was taking, on average, to triage? This information ought to be readily available from our electronic medical record system.

“I don’t know.” was her reply.

I asked how my triage times compared to the average of my peers.

“I don’t know.”

I asked if the acuity of the patients I triaged was similar, greater, or less than the average of my peers.

“I don’t know.”

I asked if the complexity of the patients I triaged differed in any identifiable way from my peers (think psych requiring lots of redirection).

“I don’t know.”

I contemplated this for a second. “Wouldn’t it be a lot easier for me to improve, if I understood the manner in which I am falling behind my peers? I had thought that one of the advantages of an EMR was the ease with which just this sort of information could be abstracted.”

@@ In my clinic, folks who are currently afflicted with covid, or who fail the screening interview/temperature taking, get seen as “covid + other” patients. They are invited to wait for their turn in their vehicles (or, in nice weather, outside), rather than in our waiting room. Inasmuch as we are a walk in clinic, there are no appointments, and, if you are at the shag end of “The Wave”, well, you face a lengthy wait.

Some of these individuals drive off, thinking (not altogether wrongly) that a lengthy wait=an opportunity to get other stuff done.

The problem with this plan, is that, should a number of the other folks in line ahead of you, either spontaneously cure themselves, or decide, in essence, “F&@k this, I’m not all that sick”, and depart, your turn may arrive earlier than your errands anticipated. So, when the MA calls you on the phone number you provided today at registration, (a) it might be useful if you answered it, as well as (b) if the phone in question was actually in service.

Among the souls who successfully pass these two tests, there are those who respond, when told that their turn was at hand, and we (the MA) had some questions for them preparatory to actually seeing them in the office, “I can be there in 25 minutes!”

Well, that is kind of a fail. The MA will then tell them, “Sorry, we’ll call the next person on the list, who is here now. You will be at the bottom of the list, since leaving the line loses you your place in line.”

Fun With Suits! · Having A Good Partner Is Very Important! · Pains in my Fifth Point of Contact · Pre Planning Your Scene

Interview Skills

A long, long time ago, in a Galaxy not so very far away, TWWWBTP (The Woman Who Would become The Plaintiff) had graduated LPN school, and was starting her LPN-to-RN studies, and I was seeking a change of employment. I was looking to add ICU to my resume, since the grad school I had my sights on required it. This one hospital was recruiting, and proclaiming that nurses who accepted positions in their ICU, would receive a $10,000 sign on bonus.

I investigated, and learned that one half of this bonus would be paid upon completion of one year of employment, and the second half would be forthcoming after completion of the second year of employment. Sounded good to me, and so I arranged an interview.

Since TWWWBTP, at that point TDW-Mark I, thought that it would be problematic should I accept a job requiring me to drive halfway across the state, as this position would, perhaps she should investigate employment (and schooling) opportunities there, as well.

Sounded good to me.

On the appointed day, she and I arrived for our interviews. I learned of the position, and they told me, “You do know, don’t you, that we require a two year commitment from nurses in order to qualify for this bonus, right?”

I acknowledged that I did, indeed, comprehend this aspect of the arrangement, and stated, “Yep, I expect that I can wait two years before going to grad school!”

They acknowledged my comment, and we proceeded.

So, we concluded our interview, TDW-Mark I and I, and we sat in the lobby, awaiting their offer(s). We were summoned, and received the news: TDW-Mark I was offered a PART TIME, LPN job. As for me, well, I did not receive an offer. They informed me, “We are looking for nurses who want to come here, and settle down here, in our community. With your grad school plans, well, you do not appear to be a good fit for that sort of longevity.”

Cool story. We drove home, TDW-Mark I composing her “Thanks but no thanks” letter in her head, and I remarked, “Ya know, honey, I believe that I have figured out what I did wrong!”

She replied, with some side-eye, “Oh, really? What was that? Other than being truthful about your higher education plans, I mean?”

“Well, you see, I should have walked in there, paused just inside the door, and, James T. Kirk like, spread my arms in an all encompassing gesture, slowly turned, taken in a deep breath, and declaimed, “I…I..feel, I feel as if I have come….HOME! I….I want my children…to grow, TALL, under these…these Blue ! Skies!…I want to spend my days….Breathing! This! Clean! Air! I…I want…my..bones, to rest…to, REST…beneath …these green hills! I…I feel as if…I am…at..HOME!”

I looked over at my bride. She smiled, and responded, “So, you are telling me that you should have lied your ass off, right?”

“Of course, right!”

Fun With Suits! · Pains in my Fifth Point of Contact

My resume is on Indeed. Read it!

The other day, I received an emailed solicitation to work as a locums. I *have* worked as a locums, and it worked out OK for me at that time. By way of scene setting, I have worked ED and urgent care as a PA, NOT as a neonatal provider of any stripe.

(paraphrased) “Hello from Erewhon Locums Company! With our national reputation for placing the right provider, in the right position, we are looking for a provider to fill the opportunity described below!

Job Highlights: 

  • Location: (some other state)
  • Specialty: Locum Nurse Practitioner
  • 7/18/2021 – Ongoing
  • Will Wait for (some other state) License / BC
  • Schedule includes day and night hours. Usual shifts 8am-5 pm, 5pm-8am or 24 hours- a combination could be required based on needs of service. Weekends and holidays required as needed. No call required.
  • Procedures Required: Intubation, umbilical lines, PICC placement, lumbar puncture, reservoir taps, thoracentesis, exchange transfusion
  • EMR System: (Infernal EMR)

Why Erewhon Locums?

  • $1,000 referral bonus opportunity
  • Personal travel and housing concierge 
  • Dedicated support specialist for payroll 
  • Experienced credentialing team 

My e mailed reply:

Well, yes, it is a great match, aside from the fact that I’m a PA, not an NP, that I am no sort of neonatal practitioner, none of the procedures listed is in my skillset, and that I will not work in (other state) for any amount of money that you are likely to pay me. 

But, other than that, yeah. Great fit. 

Fun With Suits! · Having A Good Partner Is Very Important! · Pains in my Fifth Point of Contact

Kharma

This looks like it’s going to be a lengthy spiel. Hope y’all are ready!

Perhaps, in previous ramblings, I have touched on the assertion, I credit it to Ragnar Benson, relating that, if one were to consider the deaths and illnesses attributable to contaminated water supplies, it is not unrealistic to consider that it is entirely likely that plumbers, and assurance of safe water that is their stock-in-trade, have preserved more lives, and done more to alleviate human illness and suffering, than all the physicians ever born.

I remember this thought every time that I am credited with saving lives, or some such stuff. I am as good as I am, in large part due to the folks with whom I work.

And, then there is the lay-of-the-land aspects that can accompany cordial relations with your co-workers.

So, TINS©, TIWFDASL© in a walk in clinic in Da Nawth Country. It had been somewhat tumultuous , negotiating with my locums company, as they had contracted that I start on “Date A”, yet, 4 or 5 days prior to “Date A”, had informed me that things were not organized as needed, and some aspect of my credentialing was awry, and therefore I was not going to start on “Date A”. Therefore, I was not going to be getting paid, starting on “Date A”.

I acknowledged this tidbit. I asked when they anticipated my starting work, and starting receiving pay.

My recruiter could not tell me.

I noted that I had a contract stating that I would be working for The Locums Company, starting on “Date A”, and I anticipated starting to receive pay from The Locums Company, beginning on “Date A”.

The recruiter protested that, since I was not fully credentialed, I could not work, and therefore I would not be getting paid until all these wonderful things came together, and I was, indeed, working.

I set a limit. A hard limit. “Well, simply so that you understand how things will work, *SOMEBODY* is going to be paying me, starting on “Date A”. Your input into this conversation, is will it be The Locums Company, or will it be somebody else. And, just to make everything even plainer, whoever is paying me on “Date A”, will have my loyalty. That means that, if you folks are *NOT* the ones paying me, and you abruptly get your shit together, and invite me to start working at your client’s clinic, well, I am not about to pimp the folks who are providing me with a paycheck, simply because your organization is so grabasstic that you cannot get your credentialing in a group, by the date that *YOU* specified.”

He sputtered, “We have a contract! You have committed to work for us!”

I had read that contract. “Yep. You committed to pay me for my clinical services starting, oh, next Monday. Now come you, to inform me that you are not planning to pay me, starting next Monday. Now, I am not a lawyer, I do not play a lawyer on TV, and I did not stay in a Holiday Inn last night, but it certainly appears that you are proposing to breach one of the foundational elements of your contract, and thereby nullify the entire thing. If you are paying me, then my time is yours. If you have breached that contract by not paying me, then you can go piss up a rope.”

He continued to sputter. “I cannot simply approve paying you for not working.”

“Cool story. Howzabout you speak to somebody who can, indeed, authorize you to abide by the terms of your contract, and let me know how that turns out? As for me, I’m looking for work. If you get your shit together before I find other work, perhaps we can move forward in a mutually profitable way. If not, well, toodle-oo!”

The call terminated. I placed a call to Another Locums Company, with whom I had worked, and who had demonstrated that their stool was, indeed, in a pool. That recruiter and I had a cheery chat, and she promised to see what they had available, and call me back as soon as possible.

The next day, The Locums Company recruiter, who triggered this rant, called me back, breathlessly informing me that they *WOULD* pay me, as if I was working 40 hours, 9-5. In return, I would be on a 24 hour alert to report to the client clinic, upon The Locums Company’s notification that all had been ironed out. His tone was consistent with “…and don’t you try to weasel your way out of it!”

My response was, “Well, if you are paying me, then my time is yours, and I will be available to report for work as soon as is reasonable. 24 hours sounds reasonable.”

So, I hung around, puttering around, and after a couple of days, received The Call, shortly followed by a call from The Client Clinic. These worthies articulated concern. “Uh, you know we are up north, right?”

“Yep. I kind of had figured that out, in the course of the interactions with The Northern State Licensing Authorities. Those conversations led me to assume that this placement would be in The Northern State.”

“So”, they continued, “It’s January, and, well, we get snow here.”

“I had assumed that snow had something to do with your state’s reputation as a skiing destination.”

“So, have you ever driven in snow?”

This was surprising. If somebody had read, oh, the FIRST 6 INCHES of my FREAKING RESUME, it is exceedingly likely that this reader could figure out that I had spent considerable time in A Northern Fly Over State, wherein, every year, there was an abundance of snow on the ground for, oh, heck, 5 or 6 months of the year. My response did not, however, convey this surprise. “Uh, yeah, some.”

“Are you comfortable driving in snow?”

Another aside: it occurred to me that this particular line of inquiry might have been useful, say, during the freaking phone interview. Not the goddamned day before I was to drive my clinical ass up to start work. Again, my response was milder than my thoughts. “Yeah, I’m Ok with driving in snow.”

But, they were not going to let this go. “Are you sure? We really get a lot of snow, you know!”

I was over this line of conversation. “Look, I grew up in A Northern Fly Over State, we get assloads of snow every winter. If you have seen my resume, you will realize that, not only did I learn to drive in that state, I worked my way through Nursing school working for EMS in Da City in that very state. My children were born there, and every one of *them* learned to drive in the winter, in the snow. Since this is not Fairbanks Regional Medical Center, I am pretty sure that I have seen me some snow, and that I can handle it.”

I packed up my stuff, and set out for The Client Clinic.

I got oriented, and was introduced to the EMR. On my first day in clinic, I introduced myself to the registration staff, and the floor staff. Between patients, we swapped stories. This MA was prepping for Nursing school, that one was in undergrad for business. This other one was a survivalist, and prepping for The Zombie Apocalypse. (Kindred spirit, right there!)

A couple of weeks into the contract, things were tranquil. My MA asked me if I knew why my predecessor had quit, abruptly.

I allowed that I did not know all that much about it, simply that this soul had departed with inadequate notice.

Her eyes lit up. “Ahh! You need ‘The Rest Of The Story’!” She informed me that my predecessor had discovered that he, the clinician, had not been accredited with two of the most common third party payors in that area, and, since they were something like 70-80% of the payor mix, not receiving payment for care of those patients would present a cash flow problem of significant proportions.

It seemed that the clinic had elected to have this clinician’s visits billed as if another, credentialed, provider had in fact seen, interviewed, evaluated, diagnosed, and treated those patients. Since this was not exactly accurate, it potentially could get ugly. Very, very ugly.

When it appeared that this clinician would not see that situation remedied, right stat like, that clinician elected to remove himself from that particular pot of stew, immediately. Hence, the opportunity which featured me fighting disease and saving lives.

I spoke with my recruiter at once, and observed that, he either would provide satisfactory evidence that I was, in fact, credentialed with these payors, or I would unass that scene so fast that The Flash would ask, “What the fuck was that, that streaked right past me?” And, he did not have a lot of time to convince me that this was actually so.

An hour later, he not only effusively professed my actual credential-hood, he e mailed me copies of supporting documents, such that my black heart was grudgingly convinced that it was truff! (pronounced “True-ff”)

And that, boys and girls, is one reason that I treat my floor staff, and other co workers, nicely. That, and it is simply good manners.

Fun And Games Off Duty · Fun With Suits! · Pains in my Fifth Point of Contact

Phone Company Follies

I had moved from Da City, to a more rural corner of the state. I accepted a job there, as a nursing supervisor. Since my medic license was active, I planned to volunteer with the local rescue.

In the course of securing housing, I arranged for utilities: electricity, propane delivery, and phone. Given the very rural nature of this county, and the presence, here and there throughout the state, of party lines, I inquired about same. Indeed, my question to the person taking my phone order was, “Since I am going to be a nurse for the local hospital, as well as a volunteer with the local rescue, having a private line will be very important. Will I have a private line?”

Her reply, verbatim, was “Private line? No problem!”

I subsequently learned that in Bugtussle, or wherever this particular numbnut was, the meaning of the phrase, “no problem!” was altogether different from the meaning I had become accustomed to.

I learned this when my phone rang (and, differential ringing was whole ‘nother mystery, that I did not understand at that point in time!), I picked up the handset, and found somebody-indeed, two different, and stranger to me somebodies, at that!- greeting each other.

I inquired of my colleagues at work, they being wise in the ways of rural living inasmuch as they were, well, already doing it. I learned that there was such a thing as differential ringing, that in my corner of the county there were, indeed, party lines and that it certainly appeared to be the case that I was the proud subscriber to one!

Against my will.

With this insight in mind, I telephoned the local office of the telephone company, and asked about my “private line”. I learned that the plans called for me to get a private line sometime after the year 2000. This, in a conversation taking place in 1989.

I was not (favorably) impressed.

I next called the regional office, and spoke to the Schmoe In Charge Of Taking Calls From Disgruntled Customers. This schmoe informed me that the new millennium could be celebrated, likely, by me placing calls on my new, and private, telephone line.

I reviewed the “Private line? No problem!” statement of the employee, the fact that I did not, in fact, have a private line, and that due to work and volunteer considerations, this was, and would remain, unsatisfactory.

While it was not phrased that way, the resulting communication could be summarized as “Tough luck!”.

I next uncovered, and called, the number for the Midwest Schmoe In Charge Of Taking Calls From Disgruntled Customers. I learned that the the construction plans for this telephone company did NOT include building out private lines in my corner of the state until after 1999, ten years hence. I reviewed my previous conversation with the order taker, and suggested this was inconsistent with what that worthy had stated would be fact.

Again, while it was not phrased in these words, I was told that that would be my tough luck.

So, I called my Un-Named Midwestern Fly Over State Public Utilities Commission, and was connected with the gentleman charged with fielding complaints regarding, among other things, the telephone companies.

He introduced himself. “Nikolai Tesla. What can I do for you?”

I suggested the position was ironic, given his name, and he agreed. I began my plaint. I reviewed the “Private line, no problem!” misdirection, and my unsatisfactory climb up the chain of command, seeking redress from the phone company. I interjected, “You know, it is ironic that I am calling you in the first place. I tend to be small government, minimal regulation, best government is least government sort of guy.”

He paused, then asked, “Do you mind if I savor that irony, for just a minute?”

“By all means, savor away!”

We resumed our conversation, and Mr. Tesla took my contact information, and promised that he would keep me posted on new developments.

I next called my representative in The Un-Named Flyover State, State Legislature. I spoke with a legislative assistant, and reviewed the material, presented above. I told this soul that my desired outcome was that my representative’s office would hound the PSC over my complaint about the phone company, and that I would be invited to any hearing, the next time the shitweasal telephone company wanted any sort of rate increase. The aid promised me that they would make a few calls, and look into things.

I spent the next couple of weeks fighting disease, and saving lives. (Bet you wondered if I was gonna work that in, somehow! Well, wonder no more!) Since I was working 3-11, I tended to rattle around my residence for several hours after work, before going to bed, awakening generally at the crack of noon. So, I was surprised one morning around 0800 to be awakened by the noise of a barely muffled engine, seeming to arise from the end of my driveway.

I dressed, and walked to the street, asking the workmen there what it was that they were doing?

“We’re putting in a private line. You did want a private line, didn’t you?”

“Sure did! Thank you, gentlemen! Carry on!”

I was tempted to ask him if I had overslept, and it was 1999 already?