Last week on general

After a nice relaxing weekend, I had to come back to more general surgery. Mondays as usual, are clinic days, which I normally enjoy. However, today was just worse than usual. Clinic days are usually chaotic and completely unstructured, or absolute lessons in total inefficiency, but today managed to top that. Clinics should in theory run something like this: the rooms are filled with patients, us med students see the patients first and take histories to find out why they've come to see us, and then we present the patients to either the residents or the attendings who then see the patient with us to decide a plan or what should be done. Then the plan is carried out and things keep moving. This has yet to happen. Usually, we see the patients and then end up waiting around for someone to have a break in paperwork or whatever to see a patient for 30 seconds before going back to paperwork. I understand this is the system of medicine that we live in, especially at the VA, but what makes me upset is that even under this system they could handle the chaos so much better. They could easily work out a system to that at least one resident is always getting the patient work done while another is doing the computer and ordering work. And this would be on a normal day. Today, we only had one "physician" in the entire clinic, and most of the time he was doing something on the computer that had nothing to do with clinic work! We had all these patients to present and he wasn't seeing any of them. It forced us to get very very behind. Finally one of our attendings came and tried to fix the situation, but it just ended up in him getting very pissed off and flying off the handle yelling at people. It was not a good situation. He remained very cool at the med students though and we continued to try our best just to help out with what we could. It was just a very frustrating day. I'm glad it's my last week on this service. It's clear that surgeons know what to do in the operating rooms, but don't have a clue about how to run a clinic.