Paperwork

In case you did not already know this, let me tell you what practicing medicine is: paperwork. Paperwork done by people with way too much education, but still paperwork.

This morning, CPT Lee and I got in early to do some (guess what) paperwork on our patients for travel clinic tomorrow. This entailed getting on the travax website (no, I'm not giving you a link, because it's a subscription service and you need a password), putting in the itinerary, and figuring out what vaccines and medications our patients will need. Then we looked up contraindications to vaccines and medications to make sure our patients could take them, and checked for drug interactions between what we want to give them and what they're already taking.

After that, we headed for the preventive medicine department meeting, where we heard about the various projects going on and updated everyone as to our own project. That was a little intimidating--I'm the most junior person there, both in age and rank, talking about a project that involves training I haven't had yet.

And then it was more paperwork. Everyone working on my project got together and went over the patient questionnaire I've been working on for the last week (we're on our fifth draft now), reorganizing the questions and trying to make things as clear as possible. The purpose of the questionnaire is to use it to guide patient interviews, so we can figure out what kinds of exposures our patients had, such as taking body-building supplements or working with heavy metals, and determining if the patients have the same or similar exposures. Right now, we're assuming that this is related to supplement use, so if we can get evidence of this, we're hoping we can use that get the PXes to stop carrying them.

While we were doing that, we were also coming up with a clear case definition, and using that definition to determine how common this is in the Army. We keep having to come up with more and more specific definitions, trying to get the numbers down to something reasonable. The last time we ran a query based on our case definition, we found more than five hundred cases in the last year. Obviously, that would be too many to give everyone the questionnaire, so we're trying to make it more specific and getting a better count of exactly what we're looking for.

And then more paperwork. Tomorrow, we have a couple coming into travel clinic that who will be going on a cruise. Technically, they need yellow fever vaccines, but they're both too old and too sick to take it, so we drafted vaccine waivers for the respective customs agencies, citing various studies that have shown that giving the vaccine would be bad.

We went over some more stuff for travel clinic, and then it was time for CPT Lee's phone interview with LTC Wiesen at Madigan (she's switching to preventive medicine, so she has to apply for both positions, Madigan and WRAIR), so I took off so she could do that. Fortunately, I'm all done with interviews, so all that's left is collecting letter's of recommendation (all four have been requested, I'm just waiting for them to come in) and then I can submit my application.