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Realm Status

For anyone who knows me, they know I am a gamer nerd. I'm new to this gamer nerd thing, though.

My husband is an old school nerd: he played role playing games as a kid like Dungeons and Dragons. He played the card games. He used to telnet into bulletin boards and played text based games. He loves Tekken and first person shooters (FPS) and massive multiplayer online games (MMO).

I, on the other hand, was a book nerd. I spent my formative years reading and watching TV. We didn't have internet or telnet until I got to college and beyond. I did play around in the MUSH a little, but that was for social interaction, not because I was gaming.

But, for the past 5 and a half years now, I've been sucked into the World of Warcraft. Sure, it's a nice diversion. And it's as social or anti-social as one might want it to be. However, in this time since leaving my last job, I've been playing more. I know, with time off I should have reorganized my closets, tackled my household budget or even gotten a good running start at the laundry. Instead, I've leveled up more characters, learned new in-game professions and gotten fat loot, as the nerds might say.

Every day, I've logged in, tweaked characters, fought monsters, cast spells. You know, the usual. However, not on Tuesday mornings. Tuesdays are the reset week in Azeroth. Tuesday mornings are the scheduled mornings when Blizzard Entertainment takes down the game servers, called realms, and does repairs, patches, hotfixes, bug fixes and generally makes the morning and daytime crowd who get online at that time go crazy waiting to see their realm status come back up. There's even a website where you can track the status of your realm while you wait:

I use the time to catch up on knitting projects, the week's bad television, read. I spend the time waiting for the realms to come up.

I started working in my teens as a babysitter, had the odd jobs most kids have: delivery person, ice cream scooper, fast food server, nurse's aid, housekeeper. They were all teaching experiences and grew me in my desire to be something else. Then I got my degree and my free stethoscope and I was ready to save the world. Since my teens, however, I've more or less always worked for someone else.

I seemed to make bad choices. I took my first job post-residency for the money. It cost me financially and emotionally for years. I took other jobs for the location, for the benefits. The longest job I had was one that I took as much for location as anything and it was exceptionally rewarding. I was still out to save the world, one patient at a time. I believed that you didn't have to force people to come back over and over to get paid. I balked at the "make them come back in 2 weeks to be rechecked" after every sick visit policy I was asked to institute, when a phone call was more than adequate. I believed that you could be efficient and ethical and still be reimbursed. I was working for a guy who didn't share my beliefs. He sold the clinic I worked at with about 10 minutes notice for me. The new management was money driven and not care or benchmark driven. In short, they were jerks.

I happened to have an out when that happened and I took it. Again, I was focused on being ethical, being efficient, doing the right thing, taking good care, doing no harm. Again, I was working for someone for whom the business of medicine began taking a toll on the practice of medicine. Or at least that's how I felt.

When I made it clear that I felt that way, and was shown the door.

Since that time I've been in a bit of a tailspin. Am I really that ridiculous? Am I so naive to believe that doing the right thing, being honest, giving good care and worrying about the patients first and money last are just wrong?

It's easy to paint myself as some crusader, striving for all that is good and right in the world. I am not. I am not perfect, and I am pretty sure I can be really difficult to work with. I'm bossy. I'm demanding. I want things the way I want them. Sometimes I'm too tired to be as good at my job as I want to be. Sometimes I do just enough to get by. I'm human.

That being said, I have dreams for what an ideal practice looks like. I have dreams that patient care and ethics are still important. I have a vision that we can still give good, personalized care to people, and they can afford that care and it will benefit us all. I was definitely starting to doubt. There's nothing that grows your doubts like being a 41 year old highly trained professional and feeling like you can't find work. My work with pain patients made primary care offices "choose someone more experienced" for their open positions. More experienced? I've been doing primary care for 12 years, with the last 3 being focused on chronic pain patients (who still have primary care needs). Who are you going to hire with more experience?

I was starting to feel that my bad choices were that: bad choices because they were wrong.

I spent the last 2 months waiting for my realm to come back up.

I'm starting to see a glimmer of hope, though. I have an opportunity to be affiliated with a practice where patient outcomes are important. They're the most important. The business side, but everything is fairly transparent and straightforward, not based on gaming a broken insurance reimbursement system and bleeding patients and payors dry every chance we get. It's about offering healthcare as a quality service which has value and being reimbursed for that value.

So, while I was debating my options for the future, including starting from scratch at great financial and emotional risk to me and my family, I now have a new chance. I'm starting with a clinic at least part time, with the goal of moving into a new location near where I live that would ultimately be mine full time.

I'm starting to get the vision here. My realm is up. It's a realm where I can play my game, tweak my skills, and yes, even garner myself some loot.

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