Starting Over.

This month I started something over again.

In February 2021, I started a new job as an Emergency Department medical scribe. I love medicine – specifically, surgery. Thus, I wanted to do something that would give me exposure to such a breathtaking field.

The hospital I worked at at that time was draining, to say the least. Providers were seeing nearly 30 patients every day, meaning I had to write almost 30 patient charts every time. Every one in that hospital was severely burnt out and didn’t know how to cope with the overwhelming amount of pressure. My shifts ruined my very disciplined and rigid routines as I would work 3pm-1am, 9pm-7am, 11am-11pm, etc. My sleep schedule, eating schedule, working schedule – everything – was altered. I began to internalize every comment or attituded remark made by the people working in that hospital.

This experience honestly affected my perception of medicine and I decided to leave the job once in-person classes began.

Here I am, a year later. I am now, once again, trained to be an Emergency Department medical scribe and I now work at a different hospital.

I started over.

I was terrified in the beginning when I first entered this new hospital because what if this hospital is the same as the previous one? What if it’s not the providers, it’s me? What if I am not made for the rigors of medicine?

Fortunately, this hospital was vastly different. People were still burnt out (as this is a major problem in the healthcare field), but they do not project their inner feelings onto those around them. It’s crucial to note that it was totally okay for the previous hospital’s providers to express their dissatisfaction with their job and life, in general. However, I was unable to disassociate from such statements and vibes of the hospital.

The point is, I was scared to start over. I was scared to train all over again for a job I was already experienced in. I was scared to interact and cultivate relationships with new people. I was scared of change.

Change is good. Change teaches us new things. Change gives us new perspectives. Change must be welcomed more.

Why the Physician Mental Health Questionnaire is Ineffective for Adolescents

Whether it be for a sick visit or an annual check-up, my doctor’s office always has me fill out a “Mental Health Questionnaire.” The questionnaire essentially consists of numerous statements with a scoring criteria. For example, one statement could be written as “feeling nervous, anxious, or on edge” and the right hand columns will have a 0 for “not at all,” 1 for “several days,” 2 for “more than half the days,” and 3 for “nearly every day.” As I circle a number for each statement, I arrive at the end where I am required to tally up the numbers and give myself a score. 

This questionnaire has been a recent requirement, which I appreciate as it shows that mental health is becoming more of a priority in medicine. However, there are a couple drawbacks to this that I feel defeats the whole purpose of having pediatric patients fill this out. 

For starters, minors are accompanied by their parents for these doctor visits. Therefore, parents are sitting next to them when children fill out these questionnaires. It can sometimes be uncomfortable and hard to honestly answer the questions because there’s a high probability that our parents are looking over our shoulders to see what we’re writing down. This automatically skews the answers and deems the questionnaire ineffective. 

The other major con of this questionnaire is that most doctors don’t even look at it or mention it during the visit. Out of all the years I’ve been required to fill this out, only one doctor took the time to send my mom out of the room and talk to me about my answers. The rest of the physicians didn’t even look at my responses.

What does this convey to pediatric patients? 

When the physicians didn’t even bother to take a few minutes to check in with how I was doing mentally, it conveyed to me that getting my ears, eyes, heart, and the rest of my body was more important to them than understanding the way I was feeling mentally. 

It also showed me that physicians may not be taught medicine from a holistic standpoint. Especially in the U.S, medicine is more about analyzing a patient’s somatic symptoms and arriving at a diagnosis for further treatment. Therefore, physicians are likely to overlook symptoms of depression, anxiety, suicidal tendencies, bipolar disorder, etc. because they are so focused on the issues of the physical body.  

The questionnaire was a great starting point to prioritize mental health in medicine. However, it is now time to step it up a notch. This could be done by requiring doctors to take time out of the visit to have conversations about mental health. This, not only will help children who recognize that they are mentally struggling, but will also raise awareness for the children who are not aware of mental health and mental illnesses.