I had had a long day yesterday, starting with a trip up the interstate to Columbia to meet with other medical chiefs from around the state of South Carolina to discuss the issues that affect the practice of psychiatry in the mental health system today.
We had struggled with the electronic medical record, Medicare paybacks, e-prescribing, CPT coding, content of notes, billing time, and motivating our medical staffs to accept the changes that were coming, inevitably, down the tracks towards us like a governmental bullet train, sleek and fast and unstoppable. We had come up with a plan to educate ourselves as a group, to better understand the issues so that we could pass them on, a major part of the jobs we are tasked to do in our respective mental health centers. We set goals, timelines for implementation of new procedures, discussed training sessions, and then took our leave, feeling reasonably sure that things, by sometime this spring, would go without a major hitch. The session was recorded, and information was presented by the state’s wonderful IT professionals in real time with projector and laptop and other wizardry.
I got back to the office and reviewed file folders, processed emails, looked at applications for the jobs I’m advertising to supplement the present medical staff, aggregated policies from other centers that I would use to write one for my own center today, as requested by one of the powers-that-be in the capital.
I organized the information of the day in a format that would allow me to present it cogently and succinctly to the board of directors of the mental health center that night at the regular conclave of the group. I reviewed an order I had made online on Amazon.com for a new pico projector and associated connection cable that I wanted to use with my latest generation MacBook Air to present a four hour training session on psychopharmacology to about a hundred people at the end of this month.
I checked a program on my iPhone 5s to monitor the process of the flight of a friend who was returning to Atlanta from Munich later in the day. Things clicked along pretty smoothly until 6pm, the appointed hour for the board meeting.
My place on the agenda assigned, I sat and listened patiently to others present their reports about services rendered, budgets and community issues until it was my time to speak. I them went over the main issues of my first medical staff meeting last week, since coming back on board as the chief of psychiatric services at the center. I supplemented that with the information gleaned at the chiefs’ meeting earlier in the day.
In short, I was feeling pretty good about how everything was coming together and my own ability to handle it and do my job.
When I had finished, a board member, probably ten to fifteen years my senior (I am fifty-six years old), asked to speak.
“I for one really appreciate your being back in this capacity, and presenting all of this information to us tonight. I didn’t really understand about half of what you just said, but I do appreciate your trying to give it to us in a way that we can understand it.”
“Thank you, ma’am.”
“Yes, of course. I want to say one more thing. I’m not sure if this is the right way to say this, or even if I should say it, but I will.”
“I especially appreciate your efforts in all these areas since, you know, you are not of the younger generation anymore. I know all this is hard to grasp. I applaud your efforts to learn how to use all of this new technology.”
I looked to my left at the young woman who had just taken over the position of head of the child-adolescent-family unit. I looked to my right at the slightly-older-than-that young woman who is the heir-apparent to the executive director job at the center in the next three to five years. I realized that I was, indeed, not the oldest person in the room by a long shot, but that I was most certainly no longer the youngest gun.
I also realized that this woman, trying to complement me in the best way she knew how, knew nothing of my history of using a Radio Shack TRS-80, every generation of Palm Pilot made, several Treos, one of almost every iPhone and iPad offered for sale, multiple MacBooks and PCs along the way, and having a home office complete with wireless connectivity, a scanner, two printers, two 4TB hard drives, and a cloud-based backup system just in case everything else goes up in smoke after a freak lightning bolt hits my apartment building.
One day, I hope to be really, really old.
They’ll be talking about my generation.
I’m not there yet.
Greg Smith is a psychiatrist who blogs at gregsmithmd.