Same same, but different: Work life

For any of you that have traveled SE Asia, you are all to familiar with the expression, "same same, but different." I still laugh when I think about when I was in Laos and I was with my Philippina friend. Someone asked where she was from (pretty much no one could guess), she said from where and they would say, "oh! Same same, but different." And we would sit there and be like, "umm... actually, not really" but at that point they had already moved onto something else. Ha ha.

Anyway, this isn't southeast Asia and no, no one has mistaken me for being non-other than American. BUT, I couldn't help think of this expression during my time at work. This will probably be more interesting to fellow PT's or anyone that has had PT or.... if you just want to read about my work life. So far I felt a LOT of similarities, in my field of rehabilitation we are doing just that anywhere we go, BUT... it's just different.

Here are a few things:

• Here, mostly because people are so high maintenance, as I am told, we have to do one-one treatments. Which of course isn't a bad thing. Instead of what i'm used to, patients on the half an hour with plenty of overlap, here it is 1-1 for 45 minutes. 
• Time. Generally I've found that locals typically come late and Expats either early or on time. Which can be a bit tight when it alternates, but also by looking at the name and knowing the nationality, I can gauge how much time I have. 
• Like any business, they of course are involved in marketing, etc, but it's a LOT more low key and NOT as productivity driven as the States. Yesssss.
• I've never worked in a more or less hospital setting where you have such close interactions with the docs. Yes, during internships I did a little bit, but it seemed "closed door," it still wasn't the easiest getting a hold of the MD and they weren't the most approachable. Here, it is all pretty much in the same complex, so besides running into them daily, it really is "open door." They told me that themselves AND my co-workers agreed. Nice! I experimented once when I really did have a question about a patient and walked over, knocked on the door, and it really was that easy! It's sometimes those little things in life that make a difference. At home you have to stalk them over fax's, phones, stalk the physician assistant, and it is a mess. So I like this!
• The other nice thing is that we have a universal medical system online so I have access to MRI reports, MD evaluations, pretty much everything about the patient. I cannot tell how wonderful it is. It actually cuts my history taking in 1/2 (which I need to do because I am feeling rushed with only 45 minutes for an initial evaluation vs. an hour, mostly because patients are late!). 
• I've already taken advantage of this personally by getting a couple of free-bee consults from some back pain I've been having. Hehe. 
• There is an office boy here. Actually, I understand 2, but one is on vacation. Literally someone to bring tea and coffee to you.... and clean-up/stock-up on stuff as you need it. Ha! I guess they learn how everyone likes their tea or coffee and individually prepare it. Funny! Too bad I don't drink tea or coffee but maybe I'll have him fill up my water bottle. Ahhh... Dubai.
• I believe it is temporary, but I have an office/treatment room! There is my computer station and also a high-low table to treat, and although at first I felt TOTALLY isolated because I am used to this dynamic environment where patients and PT's are running around and it is VERY interactive (and fun!), I'm not going to complain! Everything is literally right there and I don't have to move much! I already am doing some typical bad work things by closing my door and playing on the computer, making personal phone calls.... dozing off. He he.
• Internet. Everywhere. Yes, I have access to internet! As most people know, usually there is NO internet at clinics and that has been great! Granted I have dabbled on my email, etc, BUT I actually look up stuff for work as well. Love it!
• If I were to describe how things run in Arab countries, I would say one word: Disorganized. This seemingly looking professional setting is not different. I pretty much came in not knowing anything and despite a brief briefing on their computer system, it was basically me running around trying to figure things out. If anyone knows me, you know I thrive... THRIVE on organization, so this is some getting used to. I am getting things down and biggest thing is getting "my office" (hehe) organized, it's been better. But not just that, I don't know when I'm getting back, how I'm getting paid, how often, etc. Don't know when health insurance starts and when I can start using it. Don't know about vacay days and taking time off (very important). HR supposedly was going to meet with me, but we'll see when that happens.
• Same same, but different. My last job I came in and had several patients instead of "gradually being settled and by the end of the month you will have a full load." Ha! By the end of the week, I had almost a full load. I was overwhelmed and exhausted. Here no different.... 2nd day had 2 patients, end of the week I had almost the same as everyone else. Hmph. Again, I don't mind being thrown in, that's how you learn, BUT.... when I am still getting used to paperwork and other stuff, I'm already AGAIN staying late after work. Darn it! I thought this was my big break in NOT working through lunch or staying after work because everyone keeps talking that people leave on time and leisurely have time for lunch. Alll right, it's still early so I won't get ahead of myself, but I just don't want it to become a bad habit.
• Paperwork. Now, dear PT's, as we ALL know, besides actually treating patients, this is the 2nd biggest aspect of our job. At home in the USA, because of litigation and insurance, we document, document, document. Although I am the 1st one to complain about it, I do have to say sometimes it was nice to have detailed notes so you always have a great background on the patient before they come in or just know what they've been doing. Here... I understand until THIS YEAR they didn't document at all. I LITERALLY fell over when I heard this. Now it is starting and when I say it is fairly basic, it is fairly basic. Here would be a typical SOAP note (for you non-PT's: Subjective, Objective, Assessment, Plan):
• S: Patient doing well.
• O: Exercises performed.
• A: Patient doing better.
• P: Continue PT

Really..... no joke. Although that is a legit note I saw, fine, some are a TAD bit more detailed, but still about a 10th of what I would write. When someone saw my note they were like, "whoa, you write a lot." THEN... even dared to say, "you don't need to write that much. It's not necessary." So at first I was like "Woo hoo!" because this has been my dream... little note taking. BUT.... why give up a good habit? When I go back to the States... or anywhere else to work, I will have my  head in the ground because it will be hard to get used to that again. So now I am trying to work on a happy medium. We are sooo trained, almost brainwashed, to be soo detailed, but really? What is really necessary? I'm trying to cut to the chase more, so we'll see what happens.

• The patient population... I would say it's about 50/50 Expats (expatriates) and Locals. Which I'm fine with because it is REALLY interesting to work with such a diverse environment. I may change my opinion sooner than later because I can see already working with the locals can be a tad frustrating. Besides almost always coming late, they typically don't exercise at all and don't really know anything about it.... or even what we do. One lady came in and said, "my foot hurt. You make it go away." Okkaaay.... .last I checked I wasn't a miracle worker. Then they have a HORRIBLE time explaining their pain. The vague, "everywhere" I've already seen too many times, and just answered basic questions like "what makes it better/worse, etc" was almost a non-response. Soo... that's been hard to deal with. And also I am used to major patient education and going to a bit of detail about anatomy or the "why" aspect of pain, and here there is a bit of language barrier so they just don't get it and I have to keep things REALLY simple... and kinda start from scratch with treatment/exercises. They say "pain" for everything when I think they mean "soreness," but really, it's hard to tell sometimes. A bit frustrating, but I guess I'll get used to it! I have to!
• Many people have asked if I can treat local men. Yes. And local woman in their abaya's (the black cloak thing... that is actually what it is called. Not burka). This also has taken some getting used to. Most are good.... you just take them to a private room and they remove the abaya. Underneath I have everything from a hideous PJ to a beautiful Dulce & Gabanna outfit. Then it's always fun when they come in with literally everything covered except their eyes, and then they take it off (obviously with the clothes underneath still on).... some are exceptionally beautiful, some... umm... not so much. Because they CANNOT show themselves to men, I have to keep them in the private room. Fine. BUT that means I have to lug any equipment with me to the room, which can be a bit of a pain in the butt. And again, I just feel so isolated sometimes. 
• It's just a bit and I've already had a cultural issue. Here we have walk-in patients and one came in that asked for me...but already 20 minutes late for the actual session, so I was a bit annoyed and frustrated to do an evaluation in like 20 minutes. So it was a local lady fully covered and I took her into a room and was like "how can I help you?" And when she took off her abaya I realized it was a patient I had already worked with I just didn't recognize her eyes! Oops! I didn't make it better when I said, "sorry, I didn't recognize you, I thought you were a new patient." She was understanding but... I felt like a fool. 
• Both Expats and locals expect quick and almost immediate results.... which seem to be feeded by the docs, "try PT for 2-3 sessions and see how you feel." Physiologically there can be little difference in such a short time and it's hard to jump like 3 steps ahead. So a lot of it seems education on a home exercise program, which we give them. Which is waaaay different than how we do it at home... we usually see patients for 4-6 weeks and have time to really rehab them appropriately and properly. Muscle alone takes one month to develop. There is like a 80% chance patients (especially the locals) don't do their home exercises and hence I feel that we can't be effective. Well, that's a conversation for another rainy day.
• I am a minority at the PT department! There are 2 Indians, 1 Philippina, and 1 Lebanese. It's been interesting how people react... Westerns love it, locals are hesitant, and everyone in the middle is like "whatever, as long as I am being treated." 
• They seem fairly flexible with vacay days. No matter what, we work 5 days a week... 48 hours (a lot, huh?!!). We alternate working on Saturdays and when we work a Saturday we can take any day of the week off or... in maybe 1-2 circumstances, add it to our vacay. They also REALLY emphasize work/life balance and encourage you to take days off and there are always opportunities to do so. Hey, you don't need to tell me twice!
• Which, speaking of vacay days, I have to mention holidays. Here there are a lot of holidays. I was working only a week... then came Eid and got 4 days off! Because I said I would work on one of the days (it would have been 5), I get an extra day added to my holidays. Yes! So after working a week, I'm already up to 26 days off. Sweeeeet. I guess there are 5 Eids throughout the year. Nice! 
• They don't plan out too far ahead of time. The hospital decided to extend the hours, and ... well, it's a long story, but between us, we were deciding who works when, blah blah. Some wanted to do it on a bi-monthly schedule and I actually stepped up and was like "NYET" because that is NOT good patient care because then for sure a patient will be bouncing around between patients. Anyway, we worked it out to do it monthly and even planned for the next 3 months, which I think will work out... that's how we did at my old clinic (for vacations) and it worked out fine. 

Well, I think I've blabbed enough. I"m sure there are lots of other things that will come up, but I'll talk about them as need be. All and all, I like it! They say I should be involved in athletic sports, so that should be cool. Now it's not the case, but supposedly I should be the one directed to for sports cases. But then again, I don't mind this random stuff in between. My field is lot about experience and seeing and learning from different things. 

What can I say? Work life in Dubai.... Same same, but different.