34 patients, variable Monday. New PCOM Medical student (surprise). A patient with chronic pruritis since April and an intermittent urticarial rash. Turns out she was seen by a non-physician in a minute clinic at a large chain, given a large tube of Permethrin cream 5% for scabies, used it twice daily until gone, then refilled after a week or so, at the same clinic for another consecutive round, where-upon her itching started, and a reactive excoriative urticaria, and a milder form of what is functionally kno as ‘thee Lindane Crazies’. Clearly redefining what is an appropriate medical provider, can increase hazards, dilute the public healthcare dollar, ensure inadequate care and treatment of the general public, lower standards, and result in a dis-proportionality of negative outcomes. In other cases : a left eye orbit contusion, with concussion x4 days, r/o fx. Hip arthrosis referred for CT & ortho. Tooth abscesses. Cerumin disimpaction. Several allergic mediated rhino-sinusitis with secondary infection. COPD exacerbation. Physicals. Weight loss. Gastroenteritis. UTI’s. HTN. Then a number of medication renewals. Elizabeth and Bigs, Keath, and Grandpa Welk are home from Rhadi’s mat-work intensive. I’ll take Iain and head home.