John Henning Schumann

December is supposed to be the time of year filled with family gatherings and holiday good cheer. For medical residents, quite the opposite is true.

There are no school breaks during residency. Being a medical resident is a real job, and a stressful one at that. Residents work long shifts, even with caps that max out at 16 hours for the newbies and up to 28 hours for those beyond the first year.

A 40-something patient I'll call Ted has a list of conditions that would have tongue-tied Carl Sagan. Even though I see Ted in my clinic every month, he still winds up visiting the emergency room 20 times per year.

Yes, 20.

Before he became my patient, he went even more frequently. So, the current situation, bad as it may be, represents halting progress.

Debate is raging about Obamacare, and not just in Washington. Out here in Oklahoma we're grappling with implementation of the Affordable Care Act. Patients. Employers. Hospitals. Doctors. Insurers. All of us.

Here then are one doctor's predictions about what we will see in the short and medium term for what I see as the unfolding Obamacare era — the biggest domestic health expansion since the enactment of Medicare in 1965.

I became a doctor to help people.

When I was a medical student, I held the naive and idealistic belief that if I just did good work, the business side of things would somehow take care of itself.

How wrong I was.

Now I'm an internist taking care of all comers age 18 and up. Some days I find myself facing patients and feeling more like a harried airline clerk than a real doctor.

Even if I hadn't known the hospital inspectors were coming, I would have figured it out quickly enough from my email.

The admonitions were flying:

"Know your safety protocols backwards and forwards!"

"Sign things legibly, or at the very least print your name below the signature."

"Wash your hands before and after patient contact. (The surveyors will be watching .... )"

It's boilerplate stuff that doctors like me should do all the time but often overlook.