Dr. Attending: This is Dr. Orthochick. She's going to see you first and then I'll see you.
Patient: OK.
Dr. Attending departs
Me: Hi, I'm Dr. Orthochick. So what's been going on since the last time you were here?
Patient: I'll tell you when the doctor gets here.
Me: He'll be in after you and I finish talking.
Patient: No, I'll wait for the doctor.
Me: I am a doctor.
Patient: I'll wait for the real doctor.
At that point, she started reading the copy of People magazine in the examining room.
And that was the end of that patient interview for me.
How'd the attending follow-through with the case? If the patient was told beforehand that they may see a resident, I'd have stuck to my guns (especially if business wasn't hurting).
ReplyDeletePatient refusal to provide information = less work for you! Patients who refuse to clearly answer questions (distinct from being unable to do so) because "it's all in my [last 10 years of VA medical] records and I shouldn't have to answer these questions today" or who threaten to seek medical care elsewhere because they're unhappy with my department have my wholehearted support.
ReplyDeleteUnfortunately when I offer to refer them they usually backpedal and decide they want to continue care with us. I'd rather they leave as these 5-10% are the most energy-draining patients and I have more than enough reasonable (and dare I say, appreciative of my efforts to be thorough and thoughtful in their care) patients to keep me busy past the end of the workday.
Not exactly related, but today I observed a woman and her husband in the hallway complaining to a group of nurses about her mother's TV bill. Apparently she'd been charged an extra two days than warranted or something along those lines. In any case, they were expending an inordinate amount of their time (and, especially, nursing time) to make a big deal out of a bill that must have amounted to an extra $25.
ReplyDelete(And it certainly didn't sound like it related to any actual concern about the mother's *medical* care.)
If they'd come up to me with that kind of issue, I'd have referred them to hospital billing (and, in my head, told them to quit bothering staff who are actually providing patient care).
(I'm a medical student, but...)
ReplyDeleteMy attending and the intern left me in a patient's room, with the instruction to him that I was going to ask "some more questions and do an exam," some of which included repeating a few things that the attending already did (ie, heart/lungs/abdomen). The patient asked me angrily "when I was ever going to be done practicing on him." I told my attending, and she said "well he should get a PCP then and not bring himself to a teaching hospital!" I hope yours responded similarly!
This is what happens to so many PAs ... UGH
ReplyDelete