Thursday, February 11, 2010

Things that make me grumpy

Doctors who dump patient test results on me.

I don't mind being the bearer of bad news. I don't like it, but hey, it's part of the job.

But it really chaps me when a patient shows up "because Dr. Doofus said you'd tell me what the MRI showed". Most of the time Dr. Doofus hasn't even had the common courtesy to send me a copy of the damn report.

And in almost every case the studies are NORMAL. That's all. Or have some minor, benign variant like a harmless cyst. And so, because of human nature, the patients assume the worst. After all, Dr. Doofus is stonewalling them, and sends them to a specialist, so it must be time to draw up a bucket list.

Or they have a minor, benign, variant, and Dr. Doofus tells them it's either something horrible (because he has no idea what it is) or that it's sole the cause of ALL their symptoms, and Dr. Grumpy will know how to fix it. When in reality it's as relevant to their headaches (or whatever) as a hangnail would be.

I don't understand a lot of stuff in my own field, let alone outside of it. I don't expect other doctors to be any different. But if you don't know what it is or means, just be honest and say "I don't know!"

And DON'T tell them that they have to see me to get the results, then refuse to give them. They spend sleepless nights worrying about them. And when they invariably find out the test was normal, they get really pissed off at you. I've seen patients change doctors over that. And I don't blame them.


Anonymous said...

Dear Dr. G. I had no idea that neurologists were such normal people...until I started reading this blog.

Kim said...

Not only would I completely dump my doctor over something like that, I would tell everyone and their brother who would listen to me how much of a jackass that doctor is.

Why do some Doctors think an M.D. is a license to be a complete asshat?

Grumpy, M.D. said...

Oh, we aren't normal. Believe me.

WarmSocks said...

Unfortunately, that sounds familiar. I saw a doctor who had so many patients that he didn't have time to follow up on abnormal results from tests he ordered. Don't know if lightening his patient load helped him any, but it sure helped me.

Thank you for interpreting those results for people!

Helen said...

Wow. What an ass. I have, fortunately, not had that experience, but I'd be pretty pissed off about it too.

The Duchess said...

This is BS on the part of the referring doctor. It costs their patients a new co-pay to see you, plus it can be hard to get into a neuro office for some of us (even emergent appts. at my neuro is a good 2 week wait due to the lack of neuros in our area), which leaves the patient in turmoil longer than necessary.

This happened to me with my previous family doctor when they were trying to diagnose my seizure disorder - he said he "didn't feel comfortable" with his interpretation of the results of my MRI, and I should see a neuro for his advice. It took me three weeks to get into my neuro (the strange little man I've written about here before), and it turned out that the MRI scans were fine. I was so angry that I called my (ex) family doctor on it - he said something to the effect that only specialists could really tell if something was truly wrong in MRIs. Before I left, I told him the proper thing to do would be to tell me that he didn't see anything on the films, but wanted to send me to a specialist to be sure so I wouldn't spend the time waiting to see the neuro freaking out! And I found a new doctor that day.

Magnus said...

I have a friend who was told last year that she probably had bladder cancer. They did a bunch of tests.

One doctor took more than 4 weeks to get back to her with the results. His office did not return phone calls. Just silence.

And this was after telling her he'd have the results in a few days.

She did not have cancer, and my guess was that if she had it would have been important enough to tell her about it -- but still, she thought she was dying and they couldn't even return her calls to say "We don't know yet" or whatever the situation was.

I hope your patients are aware that not all doctors treat people right.

Anonymous said...

I have met VERY few doctors who are willing to say "I don't know". God bless you for being one of them. If more of them would do this and then REFER there would be a lot less wasted time in the world and a lot less misdiagnosis.

terri c said...

Awful. Just--awful. I would be livid if I had to wait weeks to find out there was nothing to find out. Actually that did happen to me once: gyn claimed he saw a serious lesion, scared me to death, told me to come back in 2 weeks by which time he not only saw nothing but forgot what he'd seen the first time. "Grumpy" doesn't cover it.

elsi said...

Sometimes even when they tell you themselves, they tell it badly.

At a level 2 ultrasound I had a maternal-fetal medicine specialist spend five minutes talking about Down Syndrome and the markers for it and the chances at my age - five minutes of thinking oh dear God, he's preparing me for the bad news - and THEN he said "So the probability has gone from 1 in 40 to 1 in 400!"

I told him he should have said right away that while this screen was not absolutely definitive, things looked good!

No bedside manner at all, leaned his elbow on my abdomen.

terri c said...

Also Dr. Grumpy is right--NOT normal, but then who is?

outre said...

I haven't had a doctor push me off to another for scan results, though I always get at least the copy of scans and radiology results before I see the ordering doctor/other consults for a follow up.

There was a game of hot potato... starring me as the hot potato that went on between my ex neuro surgeon and ex surgical oncologist. Each telling me to go talk to the other.. aggah. Turns out, I don't need either yet, but those were some awesome 6 months of unanswered questions. They were good people but I was too rare of a case I guess.

Since than I've switched to an awesome neuro who didn't feel that I needed to be monitored by neurosurgeon AND a surgical oncologist when he can follow up scan changes himself. He's always good... except when he makes fun of me for knowing so much (in good jest) :p

Dana said...

Dr G, thank you for this! Nothing makes me more angry than a doctor who cannot admit that they don't know the answer or what exactly the problem is.

My GP is a real find because he is comfortable telling me things like, "I really don't know. How about I look into it and we can discuss it at your next visit." Then he DOES his homework and we have a discussion at my next visit.

If more doctors were like you and my GP, we patients would have a lot less worry and anxiety. Thank you, Dr G!

mommy-medic said...

I've had a headache for 9 days. Base of skull and behind one eye. Made me throw up today. All morning. I refuse to get it looked at because A.) I know it's just stress, and B.) medical runaround exactly like that doc is doing by dumping onto you. Why send em for an MRI if he's not going to give them the results???

LilMsHppyPillz said...

When I was in college, I had a cervical cancer scare. A few years ago, I had a PAP and my doc called and left a message, on Friday afternoon, to call the office. I called as soon as I could and the person who answered said that the doc had left for the day and no one else could/would help me. So I spent the weekend in tears, convinced the cancer came back. When I finally got thru to her Monday morning, she just wanted to know if I wanted to change my birth control. Yeah, I dropped her, fast.

Kipper said...

I haven't needed much imaging thus far in my life, but techs who will give you their off-the-record thumbs up/thumbs down evaluation are golden. You still need to wait for a proper interpretation, obviously, but at least if you were freaking out previously it can bring the anxiety level down while you wait.

Shalom said...

Been there, done that.

When my wife was expecting our daughter, the ultrasound tech told us there were bright spots in the bowel. This is a (very slight) risk factor for Down's Syndrome, and she said that there was a blood test with genetic screening to rule that out, which they performed. We called the ob/gyn the next day to find out the results, and the office staff said "Do you really want us to discuss this over the phone?"


Oh shit.

I walked around in a daze for two weeks, until my wife's next appointment. Bear in mind that I'm 41, and older parents (although usually the mother) have a higher risk factor. We cornered the doctor and asked him straight out, What's with the bright spots in the intestine? He said Oh that's nothing to worry about, the baby probably just swallowed some meconium and it was showing up on the ultrasound. So there's no sign of Down's Syndrome? No, we ruled that out with the blood test. I asked him, So why the fsck didn't you call us and tell us that then? We've both been walking around for two weeks terrified that we're carrying a Down's Syndrome child, we both know people with such children and we were wondering how our whole lives will be turned upside down. He said, Don't worry, if you don't hear anything from us it means the test was normal.

God I was pissed off.

Other than that, he's a great doctor, and we're still using him, but now I know, any time we have any kind of test, we call for the results and don't let them get off the phone until we find out.

word verification "unfixes" ? I don't even want to know what that is.

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