Wednesday, July 7, 2010

Wednesday afternoon

Mary interrupted me when I was with a patient. A doctor who's never sent me a patient needs to talk to me urgently.


Dr. Grumpy: "This is Ibee Grumpy."

Dr. Doesntrefertome: "Hi! I need you to do a spinal tap on one of my patients. Urgently, like, this afternoon."

Dr Grumpy: "What's going on?"

Dr. Doesntrefertome: "I think she has meningitis."

Dr. Grumpy: "That's serious. You need to send her to ER."

Dr. Doesntrefertome:: "I don't want to send her to ER. Can't you do it in your office?"

Dr. Grumpy: "I don't do them in my office. I haven't had a spinal tray here for years. She needs to go to ER."

Dr. Doesntrefertome: "That's ridiculous! What kind of neurologist doesn't do taps?."

Dr. Grumpy: "I do them, I just don't do them in the office. I don't have the space or equipment."

Dr. Doesntrefertome: "This lady is SICK, dammit! You need to get a tray and do one. TODAY!"

Dr. Grumpy: "Then she needs to go to ER. If she really has meningitis, this is an emergency. She needs urgent evaluation and treatment. Send her to local ER. I can consult on her there. But this sort of thing shouldn't be worked up in the office."

Dr. Doesntrefertome: "This lazy attitude is why I don't refer to you." (hangs up phone)

32 comments:

Sarah said...

Thank goodness for your levelheadedness. I wrote a butthead 54 year old internist try one on my 72 year old father in his office. Can you believe he never got any spinal fluid????????? Ass.

Old MD Girl said...

And while you're at it, why don't you do your own gram stain too, and start empiric IV antibiotics while you fetch those results. And why not thrown in a little HSV PCR while you're at it. Wait, what? You don't have the equipment to do that in your office? What kind of neurologist are you, anyway?

singedwingangel said...

And their demeanor is why medical care is going in the crapper. If I have meningitis I want to be at the hospital to ge tested not in the office ot infect others for crying out loud..

Amanda said...

How do you not march over to his office and strangle him?

Gloria P said...

Can you imagine being one of his staff? What a lousy attitude. (You're probably the fifth one he called who wouldn't carry out his mandate.)

Jackie said...

WTF????? That is bullshit! Idiot!

xx
Jaxs

Mr-Mobius said...

You sound quite incompetent. If I were to go to a neurologist who didn't work in a hospital (in UK, so neurologists are in hospitals anyway) then I would expect them to be able to do MRIs in their office, never mind something as simple as a spinal tap. I think you should reconsider your office policy in future. No wonder he never refers to you.

(For any not noticing, this has been sarcasm)

Mugdha said...

I wonder if that patient ended up being sent to the ER. That attitude sucks the most for them, who're depending on their doctor to be helping them out, not verbally abusing neurologists.

Anonymous said...

If you can't do spinal taps what good is that laboratory doing in your closet?

Anonymous said...

wonder how many neurologists he called before and after you for the same arrangements?

if he doesn't refer to you something tells me you weren't the first person he tried and most likely the last???

Just saying!

KateA said...

Sounds like you dodged a bullet. I would love to lose some of my referring doctors. But in ER, you cannot.

Ari said...

WTF was that doctor doing not sending her to the ER? To put it mildly, that's not how I'd want my doctor to practice. To put it less mildly, but still avoiding the M word, I'm sure there's a happy lawyer out there reading this. Hopefully (for *her* sake), not a soon to be rich one.

Toni said...

So...people who SHOULD be in the ER aren't and people who SHOULDN'T are......what is wrong with this picture?

Anonymous said...

What if the patient didn't have meningitis, but something more insidious that needed emergent surgery...what, Dr. G., you don't have a full theater in your office either? Scalpel, Mary. Retractor, Ed.

Anonymous said...

Have a hood, and do your own STAT high-dose vancomycin dosing, too? Sheesshhh...

Anonymous said...

1853- you are the only doc who can help me. i know this because i already called everyone else. puhleeese?

Anonymous said...

Just wondering what the M word that Ari referred to is in this case? I think Murder would be the most applicable!

shrtstormtrooper said...

Dammit Jim, I'm an idiot, not a competent doctor!

middle child said...

Referencing one of your comments on someone's blog. I loved it! The one about all the bottles, same size and perfect order and they all say, Hampton Inn. Perfect!

terri c said...

I think as I know you do that you are lucky this eedjit doesn't refer to you. Mary wouldn't have a snowflake's chance in hell of quitting smoking if she had to deal with him regularly.

ireflect said...

Why doesn't Dr. Doesntrefertome give the patient a spinal needle, and two mirrors....

Am appalled at his gall!

Liz said...

Hopefully that doctor is really old and will retire or die soon.

Anonymous said...

OK, so I have no medical background or training at all (nor do I want any), but the tenor of these comments suggest that doing a spinal tap in the office is tantamount to doing brain surgery at Wendy's. If my inference is correct, why is Dr. Doesntrefertome so reluctant to send his patient to the ER since he should know that he will not find a competent doctor willing to do one in an office?

Grumpy, M.D. said...

That, Anon, is the $66,000 question.

Anonymous said...

I want to strangle him and I didn't have to deal with him on the phone.

Word verification:"daniu" Is that a medicine you can get for dealing with people like him?

ndenunz said...

Was the patient some kind of drug kingpin or mafiosi that the Dr. was trying to treat outside the normal boundaries?

ERP said...

Right. I bet Mary would love the menengitic patient spewing gram negative diplococci all over the office.

PHDnotMD said...

Did Dr. Jerkball have a good reason for not wanting to send the patient to the ER? Seems like it should have been a no-brainer, especially since I imagine he'd have to spend a medically injudicious amount of time trying to find a neurologist a) set up for office spinal taps and b) with a convenient immediate schedule opening for a new patient!!

Sue G said...

I'm thinking this doc doesn't refer to you because he or she has one patient. And is about to lose that one (though I sincerely hope not!)

Chris@Knucklehead! said...

Why go to the ER, when you can just remodel your office?

Make sense to me.

Not.

Olivia said...

This immediately made me think of this classic "Dilbert"
http://www.dilbert.com/fast/1994-10-17/

Anything he doesn't understand must be easy (safe, reasonable, etc.) right?

It is a mystery why he's trying to avoid the ER....can't think of any legitimate reason that wouldn't be overriden by the severity of meningitis...

donna said...

There is ONE place I would want to
have a spinal tap...hospital.

If this has already been said..
mea cupa. too tired tired to read
all comments.

 
Locations of visitors to this page