Dr. Grumpy: "Hi, are you the hospitalist seeing my patient, Mrs. Felldown?"
Dr. Hospital: "Yes. I'm sending her to rehab today."
Dr. Grumpy: "Did her tests look okay?"
Dr. Hospital: "I don't know. Do you? I'm busy today."
Dr. Grumpy: "This is Mrs. Felldown we're talking about, right?"
Dr. Hospital: "Yes. What was she admitted for, anyway?"
Dr. Grumpy: "She had a fall."
Dr. Hospital: "Okay. Anyway, I'm going to send her to rehab."
Dr. Grumpy: "Have you seen her yet?"
Dr. Hospital: "No, but the nurse told me she looks fine, and slept well last night."
Dr. Grumpy: "Do me a favor, can you hold her until I can come over and check her out myself?"
Dr. Hospital: "Okay."
Dr. Hospital may be "busy", but he's also an ass. And I'll bet he bills Mrs. Felldown for seeing her, even though he didn't actually *see* her....
ReplyDeleteSounds like Dr. Hospital might be Nurse K's friend Happy--too busy with his own stuff to check on a patient.
ReplyDeleteThis is the first time I'm posting but Mother of god...I agree probably billed her a fortune. What an ass.
ReplyDeleteI'm a nurse myself and while it's great when a doc actually listens when I say something, I can't believe that one would accept my assessment of anything over his own. Maybe in conjunction WITH his own assessment, but never instead of.
ReplyDeleteI won't hang even a plain IV bag that I didn't personally witness the opening of (who knows what could have possibly been injected into it - maybe practice overkill, but not when I'm the one responsible in the end). Scary.
I HATE hospitalists!! Not personally, mind you ~ just the whole thought behind them...
ReplyDeleteI'm sure there are great hospitalists out there, but as a pharmacist, I have yet to deal with one. They're always too busy, too important, too whatever to be bothered with a clarification on an Rx.
ReplyDeleteWait a minute...was this the Happy Hospitalist?
ReplyDeleteGuys, I don't think Happy would trust a nurse to wipe a patient's ass without going in to inspect it later -- let alone use her assessment to discharge a patient.
ReplyDeleteWow, even Magic 8-Balls can be doctors now?
ReplyDelete"Is she ok?"
"Concentrate and ask again"
Dr. Hospital tried to make her go to rehab; Dr. Grumpy said, "No, no, no."
ReplyDeleteWhen we began working on the wards in the 3rd year of med school, they told us, "Listen to the nurses because they know more than you do at this point.
ReplyDeleteAnd for some of you, they always will."
Guess this Hospitalist falls in group 2.
Lol. As a rehab doc, I've think I've been on the receiving end of a few of this hospitalist's discharges.
ReplyDelete(Most hospitalists are great, but there are a few....)
Reminds me of getting report from a certain nurse and asking if the patient had a catheter. Her response was often "I don't know." This was at the end of her 8 hr shift. And she didn't just forget something at he end of a busy day either. I checked her charting, she often hadn't known then either. Scary.
ReplyDeletewv: ranters. (isn't that what we all do best lol)
I mean, I've heard of no bed side manner, but not even seeing the bed side? That sucks.
ReplyDeleteSounds like you got Dr. Happy and he was busy attending his PT.
ReplyDeleteDr. Hospital is carrying a bullet for someone.
ReplyDeleteHe was busy at the orthopedic surgeon's office.
ReplyDeleteWhoa, this may be why Dr. Fizzy wonders why some internists don't always ensure patients' medical stability before transferring to rehab: http://doccartoon.blogspot.com/2011/05/weekly-whine-dont-you-care.html
ReplyDeleteI've transferred many, many patients to rehab. My supervising attendings never approved any transfer w/o personally evaluating & thoroughly rounding on the patient that day. If there was any unresolved question of a patient's medical stability, transfer was delayed pending further workup or treatment. Drove our social workers batty.
Looks like I'm in for a rude awakening come July 1...
our hospitalists are excellent and totally trustworthy. and they absorb a ton of scut and crap so the rest of us and the entire system can be an efficient and productive integrated multispecialty group.
ReplyDeleteI see this is "lets all jump on Happy week" How about next week it be " lets all jump on nurse K's week." OK?
ReplyDeleteAnyone else thing that Anonymous 6:09 IS Happy?
ReplyDeleteOK I'm just going to admit my stupidity and ask: what is a hospitalist? (Yes I could Google it but I'm sure y'all would explain it better.)
ReplyDelete>>>Anonymous said...
ReplyDeleteI see this is "lets all jump on Happy week" How about next week it be " lets all jump on nurse K's week." OK? 6:09<<<
Um, nobody was jumping on ALL Hospitalists, just the ONE DOING THE WRONG THING BY THE PATIENT. Are we clear now? Hell, every day is 'jump on nurses' we don't need to wait for a special week. Some nurses shouldn't bathe a stray dog, let along touch a patient - same for any profession.
Pay attention to what is ACTUALLY being said (see: assessment), don't read into things, and lighten up. When innocent comments hit too close to the bone, maybe it's something in yourself you're subconsciously picking up on that needs to be fixed.
What I heard being said about Dr Happy were not innocent comments.
ReplyDeleteMaybe not innocent comments, but pretty appropriate ones. Read his blog, and you will see why.
ReplyDeleteI wouldn't want Happy to treat a pet hamster.
I think a relative of this guy was the OBGYN when I had my first baby...
ReplyDeleteTrish, if I ever end up in hospital unconscious or still recovering from an anaesthetic, i.e. unbable to check of speak for myself, will you please be my nurse?
ReplyDeleteIt couldn't possibly be Happy. Happy would have never actually asked a nurse for her opinion on a patient. HE just reads the sugar sludge in his cereal bowl in the morning and makes patient decisions that way.
ReplyDeleteAny abuse Happy gets, it's because he airs his business for all to see. Attention sponges like good or bad attention, and it doesn't seem to faze Happy about pile ons.
SkullCandy
So what happened to the patient? Like another early commenter, I'm sure he was planning to bill for evaluating her and writing the discharge to rehab order - I kinda hope he had already done that before he called you - then he'd really have some explaining to do!!
ReplyDeleteI'm sure hospital management and internal medicine groups are sold on the advantages of hospitalists, but a lot of patients ('customers' and their families) are not.
@clairesmum: I'm an internal medicine resident who works with both hospitalist and non-hospitalist attending physicians. I'd much rather have my family member treated by a competent in-house hospitalist than a doc who spends most of his time in the office with a small amount of time set aside for seeing hospitalized patients.
ReplyDeleteThe hospitalist works closely with the entire health care team. This improved communication among team members often translates to better, more timely care. In addition a hospitalist is physically present should anything go awry. S/he can physically evaluate the patient if needed rather than rely on someone else's assessment. Again, this makes for better care.
Hospital medicine has become much more specialized than in the past. It requires a detail-oriented person with the capacity to keep up with a rapidly changing standard of care for hospitalized patients (who, btw, tend to be sicker than hospitalized patients a decade ago). It is a rare, rare
physician who is exceptionally skilled in both acute care and outpatient medicine. And even that guy can't provide consistently high quality care when he's not in the building.
Sounds like the hospitalists where I work. All they can do is say "Order and ABG and move the pt to ICU"...
ReplyDeleteI have timed their consults with patients: one female hospitalist was in and out of 15 rooms in under 1 minute and I know they got full billing......
What a guy. Maybe they should pay him in Monopoly money to match his game style of being a doctor.
ReplyDeleteHappy Hospitalist?
ReplyDeleteReminds me of the neurologist who orders a hypercoag work up on every patient with a CVA and then consults me everytime there is an abnormal lab. That what they taught you in neuro residency grumpy?
ReplyDeleteWell, I'm diabetic, and the nurses let me sit there with blood sugars in the high 300s and 400's for HOURS for 3 days because there was no order to give me insulin appropriately as basal and bolus, but only as a correction before meals (might have been OK if I didn't eat anything, but I still doubt it). Where was the hospitalist? Oh, it was the weekend, and he was off. So NO ONE was supervising my care. And I'm sure they never knew they could have killed me.
ReplyDeleteSo this 33-year old "hospitalist" sees my 83 year old, post stroke (language Problems) mom and proceeds to tell her she will have shingles pain the REST OF HER LIFE. Nice! We are not stupid and you are banned from her room, & there is a nice complaint waiting for you to deal with. How much did you charge for that opinion?
ReplyDelete