Sunday, June 12, 2011

Sunday reruns

Thank you for coming in on this lovely Friday afternoon, ma'am. I guess you called around 1:30 today, and since we didn't have a 4:00, which is my last slot of the day, Mary put you in. Let me just open another Diet Coke, and we'll get started.

So you've had headaches for the past 20 years? And never seen a doctor before for them? What made you come in today, of all days, for this? Oh, you did a Google search.

Thank you for this printout of all the horrible types of brain tumors and aneurysms that can cause headaches and kill people. I appreciate it, because as a board certified neurologist with over 10 years of experience I really have no idea what sorts of things can cause headaches.

If you'd read it you might have noticed that the average survival from these awful things is 1-2 years, not 20. But I'm sure you're busy and didn't have time to actually read the articles you were printing up. After all, you had your hands full calling every neurologist on your insurance plan trying to find one who still had openings on this lovely Friday afternoon.

Of course we can get an MRI. I understand it would make you feel better, and allows me to cover my own legal butt, too.

Oh, you're claustrophobic? No, an MRI is really the best test we have right now for evaluating this sort of thing. I'm sorry that Reader's Digest somehow gave you the impression that I had a gadget in my office I could wave over you to make sure everything is okay, but I don't. Dr. McCoy borrowed my tricorder a while back and hasn't returned it yet. But we can do the MRI with Valium to relax you, if such a thing is possible.

I'll have my staff schedule the test for next week. No, I'm sorry. It's now 4:00 on a lovely Friday afternoon. Your insurance company requires an MRI request to be approved by a panel of dart-throwing chimpanzees before agreeing to pay for one. All of their offices are in another time zone, and have closed by now on this lovely Friday afternoon.

You really feel you need it immediately? Then the only thing I could suggest would be to go to an ER, and tell them you need an MRI right now. I'm sure, that after hearing your story and realizing how urgent this is, as opposed to a guy with chest pain, the ER doc will be happy to waste spend time and money on your case. Just don't tell him that I'm your doctor.

Oh, I had no idea your ER co-pay was so high. $50 does seem a bit extravagant for a lady with diamond rings on every finger and Porsche keys hanging out of your LV purse. I certainly can understand your refusal to go there.

Then it will have to be next week. My staff will call your insurance first thing Monday morning to get this authorized and scheduled.

Your insurance coverage runs out at the end of this month? My calender shows that today, May 29, is a Friday (which is a lovely afternoon by the way) and the last workday of the month. So Monday will be June, and we won't be able to get the MRI from your current insurance then, since it will have run out.

What insurance will you have on Monday? I'm sorry, I'm not contracted with that plan. I can send your internist a letter asking him to order the MRI. Oh, he's not contracted with it either. I see.

Yes ma'am, I agree it was entirely unreasonable of Mary to not have foreseen that you'd be changing to an insurance I don't take next week. You didn't mention that to her when you called for this appointment a few hours ago, but she really should have known, anyway. I'll discuss her suboptimal psychic powers with her at her next job evaluation in 2018.

I'm sorry you have to go already. Well, try to take it easy over the weekend, and I'll send my records to a neurologist on your next insurance, so they can help you out.

Going to a hockey game tonight sounds like fun, and it's great that you have such good seats. That looks like a nice air horn in your purse. I'm sure that sort of quiet, relaxed environment will help improve your headaches in the meantime. Thank you for sharing this lovely Friday afternoon with me.

23 comments:

mcduckvet said...

Repeat after me:

A lack of planning on your part does not necessarily constitute an emergency on mine.

Anonymous said...

"And watch out for that doorknob on your way out, it's about the same height as your supercilious ass."

Lynda Halliger-Otvos said...

What was her co-pay to come see you and did she pay it at time of service ?~? I detest people when they act like that; you have my admiration, Dr G.

your gift for story-telling is only surpassed by your compassion... for yaks.

pharmacy chick said...

and did she by chance want a 90 days supply of a medication on her plan that expires that day?..and needs a PA? oh yea..its MY FAULT.
LOL. Misery loves company !

jimbo26 said...

All said with a straight face , and no sarcasm . :-)

Anonymous said...

Yes, when I worked for a surgeon as his RN...I had the wonderful job of screening these Koo-Koo-Bananas for him prior to his walking in the exam room...

Jess said...

Well, you should have pulled out your magic wand. One wave would have solved everything.

D. said...

Oh, that was hilarious (horrible but hilarious).

Linking!

Anonymous said...

Don't you just love the people who "know" everything just because they googled it and found a very convincing "article" on the internet written by a yak-herder for all they know....but they want you to buy into too!

Watercolor said...

omgah! These are the same people who call their architects at 4:30 on friday afternoons to say they need 3-d color renderings of the building from a floor plan scheme they just approved yesterday to present to a board meeting 8:30am Monday. HATE THEM.

Ben S said...

I thought all neurologists had an ADE 651 in their office for remote detection of brain tumors. It says so in Reader's Digest!

trishgwynn said...

If only that story was merely the product of an overactive imagination. The truth of it, however strikes me right between the eyes. Oh, no. Now I have a headache, too...

Jeanette said...

Oh good Lord!!!

Anonymous said...

I'm so pleased I practise in Canada :-) Here I can say what she deserved : "Piss off" ;-)

Anonymous said...

Ahhh, those Friday afternoon emergencies. The worst one I ever dealt with, in a former lifetime (well it feels like it) as a veterinarian was the guy who came in at 5 to 5 one Friday afternoon with his dog that had a triple torsion in one spermatic cord, and consequently a hugely swollen and ischaemic testis. How long had the dog been in that painful state? "Since I kicked him in the balls on Monday".

Julie said...

and you only drink diet coke?!?

Anonymous said...

On the other hand, I once had a doctor yell at me - literally yell - for coming to the emergency room when I WAS sick instead of waiting for him to finish his dinner.

The Bus Driver said...

you will only evaluate mary in 2018? she needs a raise now!!!!

newnurseinthehood said...

Would it have been ethical for you to pull out a smart phone and do a "portable MRI" during the visit? You know, apps and such. It's real ma'am, but the internet doesn't know about it yet.

cliffintokyo said...

Another fraught, frantic, freakin, female (monster) patient bites the formica.
MOTY (Misogynist Of The Year)

My online dictionary lists 13 synonyms for fraught, and 2 antonyms (including "unstressed").
Perhaps this says something about the human condition?

Deana said...

I would take a reduciton in pay if my hospital would take the WIFI and computer screens out of patients rooms. Google search by patients is never a good thing.

Packer said...

Summer hours--the staff will love you for it.

The Orange Jeep Dad said...

Your posts always strike a cord with me but by the time I get to the end of the comments, I forget what I was going to say...

What was I saying?

 
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