Monday, March 5, 2012

Care

Dr. Concerned Internist: "Hello?"

Dr. Grumpy: "Hey, Susan. It's Grumpy. I need to talk to you about Mrs. Aspirin."

Dr. Concerned Internist: "What's up?"

Dr. Grumpy: "Well, you referred her to me for a TIA, so I ordered a carotid ultrasound. Her arteries look okay, but on one side she's got a small thyroid nodule, and the radiologist is worried it's malignant."

Dr. Concerned Internist: "So why are you calling me?"

Dr. Grumpy: "Well, it needs further work-up, and you're her internist."

Dr. Concerned Internist: "You ordered the test that found it, so it's your problem now."

Click

44 comments:

Anonymous said...

wow, wouldn't like to have an internist like that

was she too lazy to even refer her to another specialist? (like an endocrinologist)

Karen Whiddon said...

Seriously? So total apathy and laziness exists in all professions.
Sigh

Packer said...

The practice of medicine as a child's game of tag.

23 Skidoo said...

"it's" your problem now....The patient is an "it"? Nice...

Is it me or is this what happens when medical school acceptance is based purely on grades and MCAT scores and not the ability to empathize/sympathize/have a personality?>?

Some of the people who are good at physics and calculus are not necessarily the type of personalities that should be dealing and interacting with human beings.

Anonymous said...

'Care' - it's just a four letter word to some.

Moose said...

Kill her and put her head on a pike outside the hospital as an example to all the others.

bobbie said...

I'm with Moose... Also put a picture of it on the cover of JAMA!

brent said...

sad.

Anonymous said...

Dr. Grumpy, is this legal?

Anonymous said...

@23 Skidoo: Strangely enough, most people would rather be treated by a genius Doctor with bad bedside manners than a friendly Doc who makes mistakes...

It is strange behavious from the Internist though.

Your Doctor's Wife said...

Patient Dumping. I hate it! My husband's colleagues do it to him ALL THE TIME! I tell him it's because they know he's too nice. He ends up with all the difficult cases and the cases that will eat up a lot of their time. Hate it.

Anonymous said...

23 Skiddoo: I interpretted the "it" as the possibly malignant nodule, not the patient.

That being said, the internist was still rude. Dr. Grumpy, please tell me you advocated for your patient either by referring him to another specialist, or telling him to find another internist.

Anonymous said...

Ummm, so a neurologist is supposed to handle a thyroid nodule? Does this internist realize that the thyroid is not part of the nervous system?

Polly said...

Wow. Yeah, Moose's prescription may seem harsh, but under the circumstances....

Can't she get into trouble for blowing off a patient like that? I hope you at least let the patient and her family know what a horrible doctor she is. I thought the whole purpose of going to generalist was to have someone who knows about all the different health problems you have.

Loren Pechtel said...

It sounds like you have found part of the problem with malpractice costs in this country.

Kim said...

Wow. Can you somehow let the patient know that the internist is a moron and she should find a different internist or would that be some sort of ethics violation? If I were the patient I'd want to know.

Jenn said...

Is this because she's not gonna get paid by the insurance company?

What's up with this? You've documented several incidents of this attitude... is it just lazy don't cares? Or is there a deeper reason?

Corn said...

Wow. Just, seriously. Could you report this to her superiors? Or is this something that typically happens in medicine, one doctor dumping their patient on another?

Kara said...

Yes, sounds like you could be talking about my pcp. Only she would have asked you to explain what pcp means.

Dan said...

I'm neither a doc, nor in your industry at all. That strikes me as rather dickish though -- wow! I'm a programmer, and if a co-worker did something like that I'd be more than mildly irked...

Anonymous said...

gotta hate those incidentalomas!

spectrummom said...

Well, as an internist, I think it's appalling. But also a good example of what happens when primary care tries to act like specialists. Oh, I said it. Appalling. Paid less to care more.

RehabNurse said...

Nah, murder?

I'd just do a Donald Trump:

"Dr. Concerned...you're fired!"

Then go find me a really concerned internist after I find a nice doc who'll work me up for this lil old malignant thingy.

What is the matter with some people? Puh-lease!

Anonymous said...

If there is any type of internal review board for physicians, she needs to be reported.

If there is any ethical way to tell the patient to find a different Internist, the patient needs to be informed.

That doctor is a total jerk and should NOT be practicing medicine. Having a great intellect and caring about people are NOT mutually exclusive. Many doctors combine both really well.

And some don't.

Anonymous said...

What? Tag, you're it? I don't think those are the rules.

Not House said...

I have to ask, did YOU wind up cross referring her to an endo/Gen Sx or did you just tell her what Dr. Dickbag here said and let her arrive at her own conclusion?

Grumpy, M.D. said...

I referred her appropriately.

Mari said...

That is trashy! Sadly happens more than we would expect. -Mari RN

Anonymous said...

She got the history of the TIA. Why didn't that stay her problem?

Anonymous said...

I guess s/he thought that since the thyroid is part of the neuroendocrine system, the buck stops with you.

southern pcp said...

Sounds like Dr. Concerned thought (incorrectly) that Dr. Grumpy was asking her to be his gold-plated, bend over and grab your ankles scut monkey.

We get calls every day from specialist A who has told a patient to see specialist B, and demands that we order tests C, D, and E first, then round up all the info, get all the pre-auths, and then kiss his butt (all without seeing the patient).

Dr. Concerned needs to learn some people skills but she was probably fed up with dealing with lazy specialists (Dr. Grumpy not included).

Anonymous said...

Dr G - SPARING THE DEMOGRAPHICS/GEOGRAPHICS OF YOUR LOCATION, AND YOU HAVE TO SWIM WITH SHARKS EVERYWHERE YOU GO....

SOME POOLS ARE LARGER, THEREFORE ENCOUNTER WITH THE NASTIES ARE STATISTICALLY LESS FREQUENT, BUT THEY ARE STILL THERE. AND YOU DONT ALWAYS HAVE A PONY TANK....SO

ONE OPTION IS "NICE - MEAN IT" LETTER... DEAR SUSAN, SUCH A JOY TO RENDER THE BEST MEDICAL CARE ANYWHERE TO YOUR PATIENT MS. NODULE. AS YOU KNOW FROM OUR TELEPHONE CONVERSATION, HER CAROTID DUPLEX REVEALED AN EXCELLENT ANGIOGRAPHIC REPORT. HOWEVER, THERE WAS A THYROID NODULE THAT NEEDED FURTHER ATTENTION. TO ENSURE DILIGENT I HAVE FOLLOWED YOUR WELL APPRECIATED ADVISE AND SEEN THAT HER CARE IS DIRECTED TO APPROPRIATE SOURCES,
...THANK YOU FOR SUCH A WELCOME REFERRAL. BLAH BLAH."

EVEN IF YOU DELETE IT.
BUT AGAIN, SHE MIGHT NOT "CATCH" IT.

AT LEAST YOU CAN SLEEP WELL. IF THE 2AM LORTAB REFILL CROWD WILL LEAVE YOU ALONE....
HAVE A GREAT DAY

Old MD Girl said...

Wow. How awful.

haldol said...

Can you repeat that, Anon @ 8:35am? I didn't quite hear you.

Liz 2 said...

Don't you mean CONCERNING internist? . . .

SMHDVM said...

Wow, if you could have just pulled a Kramer and referred her to Dr.Amanda Brown, she could have arranged for taking care of the thyroid nodule AND given her a rabies vaccine.

And maybe Dr. Internist needs a distemperment vaccine...just saying.
;-)

Anonymous said...

Wow. Such a caring world of doctors that treat us measly patients that look for professionalism. Thank you, Concerned Internist.

Marc Whipple said...

Anon (3/5@12:24):

Actually, while people would probably agree with you in the abstract, the single most predictive factor related to whether somebody will sue a doctor for malpractice is whether they like the doctor, NOT the seriousness of the mistake or the amount of harm.

In other words, while they may say they prefer smart to nice, they're more likely to forgive Good Old Doctor Bob for paralyzing them from the neck down than they are to forgive Doogie Houser for giving them the wrong kind of antibiotic and failing to cure their URI in a timely manner.

Anonymous said...

does Mary get a cut from this extra test /evaluation that was ordered? :)

Nekura said...

Order to have a pizza delivered to her home. It will have nothing but anchovies to make sure its not edible.

RehabRN said...

Aw c'mon haldol...

Could be the SHOUTING is from an old people-centered physician who can't type well without caps lock.

I married his son, so be nice, dammit!
(My f-i-l was so funny online..)

kate said...

Finders Keepers

Anonymous said...

Thyroid hormone production is due to TSH. TSH is stimulated by TRH. TRH is produced by neurons in the hypothalamus. Hence it is a problem with the nervous system and needs a neurologist.


/sarcasm

Melyssa said...

Sounds like my Internist

 
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