Dr. Grumpy: "Yeah, this is Grumpy, calling about Mrs. Protoplasm."
Dr. Hospitalist "The lady I consulted you on? What's up?"
Dr. Grumpy: "Okay, from looking at her chart she was here last month for a stroke, and then a seizure, and at that time you handled it yourself and didn't consult neurology."
Dr. Hospitalist: "That's correct."
Dr. Grumpy: "So today I get a consult and find she's obtunded, terminally ill, and scheduled to go to hospice in an hour."
Dr. Hospitalist: "Yeah, family doesn't want anything done, and I think that's reasonable."
Dr. Grumpy: "So why are you consulting me NOW?"
Dr. Hospitalist: "In case there's anything else to do."
18 comments:
At least the H&P is quick - get everything from the chart. But what a waste of medical $$$.
Make arrangements.
Perhaps you could order Dilantin to be placed in the embalming fluid. To prevent those embarassing post-mortem seizures. But how would one code for that?
That is a special kind of brilliant right there. . . . .Thank God it's not me or one of my family members!
Aaaaaargh! And your reply was???
I was on call, and obligated to do it.
"Thank you for this interesting consult."
Another AYFKM/too-late situation:
http://www.youtube.com/watch?v=3rTsvb2ef5k
Hoo boy. You're, uh, totally firing up my enthusiasm for general practice now. Yep. Like Kim Kardashian is firing up my enthusiasm for the institution of marriage. Totes.
that would be thank you written thanxxx.
And was your recommendation, "Continue hospice care and pronounce prn."?
Is the hospitalist unaware of the purpose of hospice care?
Serious question here:
Was this a case of CYA?
If so, what if you did suggest that there was something that should be done? - would they then go against the family's wishes to do nothing?
Re:foffmom,That was PRICELESS!
Do you really have to write the "interesting consult" line? Can you at least leave out the inaccurate adjective?
AYFKM? Sorry, but I don't know what that is.
Maybe they were short a pallbearer and this was the quickest way to get one on short notice.
Are you effing kidding me???
too bad you can't write
recommendations
1. prior consultation, at the time of acute CVA, may have averted current clinical situation
2. agree with palliative, comfort care given current clinical presentation and prognosis
3. increase malpractice premium
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