Thursday, May 31, 2012

Negotiations

Dr. Grumpy: "This is Dr. Grumpy, returning a page."

Mr. Shakes: "Yeah, you saw me in the hospital last week, and said I had a seizure. So now I can't drive for a month."

Dr. Grumpy: "Yes..."

Mr. Shakes "Well, I want to drive. You didn't see me have a seizure. So how do you know I had one?"

Dr. Grumpy: "Your wife and friends saw the episode, and described it as a seizure. You even had a second one in front of the paramedics. The description they all gave me was pretty consistent with one."

Mr. Shakes: "Look. I'm saying that I didn't have one. You need to go back and change the chart to say I had something else."

Dr. Grumpy: "I can't do that, sir."

Mr. Shakes: "Okay, what do you want? $100? $500? Name your price and I'll pay it. Just change the chart."

28 comments:

  1. Dr Grumpy: "Sir, you know I can't take money to change patient medical charts."

    Mr Shakes: "..."

    Dr Grumpy: "Well, let's just say, if there magically happened to appear a dozen crates of Diet Coke outside my office, I'll see what I could do."

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    Replies
    1. Hehehe this made me laugh! I'm sure that could actually work...

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  2. Sigh, maybe something bad happened. His business depends on him driving? Make ends meet?

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  3. A couple crates of diet coke, a doll for Marie, a nice toy for Craig and something nice for Mrs. Grumpy.

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  4. Screw the toys. Craig wants a new hairbrush, blow dryer, and styling gel.

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  5. I kind of go with the side that aays don't change the chart. But I am no doctor.

    Saw this story on Today shoe.

    http://minnesota.cbslocal.com/2012/05/30/police-pickup-crashes-into-restaurant-in-little-canada-6-injured/

    They think the driver may have had a seizure.

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  6. I find it so interesting that he needs your permission to the point that he will pay you to lie...alcoholics that have had their licenses revoked drive all the time. There is really no moral difference, so why doesn't he just get in his car and go?

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  7. It is probably one of the many indicators of my fundamental misanthropy that I think that anybody who has EVER had a seizure which has not been diagnosed and/or remediated should not be allowed to drive. Ever. Again.

    I had a co-worker whose wife was prone to intermittent (like one every few years) seizures of unknown origin, who constantly complained that every time she had one she wasn't allowed to drive for X months or whatever. My responses were:

    1) That is kind of stupid. The rule should be she can drive for X months AFTER SHE HAS ONE, since so far the only thing we know is that once she has one she probably won't have another one for a while.

    2) Oh, wait, I forgot. I DON'T CARE. Your wife's brain has a habit of going into neutral for unknown reasons. I don't want her operating a multi-ton guided missile on the same road people I care about use.

    Of course, I never verbalized my responses. But the temptation was sore.

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  8. He clearly shouldn't be driving, but this situation does highlight the unfortunate fact that most Americans can't really do much unless they have a car and can drive it. It's too bad he has no other way to get around.

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  9. Yeah, I got hit 2 weeks ago by one of these yo-yos (I'm fine, luckily) who KNEW they had they had this problem and chose to drive anyway. If it were up to me, it would be: "No license for you - go home in shame!"

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  10. So does this interaction now show up in his chart?

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  11. I wouldn't assume he has no other way to get around. Most urban areas, where most people live, have reasonably good public transportation. Some people just don't like riding a bus. So call a cab.

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  12. a bigger problem = people , in increasing numbers, think they are entitled to "buy" their way out of any situation = Enron , and Wallstreet miscreants , along with just about any one..... and do not get me started on dementia patients who have family members who do not pull the killer keys...

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  13. One wise ER doc I worked with years ago would have responded by asking this question: would my kids be safer with this guy off the road? Hell yes.

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  14. love this one Grumpy

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  15. Thank you for being ethical about this.

    Though if he did pay enough to risk losing your license and perhaps end up in jail if he killed someone in an accident, it might be interesting to read the drgrumpyintheslammer blog.

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  16. a:generic doc

    I think that blog would be called
    drgrumpyinthebighouse

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  17. I sincerely hope his family isn't agreeing to this behavior. There are many many people that conduct their lives a d jobs without the benefit of driving. There are public buses, trains, taxis, and/or this guy has family obviously. If his job requires driving, i do feel bad for him but not bad enough for him to put lives at risk.

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  18. In my state it is a minimum of six months of no driving, so he should count himself lucky...

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  19. Grumpy:

    My old neighbor is a neurologist specializing in epilepsy.

    I can imagine how many times she has to deal with this. Ugh!

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  20. My mom has epilepsy. Her lifestyle changed dramatically one she started having seizures that a medication regimen couldn't prevent. We live in a suburban area, without easy access to public transportation.
    While her license was never revoked, she was told not to drive and she followed those instructions.
    All this to say--she had surgery to remove the seizure focal point, and has been seizure free for 14 months, driving for 11 months. Her demeanor now is so much better--depression has lifted as her independence has returned.

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  21. Another story--I'm a RN. Witnessed an OB/GYN have a seizure at the nursing station. Fell out of her rolling chair onto the floor. She begged the ED physician who saw her to document it as a hypoglycemic event and not a seizure she she could still perform surgery.
    Still would never EVER recommend her to anyone. All of us working that day know what we saw--a seizure. We'd prefer her next one not to be while she's holding a scalpel.

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  22. yer, i'm surprised he even bothered asking - there are so many people who just drive without a licence here ...

    the other morning the cops were doing a 'licence check' on a major road nearby - within 15 mins they had pulled around a dozen cars off the road with unlicensed drivers ... (BTW you lose your licence here automatically if you don't pay fines so that's probably why there are so many)

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  23. He should consider himself lucky. Here in the UK it's twelve months seizure-free before you get your licence back.

    Tell the guy to buy a bike and a bus pass.

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  24. In the UK, for a non-vocational driver, it's 6 months of no driving licence after a solitary unprovoked fit. For a vocational driver (large lorries) after a single unprovoked fit. The driver has a legal obligation to report themselves to the licensing authority. The doctor has an obligation to tell them to do that. If they don't there's a bunch of advice for the doctor on reporting the fitter to the licensing authority without their consent. Google "DVLA at a glance guide" for more details.

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  25. In Denver, the trial is about to begin for a woman that continued driving after being told not to drive following a probable seizure until she followed up with a neurologist (which she also did not do). She's facing seven felony charges after allegedly suffering another seizure while driving in February 2011, causing the deaths of five people and endangering her own children that were in the vehicle with her.

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  26. driving is a earned benefit, not a entitlement

    Sadly public transportation just does not exist in some areas of the US.

    that aside, state law varies on what the ruling may be for new vs chronic LOC events, or other nedical maladies which make a driver dangerous and reqire recommendations to eliminate or restrict driving. Some states require the DRIVER to report, and DO NOT require the health professional. add to that - state law trumps federal, and IS NOT legally REPORTABLE by Federal healthcare providers (in fact, illegal!!) when someone drives despite being advised NO DRIVING. pretty scarey when you start thinking about your kids across the street into school, or you are in the public parking lots, not to mention highways!!

    BUG your state and local representatives about this in election years!!

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So wadda you think?