Thursday, June 5, 2014

Medicine by committee

I'm with a new patient.


Dr. Grumpy: "What did the MRI show?"

Mr. Triad: "I'm not sure, my other neurologist said..."

Dr. Grumpy: "Wait, you have another neurologist?"

Mr. Triad: "Actually, I have 2 others. I saw both of them earlier this week."

Dr. Grumpy: "Why are you seeing 3 different neurologists?"

Mr. Triad: "Well, it seems like a good idea. I mean, this way if I disagree with something one does I can call the other two, and see what the majority opinion is."

Dr. Grumpy: "Who are the other 2 neurologists?"

Mr. Triad: "I don't want any of you to know who the others are. I think that will help keep all of you impartial."

Long pause.

Dr. Grumpy: "Honestly, I'm really not comfortable with this situation. I can understand someone wanting a 2nd opinion, or even a 3rd, but to have 3 different neurologists trying to manage the same condition, ordering tests, and prescribing medications at the same time... I'm going to have to end this appointment. I won't charge you for it, but I just don't think this is a good idea, and don't want to be a part of it."

Mr. Triad: "You know, that's funny. My 5th cardiologist said the same thing yesterday."

19 comments:

  1. Pick a card. Any card.June 5, 2014 at 7:37 AM

    This is why the hem/onc practice I used to work for wouldn't even do second opinions for patients already seen locally (among others reasons). This sort of thing can be dangerous if providers are kept in the dark. Patients need to be educated about coordination of care.

    I'm really beginning to think that basic health care system concepts should be taught in high schools, along with other important life skills that are too infrequently addressed (in the US at least) by professionals and parents alike.

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  2. I wonder how many psychiatrists he has.

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  3. I wonder about the number of psychiatrists as well, I suspect he may not be seeing enough of them.

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  4. And I am so the opposite of that guy. It practically takes no vital signs to get me to go to a doctor in the first place. Not good, I know. We Norwegians think a cup of coffee will fix most anything.

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  5. Health care reform in this country is doomed.

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  6. Medicare won't pay for 2 different radiology studies in the same day... But they'll pay for this guy to see 3 different neurologists in the same WEEK? I'm assuming he was Medicare, but it would be just as bad either way. Hope for the rest of us that he was private paying.

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  7. Nobody likes to be the third wheel.

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  8. GTFO...Do not let the door slam you in the ass you whack job.

    Gees, when did this nation get divided into the haves and have nots, the few haves common sense and decency the have nots have neither.

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  9. I'd almost be afraid to ask what the right brain is saying to the left hippocampus. Not that it'd make any difference, but hey, it may have come from a different time and want to contribute its commentary to the group practice.

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  10. Bunkywise, a cup of coffee WILL fix almost anything, and anything that it doesn't fix will be better in the morning!

    --Christina

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  11. I have learned something here today about the American medical system. I had no idea that it was frowned upon in any way to have more than one neurologist or other specialist, although I don't know why one would want to have to pay for so many. Here in Canada it couldn't happen anyway, as one has to be referred to a specialist by their family physician, or it won't be covered by our medical system.

    Are you saying that multiple specialists can write prescriptions for a patient and there is not a system that keeps track of what medicines already prescribed?

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  12. This is one of many reasons I am no longer in private veterinary practice (yes, they do this to us, too).

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  13. Let me guess, he's Medicare/Medicaid and paying for none of these visits. If he was, he would not have so many.

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  14. In diagnostic imaging, the saying is: If you want three opinions, you could ask 3 radiologists on one day. Or, you could ask 1 radiologist on 3 different days.

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  15. Aha! I was just wondering who on Earth has that much time and money to see that many doctors. But at the same time, so illogical with his approach. It must be a former congress critter. They love doing things by committee, have Cadillac health plans, and just enough neurons to make and keep appointments.

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  16. No Minority Report joke? I'm disappointed in you all.

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  17. This guy will want 3 coroner's reports before he accepts that he died yesterday.

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  18. Love the title. I think the story is kind of hilarious. And the way you described your response to this patient. Of course it's a waste of resources and doubt it does much to contribute to effective management!

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So wadda you think?