Monday, October 20, 2014

Details

I'm with a patient, when Mary knocks on my office door.

Mary: "Dr. Schnozz is on the phone, says he needs to talk to you ASAP."

Dr. Grumpy: "Excuse me..." grabs phone "This is Dr. Grumpy."

Dr. Schnozz: "Hi, we have a mutual patient, Mr. Platelet, and he was here with his wife a short while ago for his sinuses. Anyway, I'm concerned he needs you to work him in urgently."

Dr. Grumpy: "What's up? I mean, he was just here this morning at 9:00."

Dr. Schnozz: "Really? They didn't mention that. Anyway, he's weak on his left side, and I'm worried he had a stroke."

Dr. Grumpy: "He DID have a stroke. I had him in the hospital last week for it, and I saw him today in follow-up. He's weak on the left, and I ordered physical therapy."

Dr. Schnozz: "They didn't tell me that either. Never mind."

14 comments:

Anonymous said...

I think I like Dr. Schnozz.

Anonymous said...

Whenever I hear stories from patients that make other doctors sound like complete imbeciles, I think of stories like this were huge chunks of information from the patient were not presented and/or were completely wrong.

The Patient Doc said...

This actually happens quite a bit . A lot of patients either assume we already know cause it's in their "record" or they don't think their primary needs to know cause the specialist already is handling it. There needs to be better communication sometimes.

ronstew said...

I think this is the first time Dr Grumpy has told us about a telephone interruption where the caller had a good reason for interrupting.

Ms. Donna said...

Well, at least Dr. Schnozz wanted to check things out. Tho, if Dr. S suspected stroke, wouldn't a trip to the ER be in order?

Still 10 points to Dr. S. Not all your colleagues are idiots.

PediNP said...

My favorite was a 15 year old I saw with headaches. His mother refused to come back to the exam room--apparently she has some issues with anxiety. I saw him alone. I went through the whole headache history taking, examined him, and prescribed ibuprofen for him. At the end of the visit, as I stood up to leave the room, he told me he hit his head on a sign the week before and was told he had a concussion.

Well, he does have a history of ADHD....

Denise Perry said...

I think Ronstew is right. I was totally expecting the doctor to not have a good reason because of every single entry on this topic prior to this post.

RehabRN said...

A lot of patients either assume we already know cause it's in their "record" or they don't think their primary needs to know cause the specialist already is handling it. There needs to be better communication sometimes.

Yes, this is going to start me on my soapbox, so here goes.

Yes, it does go in your record, but unless you're in the same hospital system, the docs can't just open it up and read it to figure out what's going on. Poor Dr. Schnozz.

Patients have to learn to be responsible for conveying this information and having a DIALOG with their providers.

The right information at the right time does really make a difference in the care you get. You really do have to ask questions.

BTW I have several versions of this guy at the Hotel. Thank goodness most of them have wives, children, observant caregivers (or good nurses at the nursing homes) who track this stuff and tell us about it.

Candida Gomez said...

My doctor and my dentist both work for the same healthcare nonprofit group and have offices in the same building. They can both access some basic patient stuff, but not each other's records. Thank both HIPAA and their group's rules.

That means when my doctor puts me on a new medication for whatever, I have to be the one to tell the dentist. (Speaking of which, I'd better type that antibiotic into my phone's notepad for tomorrow. 'Scuse me.)

Shellye said...

I'm surprised Dr. Schnozz did not ask the patient about the stroke or if he had indeed seen Dr. Grumpy concerning his symptoms. It was nice that he cared enough about the patient to ring the office.

PGYx said...

@Shellye You'd be surprised what patients leave out. He easily could have said, "I'm concerned you may have had a stroke at some point," without the patient and family member copping to the recent hospitalization for stroke. People forget things when you put them in a different context, like an outpatient doctor's office visit for sinus evaluation. Or they dismiss it because they don't think they had a *new* stroke, so they don't feel concerned and also don't realize it would be helpful to fill the new doctor in on details of the old stroke, which they perceive to be common knowledge.

It sounds unbelievable, but as a medical student I saw this many times. I had the opportunity to follow certain patients through the medical system and frequently observed cognitively intact patients totally incorrectly relaying what another doctor had said or done. I noticed the listening doctor was usually quick to judge the doctor in the story. These were cases where I passively observed, so it wasn't that I thought *my* communication was misinterpreted. At times it struck me as ludicrous that anyone could have interpreted the doctor's clear words or actions in such a blatantly wrong way.

People also often forget major hospitalizations or surgeries once the condition resolves and we find ourselves in a different context.

Holly said...

My GP has no clue what my oncologist does, nor does my surgeon know what my GP or oncologist does. Communication folks!

All this information is supposed to be shared among all of them, but then, I don't assume that my physicians have all the time in the world to sit around and read up on all the latest info about me.
Being in the medical field, it helps to know this.

My mother thinks however, that after a long work day, all her physicians get together at a bar and talk about her. She's 86 so it's a wonderful teaching moment. Love her train of thought.

Anonymous said...

I thought you gained the power of telepathy when you graduated from medical school; or maybe that was empathy, I'm not sure. I'm pretty sure my doctor graduated from a school where he learned osteopathy.

BelgiumDoc said...

Every. Damn. Day. Every day a patient tells me he had some major disease or surgery (halfway across the country, of course) and then fails to tell me which.

"Well, can't you just look that up in your computer?".

COMPUTERS DO NOT WORK THAT WAY. GOOD NIGHT.

 
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