Tuesday, November 18, 2014

Run that by me again

Seen in another doctor's note:


25 comments:

Anonymous said...

Is this a disability evaluation?

Anonymous said...

Probably just a crappy EMR(yeah I know that that description is universal) that didn't show for an option of a sensation complaint that isn't pain.

The Angry Medic said...

And I thought MY notes were bad.

What is your colleague smoking (and where can I get some)?

Anonymous said...

But does it hurt?

Anonymous said...

Well then she obviously needs some pain meds that don't reduce pain. She'll be good as new in no time.

The Condign Gentleman said...

I see a drinking game...

Denise Perry said...

I'm hoping it's one of two possibilities. Either Anonymous at 7:04's explanation, or the patient is an idiot.

"Doctor, it hurts right here."
"When did the pain start?"
"I'm not in pain, it just hurts."

I think I've been reading too much of your blog and Not Always Right if I'm able to come up with that explanation and conversation so quickly.

peace said...

Post call huh

The Patient Doc said...

You'd be surprised how many patients come in complaining of pain in some part of their body, but when I ask them to describe it they say it's not painful. I think we describe any irritating sensation as pain.

Marni said...

Another example of a crappy EMR.

clairesmum said...

was it accompanied by the disclaimer that any errors were due to the transcription software and not the fault of the author?
patients sometimes report that the doc didn't seem to make sense, or to know what he/she was talking about, or to really listen to what patient was saying...this note supports all three patient reactions!

Retired APRN said...

I'm going with "Thank you, EMR" on this one.

Loren Pechtel said...

I think The Patient Doc nailed it--it's something other than pain. Either it was misreported or it's software that lacked a proper category.

Candida Gomez said...

I think one or the other of the options of lack of places on the documentation or poor patient communication are likely. Or the patient just didn't know how to describe non-pain pressure.

I know how that can be. My left knee (due to a life-long leg-alignment issue) tends to be wonky. I frequently feel pressure in it, but it rarely actually hurts, and that's when I've been walking on it a lot. There's a lot of discomfort, but not much pain. But that can be hard to explain, particularly since my verbal communication skills are much poorer then my writing skills.

I hang out on Not Always Right, too, Denise. I just use my nickname on FB. ;p And I totally understand what you mean. :)

Anonymous said...

But, what is it on a scale of 1-10 (or is the scale in this case 0-10)?

Anonymous said...

It does pain me to read this, however.

Nigel said...

Her non-pain goes to 11.

Anonymous said...

"or the patient is an idiot"?

nice attitude

Denise Perry said...

Alright, how would you classify someone who claims to hurt but also claims to have no pain?

Denise Perry said...

I retract my previous comment asking how you would classify them. Instead, I have a better technique for making someone rethink their original position.

You see how Candida Gomez and other people further down in the comments explained that it might be because "pain," while not necessarily accurate, is the only word they can come up with to describe it?

That gave me new knowledge, and a different way of thinking about it. Now that I'm aware of this new information, I feel bad about my original "idiot" comment.

The only thing a sarcastic "Nice attitude" is going to do is make me defensive and cling to my original position, hence my retracted previous comment.

Anonymous said...

On the other hand, Shel Silverstein (May he R.I.P.) could've done something with these lyrics.

Shellye said...

So is it painful or not?

Anonymous said...

In our EMR's patient foolishness goes in quotes. This would probably read - Patient complains of "pain" which "does not hurt" and "is not painful". Boom.

Anonymous said...

Painless pain is the best sort to have.

Anonymous said...

If this was done by a neurologist, I'd assume the patient reports pain but physical exam actually does not elict pain when jabbed,prodded etc.

Diagnosis would be phantom or referred pain then, hence the neuro eval.

But that's a cocakamine way to write it. I suspect the doctor's feeling no pain himself.

 
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