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.
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.
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!
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. :)
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.
Is this a disability evaluation?
ReplyDeleteProbably 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.
ReplyDeleteAnd I thought MY notes were bad.
ReplyDeleteWhat is your colleague smoking (and where can I get some)?
But does it hurt?
ReplyDeleteWell then she obviously needs some pain meds that don't reduce pain. She'll be good as new in no time.
ReplyDeleteI see a drinking game...
ReplyDeleteI'm hoping it's one of two possibilities. Either Anonymous at 7:04's explanation, or the patient is an idiot.
ReplyDelete"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.
"or the patient is an idiot"?
Deletenice attitude
Alright, how would you classify someone who claims to hurt but also claims to have no pain?
DeleteI retract my previous comment asking how you would classify them. Instead, I have a better technique for making someone rethink their original position.
DeleteYou 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.
Post call huh
ReplyDeleteYou'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.
ReplyDeleteAnother example of a crappy EMR.
ReplyDeletewas it accompanied by the disclaimer that any errors were due to the transcription software and not the fault of the author?
ReplyDeletepatients 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!
I'm going with "Thank you, EMR" on this one.
ReplyDeleteI 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.
ReplyDeleteI 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.
ReplyDeleteI 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. :)
But, what is it on a scale of 1-10 (or is the scale in this case 0-10)?
ReplyDeleteIt does pain me to read this, however.
ReplyDeleteHer non-pain goes to 11.
ReplyDeleteOn the other hand, Shel Silverstein (May he R.I.P.) could've done something with these lyrics.
ReplyDeleteSo is it painful or not?
ReplyDeleteIn 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.
ReplyDeletePainless pain is the best sort to have.
ReplyDeleteIf 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.
ReplyDeleteDiagnosis 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.