Wednesday, January 18, 2017

Rules

Clerk: "Emergency room, this is Kim."

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

Clerk: "Please hold for Dr. Stat."

(15 seconds of ONJ's 1980 hit "Let's Get Physical")

Dr. Stat: "Dr. Grumpy? Hi, this is Suzy Stat over at Local ER. I'm a new doc here. Anyway, I have a guy who needs to establish with a neurologist, and I have you down as on call."

Dr. Grumpy: "I am, what's up?"

Dr. Stat: "Nothing big, he moved here and has a history of seizures. He hasn't had a chance to find a doc yet, and so came in here looking for a refill and referral name before he ran out."

Dr. Grumpy: "That's fine. Give him my info and a few days of meds and I'll get him in this week."

Dr. Stat: "Great. Where's your office? Isn't it south of here?"

Dr. Grumpy: "No, I'm in downtown Grumpyville."

Dr. Stat: "Oh... He lives on the south side and doesn't have a car. He needs a doc he can walk to."

Dr. Grumpy: "I..."

Dr. Stat: "Could you, like, rent an office on the south side to see him? He likely only needs to come in once a year or so."

Dr. Grumpy: "Uh, no. He can take a bus, or Lyft, or Uber, or whatever."

Dr. Stat: "But as the ER on-call doc you're obligated to see him."

Dr. Grumpy: "Correct, and I'm happy to do so this week. But I only have one office, and that's where he'll find me."

Dr. Stat: "Is that allowed?"

Dr. Grumpy: "Yes."

Dr. Stat: "They never teach you these things in training."

25 comments:

  1. Ah, the often elusive common sense.

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  2. I don't see why you can't be everywhere at once. Geez.

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  3. Please, please tell us that the suggestion to rent an office on the South side was not serious! Surely a physician can not be this inept about business.

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  4. I thought common sense was a requirement for college, much less med school.

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  5. I'm surprised she didn't ask you to make a house call on him!!!

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  6. Picture me banging my head against a desk over and over and over...


    How is "establishing with a neuro" a stat?

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  7. I saw an explanation for this phenomenon this week.

    She is an example of someone who is clever but not smart.

    She is an expert in her field, is good on tests, but doesn't understand how to apply her knowledge to the world around her

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  8. To Anon at 8:58:

    Don't call me Shirley.

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  9. Tarquin "R.J." Toffeebridge VJanuary 18, 2017 at 12:33 PM

    "How about if you just buy him a house near your office?"

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  10. Here's an idea: once a year or so, you fly him first class to London, get him a suite at the Savoy, and then you fly out there and get an adjoining suite. Problem solved!

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  11. Dear Helicopter parents..

    these are your children and their peers who will provide YOUR healthcare....


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  12. Anon @12:40 may have just stumbled onto the good doctors secret of the extended vacation...

    MBee

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  13. First pt with seizure disorder may not have license to drive. A number of communities have a program (BRATS here) that allows people with disabilities to schedule a ride. I hope there is such a program in your community (see, the south does do some things right. ;-))

    BUT, this young doc (I assume age) has much to learn. Full points for caring for and learning needs of pt., but one of you old and crusty attendings will be administering whooopings soon.

    In a way, that's too bad, but I get the point.

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  14. This joke soooooooo fits. "what do they call the person who graduated dead last in medical school?" They call her doctor! Sadly she probably was not even near the lowest in class - she's probably very, very smart - with zero common sense - and peoples lives in her hands.

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  15. to Don at 11:48
    I work in medical imaging, and am starting to see more and more of this 'clever but not smart'. The students can ace their exams, they are book smart and they get into the difficult programs. But then they just don't do well at the practical part of dealing with people. No patient interaction skills. No common sense. Remember stuff, but can't always apply it.

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  16. Seems to me the new doc is identifying very well with the patient and wants what's best for him/both of them. Of course that means the new doc was taught that what's best is that it be provided at all costs by someone else. I think I can guess who the new doc voted for in the last election and what party new doc belongs to.

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  17. Ok, I have a (non-snark) theory about this.

    She's undoubtedly a bright woman. She has been so immersed in her training that the part of her brain (everyday common sense stuff) that has, by necessity, gone a bit dormant, hasn't fully synced back with her "training brain".

    She hasn't yet fully assimilated her learning experience with her life experience. Simply put, she doesn't have full perspective yet.

    While I've never experienced anything like medical school, it isn't difficult to imagine how all-encompassing that must be.

    Dr. Grumpy did her a huge solid by not going off on her and, instead, giving sensical answers to her "silly" questions. She'll reflect on what she suggested and do a painful eye roll.

    But she will have learned from it. She sounds a little overwhelmed. Which is what I've heard about medical training...just a tad overwhelming.

    That's my theory, anyway.

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  18. Dr Stat: "Oh, and he doesn't have insurance either and his on Epilyptic XR."

    Ibee: "My charge for a new pt without insurance is $xx"

    Dr Stat: "But he doesn't have insurance.....

    Ibee bangs head against wall

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  19. He made it to the ED. Surely he can make it to Dr. Grumpy's office.

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  20. Mary: Dr. Grumpy's office, Mary speaking.
    ER patient: Hello, the doc in the ER said Dr. Grumpy wanted ms to call you for an appointment this week. Where is your office? I don't drive so I need to walk there, and I live in South Grumpyville.
    Mary: We're in North Grumpyville. Could you take a bus, or Uber?
    ER patient: Yes, but I will need you to reimburse me. Isn't that part of Dr. Grumpy's service?
    Mary: Well, no ....

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  21. `Eat what you kill has a way of focusing attention on the necessities of life. Children of the realm have never learned any of this, because they have been coddled to the point of incapacity and as such they can't figure anything out. My daughter who is strikingly independent for her age , calls for advice but works things out on her own. She frequently says what will our generation do when your generation is gone. She recognizes the reasoning and knowledge gap in her contemporaries. There is now a course being offered to post college millennials , being called Adultering. Matters of leasing, banking, check balancing, medical care and insurance and sundry other rudimentary skills are being offered.
    We joke about it, but society as a whole can no longer joke , it is a severe problem for our future.

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So wadda you think?