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Saturday, February 1, 2025
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A Blog detailing the insanity of my medical practice and the stupidity of everyday life.
Welcome to my whining!
This blog is entirely for entertainment purposes. All posts about patients, or my everyday life, or anything else may be fictional, or be my experience, or were submitted by a reader, or any combination of the above. Factual statements may or may not be accurate. I could be making all this up. I may not even be a doctor. The only true statement on here is that I probably drink more Diet Coke than you do. A lot more.
Singing Foo!
Singing Foo!
Twitter fans- you can follow me @docgrumpy
Cast of Characters:
Annie: My Phenomenal MA
Mary: My Awesome Secretary
Ed: The office fish
Dr. Pissy: The guy I share an office with
Mrs. Grumpy: My Boss (also the world's greatest school nurse)
Frank, Craig, and Marie: The Grumpy Tribe
Garlic and Riley: The Grumpy Dogs
Questions? Comments? Biting sarcasm? Write to: pagingdrgrumpy [at] gmail [dot] com
Note: I do not answer medical questions. If you are having a medical issue, see your own doctor. For all you know I'm really a Mongolian yak herder and have no medical training at all except in issues regarding the care and feeding of Mongolian yaks.
Cast of Characters:
Annie: My Phenomenal MA
Mary: My Awesome Secretary
Ed: The office fish
Dr. Pissy: The guy I share an office with
Mrs. Grumpy: My Boss (also the world's greatest school nurse)
Frank, Craig, and Marie: The Grumpy Tribe
Garlic and Riley: The Grumpy Dogs
Questions? Comments? Biting sarcasm? Write to: pagingdrgrumpy [at] gmail [dot] com
Note: I do not answer medical questions. If you are having a medical issue, see your own doctor. For all you know I'm really a Mongolian yak herder and have no medical training at all except in issues regarding the care and feeding of Mongolian yaks.
14 comments:
I'm not a medical professional, but I think I may see a hole in our pay-to-play medical policies. I'm pretty sure I don't want to be that patient!
Logic has to always be apparent .
Well, recent personal experience as a patient suggests that, these days, clinical examination is as rare as an honest politician.
These attestations where the attending adds comments or clarifications to the resident note are a real liability problem. Same problem where the attending physician "corrects" resident note text that is incorrect in a different text color, thus highlighting the resident's errors. When I am reviewing and signing resident in-patient notes, I correct their misstatements in the text of their note itself and my attestation says, "...In the resident’s progress note above I have made any changes to the resident’s text that were necessary to correct, expand details, or further explain points so that the resident’s note above accurately describes the interval history, the review of systems, my physical exam findings, and my assessment and plans that was developed during rounds..." But I never highlight or change text color or do anything to draw attention to, or identify, the things that I corrected.
Leaving text in a resident note that the attending knows is incorrect but clarifying it in the attestation is telling anyone and everyone that one or more physicians who are participating in the care of the patient are misinformed or not competent. That would lead a plaintiff attorney to ask in front of a jury, "what else did this physician do that was wrong that you had to correct and why is it not documented in the chart, and why do you even allow an incompetent person to enter orders and notes on this patient's chart?" When the resident and attending enter different information in the chart, you are basically telling the world that misinformed and potentially incompetent physicians were allowed to be part of the medical care of a patient.
'Tis but a flesh wound.
"Well, the patient's condition is good for me, and I have no complaints or distress. It's all relative."
Sent me to big word look up. I said a prayer for the patient.
Medical record templates are only as good as the level of detail-orientation possessed by the person entering them. Someone needs a lesson in creating and editing medical record templates
Wowza! Long time reader here - just want to thank Dr G for all the insight and laughs.
One part might be right. The patient probably is not doing any complaining.
A very reasonable position. The resident is still in training (as are we all, some less formally ). Trainees are expected to make errors; if they did not, they would not be trainees (they'd be God). I wish it were not so, but admitting the obvious - trainees err, hopefully more than attendings - is fodder for the unscrupulous. Correct, revise, and counsel - but don't gratuitously offer a club with which one may be bludgeoned.
But otherwise....
"Some doctors see the patient as half dead, but I prefer to see them as half alive."
You are exactly right! The pre-filled templates are just trouble. I much prefer the old SOAP notes that were handwritten or typed.
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