"When will my labs be back?"

Labs fall into 3 groups:

1. Regular tests (done at the lab, back within a few hours).

2. Local send-outs (done in the city, but we "send-out" the sample to another hospital. Can take a few days).

3. Major League send-outs (only a few places in the country, or even the world, may do these. Several weeks to get back).


So yesterday afternoon, around 4:00, I was trying to track down some results in category #3. The hospital lab kept switching me from person to person, and each time I had to tell them my story, the patient's name, etc.

Finally I reached a supervisor, who said: "Oh, those are rare labs. We had to send them quite a ways. I'm going to have to connect you to Israel."

I was quite surprised, but patiently held the line. After about 10 seconds it began ringing, and a male voice answered.

Male voice: "Lab, can I help you?"

Dr. Grumpy: "Um, I'm looking for some send-out results from about a month ago on Mr. John Smith..... Hey, what time is it there anyway?"

Male voice (surprised): "Uh, about 4 in the afternoon."

Dr. Grumpy: "Oh..... I thought I was being connected to Israel."

Male voice: "I'm Israel Nunez. I work in send-outs. What's the patient's birthday?"


At least he got me my lab results.

My Readers Write

Dr. Phil (I assume not THE Dr. Phil) wrote in today with this horrifying story. Which I think is certainly worthy of sharing with the rest of you. So take it away, Dr. Phil:


"The following story happened just this morning, and I thought I'd share it with you....

Jackie is our newest employee, staffing the front desk, fielding phone calls from crazy patients, checking in patients, and in general controlling the chaos and preventing riots on a daily basis (and, if we're lucky, she brings doughnuts on Fridays!).

This morning, a patient showed up and handed her a Sephora bag. She told Jackie she was dropping off some samples.

When Jackie saw the Sephora bag, she immediately got excited. Once the patient left, she started digging through it to examine the contents. The plastic containers in the bag didn't resemble the typical Sephora product packaging.........

Fortunately for Jackie, she didn't apply any lipstick or hand lotion, as the "samples" were of the stool variety.

Next time she brings in doughnuts I'm going to avoid the chocolate. Poor Jackie."


Thank you for this awesome story, Dr. Phil.

Jackie, welcome to the medical office world. If anyone brings in a sample that looks like apple juice, I wouldn't drink it.

Math Issues

I was reading some news stories this evening, and found these remarkable poll results. The study is still in progress, so I have no idea how much sillier they'll get.

I think spending money on math lessons sounds a bit smarter at this point.

Fond Memories

A while back........

Pattie, RN’s comment on this recent post led me to remember this story:

As my regular readers know, I have boy/girl twins (Craig and Marie).

Years ago, just after they were born, I was talking to a drug rep. My secretary had mentioned to him that I had twins, and so he was asking about them.

Mr. Drugrep: “So it’s a boy and a girl?”

Dr. Grumpy: "Yes."

Mr. Drugrep: “Are they fraternal or identical?”

To my staffs’ horror, and with a straight face, I immediately said “identical”, whereupon he humiliated himself even further.

Mr. Drugrep: “Wow! That is just so cool. So they look alike?”

Dr. Grumpy: “Yes.”

Mr. Drugrep: “And so, even though they're a boy and a girl, they will always look exactly alike?”

Dr. Grumpy: “Yes”.

Mr. Drugrep: “That is so neat. I’ll have to tell my wife about that tonight”.


When he left the office I told Mary that his wife will think that he either calls on the stupidest people in the world, or that she married one of them, or both.

Unfortunately, he got transferred to another territory 2 weeks later, and so I never saw him again.

Thanks, Ron

I got this voicemail last night at 6:45:

"Hi, this is Ron, at Local Pharmacy. An amazingly clueless patient of yours is here now, asking for a medication refill. She doesn't know what it's called, or why she takes it. If you have any idea, please call me."


Nice to know my patients are driving others nuts, too. I'd hate to think I was hogging it all.

So?

Mrs. X: "Is my muscle disease hereditary? Because I'm worried about my kids getting it."

Dr. Grumpy: "No, it's not." (pause) "I thought you once told me all your children were adopted?"

Mrs. X: "They are. So?"

Attention Patients

Leaving the following voicemail message for my nurse is NOT helpful:

"I have pain! Please call me back!"

If this was you, leaving your name and/or phone number in the future would be helpful. We do not have caller ID (if we did my staff wouldn't answer the phones at all).

New Olympic Sport

When I got home today all 3 kids were playing Wii "Dance Dance Revolution" on a difficult setting to a fast song. They each were on a dance mat, and were wildly trying to keep up.

I thought it looked like a new sport for the Neurology Olympics: Synchronized Seizing.

Dragonisms

What is a Dragonism? I'm not sure who came up with the word, but think it was my old chairman, Bob (who I doubt reads this, but if you do, I'm crediting this to you).

A Dragonism is an unintentionally comical error made by voice recognition (VR) software. Many physicians, including myself, use them for dictating. The programs are great, they don't make spelling errors, BUT (and this is HUGE) they often mistake one word for another, especially when the words are long, or you're talking too fast, or they just want to piss you off. Usually they're simply stupid, but occasionally can be quite hilarious.

This is why it's CRITICALLY IMPORTANT for anyone using VR dictation to proofread VERY VERY CAREFULLY. Because many physicians don't. If you're one of them, I've seen your notes. They look like crap, and make you sound like a complete idiot.

The word Dragonism was coined because Bob used Dragon Dictate, which remains the most commonly used program of this type. Dragonisms, however, are NOT restricted only to Dragon Dictate. They also occur with it's competitors, such as ViaVoice and iListen. I've used all 3 at various times. Dragonisms just sounds so much better then "ViaVoicisms" or "iListenisms".

Anyway, today my VR system was out to aggravate me, and coughed up 3 gems:


Dr. Grumpy said: "She has an upper respiratory infection."
The computer said: "She has an upper breast infection."


Dr. Grumpy said: "Her symptoms are likely from lumbar disease."
The Computer said: "Her symptoms are likely from Wal-Mart disease."


Dr. Grumpy said: "I've ordered an echocardiogram with bubble study."
The Computer said: "I've ordered an echocardiogram with Bible study."

Hello, Mrs. Geritol

Mrs. Geritol, I'm terribly sorry that my prescription for Vicodin didn't help your back pain and made you so sleepy.

In reviewing the shoebox full of medications you brought in today, it's now clear that you were really taking Valium instead. I was unaware that you had some, as it wasn't on the medication list you provided at your last visit. How you got it is anyone's guess, as it's actually in your husband's name, and the doctor who prescribed it retired and moved away in 2003.

I really do suggest you give the Vicodin another shot, especially considering that you haven't yet taken it in the first place.

I can understand you confusing the two medications, since they both begin with "V" and have 3 syllables. Anyone would have made the same mistake. I must suggest that you exercise caution in the future, as between you and your husband you also have prescriptions for Vytorin, Vagifem, and Viagra.

Thank you for coming in today. I need to go pull out my few remaining hairs now.

Why? Why? Why? Why? Why?

If I ordered physical therapy, and told you to come back afterwards to see how you were doing, DO NOT come back to me 4 weeks later, complaining of how you are no better WHEN YOU DIDN'T EVEN BOTHER TO GO TO THE FREAKIN' THERAPY.

Saying "I dunno" when I ask why you didn't go is NOT an acceptable answer.

Telling me you needed the co-pay money to buy cigarettes is not going to get you any sympathy, either.

Crazy Scale

I generally try not to steal from other bloggers, but this time I'm gonna have to.

ER's Mom wrote this excellent post a few weeks ago, and I just have to reprint it here. But I take no credit for it. It will, however, be remarkably useful in my practice (and likely most others).


Levels of Crazy

Been thinking about this for awhile. I now have the "ER's Mom Official Guidelines for Assigning Levels of Crazy".

1. Normal. They exist, even constitute the majority of patients. They make poor blog fodder however, so you wouldn't know that that they even exist from reading any medical blog.

2. Crazy. These are the "fun crazy" folks. A little off, but you don't cringe when you see them on the schedule.

3. Bat-shit crazy. Your stomach drops a little when you see the name on the schedule.

4. Fucking Nuts. These folks seem intent on driving YOU nuts too.

5. Mouth agape and head shaking. You are lost for words upon meeting these folks. Fortunately, they are rare.

ER's mom: Please don't be offended I used this. It was just too good not to share.

Monday Morning, 12:08 a.m.

My cell phone beeps. Someone has left this message:

"Hi, I have an appointment with Dr. Grumpy. I think it's this Monday, or maybe it's next Monday. Anyway, it's on some Monday, and I won't be able to make it. Thank you!"

And, of course, no name or number left.

Marieeeeeeeeeeeeeeeeeeeeeeeee!!!!!!!!!!!!!!!!!!!!

Marie wanted to talk to my parents this morning, for whatever reason. So I dialed the phone and handed it to her.

After a pause, she said "Hi, it's Marie.... okay, Grandpa" and handed it back to me. She said my dad had answered and said he was busy, but would call her back.

After a while we didn't hear back from them, which is odd. So I called them, to find they'd just gotten in from shopping, and neither had spoken to Marie.

As it turned out, she'd reached their answering machine.