Sunday, December 20, 2009

Things that make me grumpy

I had a consult for Parkinson's disease over at Local Rehab hospital today. So I dragged my butt out of bed on Sunday and drove over there.

Parkinson's patients, unless they live in the boondocks, generally have a neurologist. Most PCP's don't want to manage this (nor should they). So when I see a Parkie in the hospital I always ask them who their regular neurologist is.

And this lady told me it was Dr. Osa, who works across the street from the rehab hospital and goes there to round. He's been following her for 5 years.

So I went back to her chart, and reviewed the records. She was recently hospitalized for hip surgery, and during the hospital stay Dr. Osa saw her EVERY FREAKING DAY and, as a consultant his name was printed at the top of every damn page of her hospital stay. But Dr. Fruitcake, who's following her in rehab, somehow didn't notice that minor detail.

So I went back and asked the patient. Did you tell Dr. Fruitcake you see Dr. Osa? "Of course I did, but she never payed attention. She just said she'd have a neurologist come see me."

So I asked the charge nurse. Did Dr. Fruitcake even look at the hospital records? "Of course. I handed them to her myself. She gave them back to me and said to put them in the chart. She told me that she never wastes time looking at hospital records because she has a busy life."

I changed the consult to Dr. Osa, and called him myself. He'll be in later today.

I drove home, an hour wasted.

Dr. Fruitcake, READ THE FUCKING CHART. If you don't have time to take proper care of patients then get out of medicine.


OMDG said...

How irritating.

A question about PD -- On my sub-i my friend had a gastroparesis patient with masked facies and a mean resting tremor. She wasn't able to walk or stand, probably for a variety of reasons. She'd never been diagnosed with PD, I thought it was a strong possibility. I wondered how often this sort of thing is missed by the PMD. It seemed like it would be kind of difficult to miss....

Doctor D said...

I imagine that being an attending at the Rehab Hospital is Dr. Fruitcake's attempt to get out of medicine. Best of both worlds: still get paid for doctoring without any thinking required!

Let's all say a Christmas prayer for the patients at Rehab Hospital --may they get well enough that they survive being Dr. Fruitcake's care!

Grumpy, M.D. said...

Old MD Girl- Sounds like PD, or one of the "PD plus syndromes" (Shy-Drager, MSA, etc.) though with the tremor PD most likely.

In early cases PD can be tricky, even for a neurologist. Advanced cases, though, are pretty hard to miss. And cases with odd features can throw you off.

If you ever have questions about the field, feel free to email me directly. My address is in the sidebar.

The Nice Lady said...

What? Reading the chart is for people doing Patient Care. Clearly that's outside of Dr. Fruitcake's practice.

mommy-medic said...

Could you not have brought this to Dr. Fruitcake's attention? Subtly? Like with a bullhorn? *eyeroll*

Grumpy, M.D. said...

Mommy-Medic: I wrote a brief note saying that I came by, and why I wouldn't be doing the consult.

Dr. Fruitcake won't give a shit, if she even reads my note. Reading charts is for doctors who don't have busy lives, I guess.

Anonymous said...

You have much restraint... I probably would have called Dr. Fruitcake myself and told her that due to her not "wasting her time" reading a fucking chart, I would be sending HER a bill for my travel time. And I might mention her busy fucking life to just the right people so they can cut her hours back... obviously such a busy person needs to have a little extra time on their hands.

Gah. People like this suck donkeys.

Frantic Pharmacist said...

God, that's irritating. I find myself almost ready to give up the ghost when it comes to people reading anything...

webhill said...

that seriously blows.

ERP said...

Dr Fruitcake is a very nice way of referring to this Doctor. I expected something more spicy.

ACZ said...


"Dr Fruitcake is a very nice way of referring to this Doctor. I expected something more spicy."

Such as, Dr Fuckknob or something like that? That's what I would have gone with, but I don't possess Herr Grumplepuss' (meant affectionately, so I hope you don't take offense, Dr. G) restraint.

verification word is: worse

How appropriate on so many levels!

Anonymous said...

That sounds exactly like my last hospital admission.
Told the doc I'd already seen (my regular consultant came by,& it was in the chart) he ordered another consult anyway.No one bothers to look at the chart(or listen to the patient) anymore.

(word verification:tryis.As in,let's try this again!)

Anonymous said...

Makes me glad my Docs HAVE to read and know the Pts history before they enter a room. (All the specialties work together) All the medical records are together and in the folder (computer). And as a Pt myself, Me likes it that way! Signed: Hosp switchboard and BIG clinic operator.

student dr. blaze said...

I agree with ERP & ACZ. Fruitcake is too kind as a moniker. She deserved something much, much worse.

I personally despise (and refuse to see) physicians who cannot read. (Or write, for that matter.) Gotta wonder what else she's missing....

word verification: dissemb

Christine said...

Neurology coming in everyday for a hip fracture? That's impressive.

Julie said...

i'm with 'anonymous' who said you showed restraint.

I'ld be calling Dr Fruitcake (Dr Imtoobusy would have been my name) and said a word or two ...

Anonymous said...

It's called passing the buck

Doris said...

I have a friend who has been in rehab recovering from really horrendous intestinal surgery.

She has been on an anti-depressant and anti-anxiety regime for some time. After months in the hospital and facing more months in rehab and the idea of leaving her home forever for an assisted living facility (best case) she was understandably more depressed and anxious than ever.

What does the rehab doctor do? Discontinue BOTH. ARGH!

As if that wasn't bad enough, my friend has COPD and has been on 30 mg of prednisone for months. Every time they try to taper off the dose, she has a breathing crisis. The lowest does she has been on in the last year is 15 mg.

What does the rehab doctor do? Reduce her prednisone to 5 mg.

Not long after this was discovered my friend was back in the hospital with pneumonia.

And this is GOOD rehab place!

I believe this doctor's name was Dr. Quack-er.

My friend's doctors were all over this nitwit's ass. I hope it left a huge freaking scar.


Niufan99 said...

hilarious.. dr grumpy.. just wait it will get better with Obimbo's health care... I'm in line for the Soylent Green treatment my generation will recieve... so I'm not just old and cranky.. docs don't care...they did in the day I was a new nurse and bowed everytime one came on the floor, we also wore caps which were a pain.... I'm sad to see it all come falling down... at least we have you and you seem to still care your right.... when your too busy to be effective and you just don't care enough to READ A CHART just quit... nuff said

Niufan99 said...

back in the day when a doc entered the building all nurses bowed and listened and obeyed every command they yelled. All Charts written by hand and could not be read quickly... but they did get read... I'm thrilled to see there is an M.D. who cares... thank you... as one of the Soylent Green generation, I appreciate that in a dr... I did have a stainless bedpan thrown at me by a doc when I was a newby, but that's another story... I didn't follow directions to his satisfaction... never crossed him again...

stewbert said...

because she's the only busy person or doctor in the world?

I despise people who think they're more important than anyone else. She should be fired.

WTF? said...


If you are a senior, 65+ years of age, you are not part of the "Soylent Green generation", you are part of the ENTITLEMENT generation.

Ever hear of Social Security, Medicare, and the fact that AARP is going to close your donut hole if this botched abortion of a health-care reform bill ever makes it into law?

It's the young'uns and future generations that will be fucked by this reform, not you.

By the way, there are no death-panels under the current health care reform plan. Hope that puts your mind at ease.

ACZ said...


There must be good rehab hospitals out there somewhere, right?

When my father was in a rehab hospital post bk-amputation, it was a nightmare.
Mainly because the head Dr. was a flaming (not homosexual-type flaming) arrogant prick!

And, again, this was supposed to be the BEST rehab hospital in town.

What the hell is wrong with rehab Drs and rehab hospitals anyways? (gets ready to duck).

Anonymous said...

Hey! I think she was my attending during residency!


Rehab Doc

(And where I am, I'm the one who is picking up Acute Renal Failure, catching errors in patient's meds--on patients discharged to me from the hospitalist service. As I've been saying recently, when your Rehab Doc is the shining star, your hospital is in trouble!)

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