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Thursday, July 8, 2010
That brain tumor can wait 4-8 weeks, can't it?
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I'd like to thank my reader Lauren, who says a neurosurgeon in her town recently faxed this letter to his referring physicians. I can only hope they have someone else to refer to.
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A Blog detailing the insanity of my medical practice and the stupidity of everyday life.
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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.
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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.
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29 comments:
My father has Normal Pressure Hydrocephalus. When his shunt failed he went, in a period of 12 weeks, from being able to walk and drive to being aphasic.
The idea of a neurosurgeon assuming a 4-8 week delay before deciding to even treat a patient fills me full of fury.
Maybe Dr. Doesntrefertome should send his menangitis patient over to this doctor.
Maybe not quite brain tumor territory, but one of my relatives had a pinched nerve at the elbow. It was so severe, the primary care doctor expected the nerve endings to die from the pinch point down unless she got immediate surgery. Wait time until the neurosurgeon would see her? Twelve weeks.
Dr. I. B. Bizzy is not alone.
(And, yes, she did lose some ability to move her hand and fingers.)
Wow. To be in such high demand must be really gratifying, eh? I go to a dermatologist that has a long wait time for first time patients, and she turned out to be worth it.
But if someone had told me to wait 8 weeks to find out if a neurologist would even consider my case when I was having headaches so bad on a daily basis, I wanted to put a drill to my head? I would've told them to go suck it. I know it was surgery level shit I was dealing with, but still...like you said, Grumpy, I sure hope they have another surgeon as an option to refer to! Wow.
C'mon this is you right? THAT's why the good Drdoesntrefer doesn't refer to you. (J/K!)
He's a SURGEON. Not me. I'm just a lowly neurologist.
I started smelling phantom smoke, then really severe hand tremors. It was to the point of not being able to perform surgery. I called my GP and their office called to set up an appt with a neurologist. My appointment was for 2 months in the future. I called the neurologist office and told them that I had to get in ASAP as this was affecting *my* ability to perform surgery. I had an appointment for the next day.
Once you have the initial appointment set up through your GP, a call to the office might yield a faster appointment. I was very polite about it, just advised that it was an urgent situation.
If that neurosurgeon ever has a fire in his house, I hope he can wait 4-8 weeks for the local Fire Department to evaluate his case and decide whether they can help him. Or burglar/Police Department. And that he has filled out the required forms....
From some of the quack referral paperwork you've gotten, it seems that this would be a form letter you would provide. It sounds like it might cut down on the amount of sheer junk coming through the referral system.
How then do they schedule appts without using a phone. I hope that
his patient is not in dire straights
since there is a LONG wait.
OMG!! It seems like he wants to pick
and choose his cases! He needs to decide if case is worthy of his care
and if it is surgical.
I had a disc repair by my neuro-surg
and about 3 years later some more
problems. When I saw him, case was not
surgical but he had many ideas on how
to deal.
This guy seems like a real douch
Wow, it's a wonder he has any patients at all.
Hope he never finds himself in his patients' positions.
the logic of having the imaging for the consult is lost in the arrogance.
4-8 week wait...
a) He's really busy and doesn't want to waste well paid OR time for seeing patients he can't heal with steel.
b) He doesn't want to ruin his statistics by operating on people who are so sick they might die quickly no matter what he does.
c) He's an asshole... er, wait, we already know that since he's a neurosurgeon.
Wow! How is that even ethical? ..Or should I say legal?
To The Good Cook, yeah, I was wondering if he does spinal taps in the office... I also wonder if he has to consult oracles or read tea leaves or something, sure seems like it takes him a long time to review stuff. And what if the patient "does not have the time to invest" because the patient's condition will be fatal without surgery? Too bad, so sad I guess!
I agree with a.generic above about the doc not wanting his statistics messed up with people who are going to die anyway, but also I wondered if he was losing his skills and had to take only the cases he could study up for in 4-8 weeks? Kind of like a teacher being a chapter ahead of the class. Maybe he needs to re-read the part on (insert symptoms/problem here) before he can manage the consult? Either way, "danger, Will Robinson!"
I have chronic health problems (anyone who wants to look up Ehlers Danlos Syndrome is welcome!) and am having very very strange massive above the waist sweating and other problems (swallowing, dizzy, sleeping etc) which are deemed to probably be neurological. Back in may my internist sent off a request for a neurologist in the 'big city' near here. I got a letter a month later with a date for November!
However, I can also see why he screens his patients as I was due to see a rheumy before my EDS diagnosis and once I was diagnosed I called the office to see if they wanted me to send some information over and they cancelled my appointment right on the spot. I also had an appointment with an orthopedic surgeon who did not have all my images before hand and walked in the room, saw all the scars (have had 3 knee operations) and said sorry I wont work on you and walked out. I wish he had of told me this over the phone instead of having to wait 4 months to get into see him!
Keep up the good work Dr. Grumpy! I finally have a good team of doctors after years of looking and you remind me that if you just be patient and keep looking you will find the doctor that fits you.
~SS
Um, I bet some nurse with an attitude wrote that and it was not fully approved by Dr. I B Bizzy... What doc would let that go out?
As a primary care doc, I'm finding this increasingly common, especially among neurosurgeons and, for some reason, rheumatologists.
What this doc is saying is that he is intellectually incapable of examining and evaluating patients on his own. He can only deal with patients who already have a definitive diagnosis made by the time he sees them. He has reduced himself to the level of a surgical technician.
You know what I think? Bull-effing-shit!
:X
WTF? How can he possibly be in practice?
Although I am not a neurosurgeon, or even currently certified in CPR, I am pretty sure that things in the brain requiring surgery that can wait 4-8 weeks don't happen often.
OK, I'll defend the guy, maybe, a little bit. The letter specifies that the patient has to get his/her most recent spine VT or CT myelogram, and then says that the surgeon will evaluate whether or not anything surgical can be done.
I'm assuming that this is the letter that the neurosurgeon sends out regarding prospective back pain patients.
I bet that (if he touches tumor patients) he doesn't send them (or their doc) this letter.
Having run the gauntlet recently with a messed up C-3 disc, I'm not surprised by this. I got in to see a spine guy within a week only because I was already a patient for the ortho group - otherwise, it would have likely been 6-8 weeks. I actually talked to the spine doc about it, and he said that they get overwhelmed by people that they can't do anything for, other than recommend PT.
Greg
this sort of reminds me of my orthopedic oncology surgeon. When i was diagnosed with Mets in my bones, my oncologist thought i should look into having a part of my hip replaced b/c of the large lesion it contained.
i had to jump thru an amazing amount of hoops in terms of providing information, films etc.
when i arrived for my appointment, said doctor had not looked at any of the documents that had to be received ten days before my appointment. HAD he actually done so, he might have noticed that some of my films were crap - and then I would not have had my consult cut short and a return visit scheduled b/c he couldn't read the films.
I bet said douchey neurosurgeon probably walks into appointments the same way - unprepared, with attitude and completely winging it.
THe surgeon I saw insisted upon doing a biopsy of my lesion to make sure it was really metastatic breast cancer - and a met that gave me no pain, now aches constantly.
argh.
This must be Canada, right? Things like this don't happen in the USA
Casmsar:
Sorry, but the neurosurgeon who sent that practices, and was born in, the U.S. In a large city.
My mother in law had a brain tumor. When her drugs stopped working, she went from being a possible candidate for a second surgery to a hospice situation in 7 days. The tumor grew that fast... she was an RN and knew exactly what was going on. She refused a feeding tube even though by the end of those 7 days she had lost her ability to swallow from tumor growth/pressure.
4-8 weeks versus ASAP can be the difference between weeks and years for survival.
The dude did say up to 4 to 8 weeks
before he may-or-may not see the
patient!!! The films I can see
he needs. But what about emergent cases?? It can be (probably is) a
case of life or death!
I think he is just lazy and doing
the old pick and choose..maybe to
fit into his schedule...
I seems he has received a lot of chronic back pain patients that might simply be chronic pain patients that do not require surgery or any other interventions that he can do. He is tired of the chronic pain referrals. That being said, he also seems like he is culling for the more profitable patients only.
He would not be on my referral list.
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