Thursday, March 26, 2015

Things that make me grumpy

This is an actual note I had to dictate today.

Dear Dr. Intern,

Mrs. Payne returns today. I haven't seen her since March.

She says she never had any of the tests I ordered, and transferred care to another neurologist in North Grumpyville. She says she was unhappy with me and my staff, and didn't want to continue care here.

She continues to have a constant headache and intermittent arm tremors. She says the other neurologist is managing all these symptoms with medication, and has ordered further studies. I wasn’t previously aware of any of this.

The reason she comes in today is because she needs disability forms completed, but the other neurologist is on vacation for the next 2 weeks. Therefore she made this appointment with me to have them filled out since they're due before then. She's then planning to return to the other neurologist for future care.

Yes, Mrs. Payne, I did send that to your internist.

I'm sorry you felt it was unreasonable of me to refuse your request, but in good conscience I can't fill out forms on a patient I'm not treating. I'm sure some less ethical doc would have agreed to do so, and billed you $50 for it, but I won't even play that game. It just isn't worth it to me.

I didn't charge for your ludicrous visit, either. I probably could, but if it gets audited, or the insurance (or you) complain, I'm sure doing so would make me look bad. So I took a loss on the 30 minutes you'd booked "to discuss my case."

I'm not offended you don't like me. You learn early on in this job that you can't please everyone. But if you change docs, don't waste my time coming back here for bullshit reasons.

There simply aren't enough hours in my day as it is, and life is too short for that kind of crap.

Yours truly,

Ibee Grumpy, M.D.


Officer Cynical said...

I'll do it for $25.

Anonymous said...

Could you bottle and sell some 'Dr. Gumpy Bullsh!t Elixer'? I need some.

ronstew said...

I'm puzzled because I am not sure why the message needed to be sent. Maybe if I knew what an internist is, and how that relates to patient care? (No sarcasm or irony here. Genuine curiosity.)

Anyway, some people have a lot of nerve, don't they?

Anonymous said...

The internist is the guy (or gal) who oversees the entire patient, coordinating care between the various specialists overseeing just particular pieces of the patient.

As I type this in between the walk in emergency we haven't seen since 2011 and the two appointments here 15 and 30 minutes early wondering what it's like to actually eat lunch at lunchtime, I find myself with indigestion (again) wondering why the hell we don't close for lunch and wishing my boss was more like you. But he's off in his truck clueless about how his business runs.

Anonymous said...

Headaches? Sounds to me like this patient has a nerve problem.

Anonymous said...

Not your patient - not your problem. Besides, you can save her $25 by referring her to Officer Cynical!

Anonymous said...

Only one word comes to mind after reading that...........


Does anything surprise you anymore????

Candi said...

@warmsocks -you win the internet. :p :)

I don't even want to think about how much trouble the awesome Doc G would get into if he tried to fill out that paperwork.

Thinking about it, the odds are fairly even of her just having gotten the paperwork vs her having received it before her doctor went on vacation, and sitting on it until the "oops" moment arrived.

Anonymous said...

Agree with you, Candida. Lack of planning on her part does not create an emergency on Dr
G's part.

Anonymous said...

The only other option is to charge her $50 and fill out her paperwork truthfully with, "This doctor has no evidence to support of claim of disability at this time." and filling every thing out at "able" level, which, as far as you know, is true.

That would be the roughest punishment of all. She should be grateful you didn't go that route.

migraineur said...

I'm with Anonymous @4:19- If this 'lady' really wants you to fill out the form, do so, and answer it truthfully. As far as you know, her problems must have resolved, because she last used your care a year ago. With this as your records of care, she must have her symptoms under control. (This would be a legal, but passive aggressive way to have the pt not be upset, since you would have filled out the paperwork) As for the term lady, I'm using it as a substitute for any number of four letter words you could describe her with

Anonymous said...

Oh good riddance, crazy lady!

To all the high-maintenance, demanding, exhausting patients out there, please, PLEASE move on to another doctor - we`ll transfer all your documents (with all the pointless tests you didn't need, and all the quasi-placebo medications you harangued us into prescribing) for free! In fact, I'll photocopy them my own self.

These patients don't know how happy I am to see them decide to go, given that it's very difficult for me a a physician to terminate the relationship .

RehabRN said...

Oh Grumpy! I wonder how many docs at the Hotel would commiserate (I can think of a dozen all by myself, just in rehab).

Good for you! I hope she's so irritated she never darkens your door again.

Locations of visitors to this page