#$%@ my Clinic!!!

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jdh71

jdh71

Grim Optimist.
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If you take a look at some of the other boards, we are lame in comparisan . . . not the lamest by any means, but still kind of weak an sickly. We need to change that, and with that in mind I present to you, the "#$%@ my clinic" thread where we can complain about all things continuity clinc (or other specialty clinic orientated) . . . so let's hear the stories. Let's vent. Let's comiserate. And most importantly, let's laugh.
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Some of my favorite patients are those who storm off in a huff, mostly because it's much less paper work for me . . . (medical student's please frogive my cynicism)

Guy comes into my clinic this morning - he want a motorized scooter, despite the fact that he's abulating fine (I was running a little behind this morning because I actually had a few patient's with REAL problems that needed dealing with) and I know this because when I went out to call this guy into my exam room, he had decided that it was a good time for a "smokey treat", and he comes come stomping back in all disgruntled because . . . apparently . . . the universe didn't revolve around his silly ass . . . and went onto complain about how long he had been waiting. At which point I point out that I was busy that morning and we could reschedule if he liked. So I get him settled enough to start asking him what brings him in and he starts in this wild story involving "bed bugs", but not just any bed bugs but super-evolved beg bugs because we was living above a chemical dump (I'm not joking because, you just can't make this kind of stuff up). The before I can ask more about these "bed bugs", he tells me his hair is falling out, and asks if he can get rogaine, and I tell him not at the VA. He goes on a tired for a few minutes about the VA, which trails off without any coherent end point, and he asks me for a motorized scooter and that is his real reason for the visit that he has been unable to get a motorized scooter anywhere and at any VA in 5 different states, and I told him, there would be no way I would be able to get him one today. He then flips out, and walks out.

Seriously some people don't get it. I'd have an easier time getting someone IV demerol from the pharamacy than a motorized scooter from prosthetics.
 
i haven't started residency yet but i have a story from when i was on my M3 continuity clinic rotation. it isn't venting but it's kind of a sad, amusing story, and involves a scooter.

Patient is a woman on a scooter who was just discharged after a stint in the hospital for a stroke (not her first time) and presents for a follow up visit. She has many risk factors for stroke, including SMOKING. She hasn't stopped smoking since she was discharged, and reports experiencing stroke symptoms earlier that morning. Resident tells me, the student, to escort the patient to the ER across the street. On the way out, attending tells the patient, "No more smoking." Attending tells me, "Make sure she doesn't smoke on the way to the ER; that is your job." The moment we left the building, patient tells me, "I know I won't be able to smoke in the hospital, so I'm going to light one up now and there's nothing you can say that will stop me." Here I am shuffling along next to the patient in her scooter, having failed my job from the moment it began. When we get to the ER entrance, she stops and says, "I'm going to finish this." I have to wait several minutes, and then she says, "That was good." We get to registration and I wish her well. The end. Well, not exactly, because when I reported back to clinic the attending asked me how the trip was >.<

What have I gotten myself into, signing up for becoming a doctor? I hope i won't be beating dead horses for the rest of my life. I know this isn't how it always is, but it must sometime get really frustrating.
 
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IMdocT said:
What have I gotten myself into, signing up for becoming a doctor? I hope i won't be beating dead horses for the rest of my life. I know this isn't how it always is, but it must sometime get really frustrating.
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Great story.

Some humans suck, but I think most people are genuinely grateful and appreciate what we do for them. It's just that jackasses seem to stick out in our mind more, and because they are non-compliant ******s we get to see them multiple times because, you know, taking that insulin and not eating chips and candy bars is just way too hard . . .

I still think I have one of the coolest jobs in the world.
 
jdh71 said:
Great story.

Some humans suck, but I think most people are genuinely grateful and appreciate what we do for them. It's just that jackasses seem to stick out in our mind more, and because they are non-compliant ******s we get to see them multiple times because, you know, taking that insulin and not eating chips and candy bars is just way too hard . . .

I still think I have one of the coolest jobs in the world.
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I had a 19 yo pt this last couple days who uses the hospital as a hotel and a means to get drugs, food, and rest.

He tells me he is vomiting but needs me to increase his food intake, I said no if you are vomiting we have to go NPO. So suddenly it is no longer vomit just spitting saliva.

He says his testicles hurt.... so I said fine, we going to get surgery on board and they will remove your stuff and they won't hurt anymore. Then suddenly it didn't hurt anymore.
 
I had a lady who wanted me to sign that her 9 year old chihuahua was a service dog because it helped her with "anxiety," which of course, was disabling for her.
 
This is normally how I feel about my clinic, but this past week, I had 2 WWII vets in my clinic (one was a WASP, the other a battleship gunner) and, given all they'd already been through, what I had to tell them (I am an oncologist after all), they were probably my favorite patients ever.

Also, another guy brought me a 5# salmon filet from a fish he caught a few weeks ago and another brought homemade steelhead pate. So it was a pretty good week for me. I'm sure the next one will be much less awesome.
 
I had a guy on a wheelchair accompanied by a HUGE dog the size of a bull. He claimed to have been on Oxycodone for 16 years. This was his first visit at our clinic. Said he had just moved from the other side of the country. When I asked him: what brought you to our state? He says: I read online that your state is number1 whleechair friendly. Bull$****. So when my attending refused to give him any Oxycodone, specially that we never got to know what he need pain meds for (all he kept saying was: just give me Oxycodone, you don't have time to listen to my story) I was explaining to him how my attending is bound by certain rules and we can't write him a script, he goes crazy, gets up from his chair and yells at his dog, which in turn jumps at me, almost injuring my face. Thank God I had left the door partially open. This maniac was willing to do anything for Oxycodone.
 
Good idea for a thread, jdh. Here's a story about how I got to see a patient who never saw medical students.

The patient was an older lady, cranky about having been kept waiting as long as she had. Of course, I didn't point out that the reason why she had been waiting so long was probably because of how much I slowed my preceptor down, but that's besides the point. Anyway, after I introduced myself, she told me that she doesn't talk to medical students, and she wants me to get the doctor. So I told her that the doctor is in another room and wouldn't be able to come see her for a while still. Couldn't I just come in for a few minutes since she had to wait anyway? Maybe I looked desperate, but she finally did let me come in.

Almost an hour later, I apologized and said that I really had to go get the doctor now. Obviously I had spent a lot longer talking to her than I was supposed to. After I presented the case and my preceptor examined her, she was on her way out the door when she stopped, turned to me, and said, "You know, I never talk to medical students. You must be very special." I stammered out a "thank you." My preceptor told me that I had done a good job because that patient didn't like anyone, not even him, but would I please be quicker with the next patient. :hungover:
 
I had a patient who moved into a new apartment that did not allow pets. She wanted a doctor's note from me saying that she needed her dog's company for "psychological reasons." The same lady called me a few months later, saying that she needed a doctor's note stating her medical conditions. I asked her who this letter was for. She told me that she needed it for court. She was being charged with a crime, and she wanted them to know about all of her medical problems, thinking that somehow this would get her out of being charged. Her crime- armed robbery. When I told her that none of her medical conditions could get her off the hook for armed robbery, she replied "not even my diabetes?"
 
gutonc said:
This is normally how I feel about my clinic, but this past week, I had 2 WWII vets in my clinic (one was a WASP, the other a battleship gunner) and, given all they'd already been through, what I had to tell them (I am an oncologist after all), they were probably my favorite patients ever.

Also, another guy brought me a 5# salmon filet from a fish he caught a few weeks ago and another brought homemade steelhead pate. So it was a pretty good week for me. I'm sure the next one will be much less awesome.
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I LOVE WW2 vets!! I'm so serious. It's too bad they are starting to drop like flies. Greatest generation? I think so.
 
OncHem said:
I had a guy on a wheelchair accompanied by a HUGE dog the size of a bull. He claimed to have been on Oxycodone for 16 years. This was his first visit at our clinic. Said he had just moved from the other side of the country. When I asked him: what brought you to our state? He says: I read online that your state is number1 whleechair friendly. Bull$****. So when my attending refused to give him any Oxycodone, specially that we never got to know what he need pain meds for (all he kept saying was: just give me Oxycodone, you don't have time to listen to my story) I was explaining to him how my attending is bound by certain rules and we can't write him a script, he goes crazy, gets up from his chair and yells at his dog, which in turn jumps at me, almost injuring my face. Thank God I had left the door partially open. This maniac was willing to do anything for Oxycodone.
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:laugh:

No dogs in the room!! New policy I just decided.
 
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QofQuimica said:
Good idea for a thread, jdh. Here's a story about how I got to see a patient who never saw medical students.

The patient was an older lady, cranky about having been kept waiting as long as she had. Of course, I didn't point out that the reason why she had been waiting so long was probably because of how much I slowed my preceptor down, but that's besides the point. Anyway, after I introduced myself, she told me that she doesn't talk to medical students, and she wants me to get the doctor. So I told her that the doctor is in another room and wouldn't be able to come see her for a while still. Couldn't I just come in for a few minutes since she had to wait anyway? Maybe I looked desperate, but she finally did let me come in.

Almost an hour later, I apologized and said that I really had to go get the doctor now. Obviously I had spent a lot longer talking to her than I was supposed to. After I presented the case and my preceptor examined her, she was on her way out the door when she stopped, turned to me, and said, "You know, I never talk to medical students. You must be very special." I stammered out a "thank you." My preceptor told me that I had done a good job because that patient didn't like anyone, not even him, but would I please be quicker with the next patient. :hungover:
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You did do a good job. I know I would have a VERY hard time keeping my patience in that kind of situation. Some of us are better at out-patient medicine than others I think.
 
angel80 said:
I had a patient who moved into a new apartment that did not allow pets. She wanted a doctor's note from me saying that she needed her dog's company for "psychological reasons." The same lady called me a few months later, saying that she needed a doctor's note stating her medical conditions. I asked her who this letter was for. She told me that she needed it for court. She was being charged with a crime, and she wanted them to know about all of her medical problems, thinking that somehow this would get her out of being charged. Her crime- armed robbery. When I told her that none of her medical conditions could get her off the hook for armed robbery, she replied "not even my diabetes?"
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You mean her "diabeetus"?

DiabeetusCat.jpg
 
One of my morbidly obese patients came in for an urgent visit with the chief complaint of "problems with erection". He walked in and said, "Doc -- I can only orgasm with a hand held penis pump. Can you give me something I can plug into a wall? My hand is killing me!"

That day I learned that Medicare will reimburse battery powered penis pumps.

/keeping my customers satisfied
 
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Geri_Gal said:
One of my morbidly obese patients came in for an urgent visit with the chief complaint of "problems with erection". He walked in and said, "Doc -- I can only orgasm with a hand held penis pump. Can you give me something I can plug into a wall? My hand is killing me!"

That day I learned that Medicare *will* reimburse battery powered penis pumps.
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And to think people wonder why I have a problem with paying MORE taxes!
 
Honestly, I'm spent and don't even feel like getting into it . . . let me just say though, that attendings should be there is help, and when a resident asks for help, it's because they actually need it.
 
During residency my first year clinic was at a county type facility, which I ultimately switched out of because I felt bad not knowing Spanish. My second clinic was at the VA, where I felt bad not knowing trach speak :p

Luckily, I need no outpatient skills as a hospitalist, and I've always been fluent in "delirious old guy" ;)
 
WWII vets rock! I used to have a little old lady in my VA clinic who was a WASP. All she wanted was a hearing aid and nothing else...apparently it wasn't covered so I couldn't get her one. That really sucked.

I also took care of a guy who had funny looking ischemic-type lesions on his feet. His family said he got really bad frostbite during the Battle of the Bulge.
 
dragonfly99 said:
WWII vets rock! I used to have a little old lady in my VA clinic who was a WASP. All she wanted was a hearing aid and nothing else...apparently it wasn't covered so I couldn't get her one. That really sucked.

I also took care of a guy who had funny looking ischemic-type lesions on his feet. His family said he got really bad frostbite during the Battle of the Bulge.
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WWII vets are my absolute favorite pts. In my experience it's these guys yiu really got to watch as they'll down play feeling bad even when they're dying. I've got more than a few examples

My I'M clinic primarily was people asking me to fill out paperwork so they can "get ma check"
 
No.

You may not have any antibiotics.

You have a cold.

It is caused by a virus and antibiotics do not help. I do not care that your son's pediatrician gave him antibiotics. I am not seeing your son. I am seeing you. And if your son's pediatrician gave him antibiotics for a cold, he should not have done that. You may use robitussin DM or it's generic equivalent, get plenty of rest and fluids.
 
Thank GOD I am not going into primary care....

24 yo F wanted me to give her a "work excuse" for chronically being late to work in the AM WTF? of course I said NO.
 
I tell every new patient that I don't fill out scripts for narcotics unless they enroll in a pain contract and try other pain relieving activities such as pool therapy and physical therapy. I also tell them I don't fill out disability paperwork. No attending's told me to change my habits otherwise.

I had an 18 year old kid from the street concealing a knife into the exam room saying he needed oxycontin and that he needed the brand name ones with the "mark on the tabs". I told him I'd be right back with the script, filled it out for 10 generic tabs, and called security to escort him out because he brought in a concealed weapon. See ya!
 
Every fibromyalgia patient I decide to keep in my continuity clinic has to enroll in physical therapy and a gym membership to show they're motivated to be moving around. They also have to try using duloxetine or Savella and sign a pain contract if they need any narcotics. The ones that don't comply get referred out to rheum.
 
This is my favorite. I had a patient that showed up over an hour late and the office staff turned her away and told her she had to reschedule. (our policy was >30 minutes they need to reschedule). The next day I get an email from the Dean of the medical school after he had an email forwarded to him with a link to a rant on Craigslist about the terrible doctor that turned away this guy's sick mother with a "staff" infection and "conjustive heart failure". I had to call this tool and apologize as well as kiss his ***** and kindley ask him to remove the post about how terrible our university is and what crap doctors we make.

Clinic sucks!!!

I also had a patient that looked like Tammy Faye Baker Mixed with the Joker (heath ledger style) who always hugged me at the end of her appointments and left a face print like the shroud of turin on my damn white coat!:D

Clinic can be great and it can totally blow. I think if we had more time it would be pretty awesome.
 
My favorite train wreck: My legs are swelling up again.

Me: Are you wearing your CPAP at night?

My favorite train wreck: No.

Me: Wear your CPAP!

:mad:
 
Me: so why did you go to jail?
Pt: prostitution
Me: i thought you told me that you weren't previously employed... prostitution is considered employment
Pt: na uh!
Me: yes uh!
Pt: na uh... it ain't tax deductible...:eek:
 
well . . . as if I hadn't enough reasons to kill myself, I've been scheduled for an "extra" clinic today, because, apparently, having a research month doesn't mean they actually want me to do any research, but would rather have me filling in gaps in the program that the chiefs do not want to dela with . . . ugh . . . I am about to see my "favorite" fibro patient . . . If do not return you will all know that I did my best, but just couldn't handle it any longer and I took an overdose of tap water, straight to the dome, because if I drop my serum sodium low enough, I might just seeze and die, right?

So this is how it ends . . . huh, who'd of thought it . . . well, it's been a good run . . .
 
your humble correspondent is still alive!!

*cue the cheering throngs*

*cue the hater's evil glances*

(DIE haters!!)
 
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Here's what I now LOVE about fibro. The only things that has been shown to really benefit pateints (despite what people pushing lyrica have to say) is aerobic exercise.

So you say, "Yeah, your pain is real, we know your brain percieves pain differently based on PET scans of the brain, but the only thing that really helps fibromyalgia is exercise, and I don't care what you do walk, ride a bike, swim, but if YOU want to feel better YOU will need to do something - expect slow progress, but still expect progress if you start exercising"
 
jdh71 said:
Here's what I now LOVE about fibro. The only things that has been shown to really benefit pateints (despite what people pushing lyrica have to say) is aerobic exercise.

So you say, "Yeah, your pain is real, we know your brain percieves pain differently based on PET scans of the brain, but the only thing that really helps fibromyalgia is exercise, and I don't care what you do walk, ride a bike, swim, but if YOU want to feel better YOU will need to do something - expect slow progress, but still expect progress if you start exercising"
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I had a patient tell me that getting lymphoma cured her fibro and that the fibro was probably just lymphoma all along.

It took a while to convince her that it was probably the 12 kilos of prednisone and a big whack of cytoxan (and maybe a shot of Rituximab...that seems to be good for what ails you) that "cured" her "fibro."
 
gutonc said:
I had a patient tell me that getting lymphoma cured her fibro and that the fibro was probably just lymphoma all along.

It took a while to convince her that it was probably the 12 kilos of prednisone and a big whack of cytoxan (and maybe a shot of Rituximab...that seems to be good for what ails you) that "cured" her "fibro."
Click to expand...

:laugh:
 
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