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No comment necessary.
"You MUST refill it! You HAVE to!" Um, no, I don't.I did have a patient asking me to document my refusal to refill her ativan.
Plus it alerts future physicians that this person is a pain in the backside.I’ve had this before and I reply with “sure” and then document in the chart why I don’t think it’s medically necessary. These people have no power over me.
“I always document what tests I chose to perform or not perform and why. I’m happy to include my specific reasoning for that exam in the chart.”No comment necessary.
I had a guy recently tell me in his first sentence he’s a med-mal attorney who “usually only sees people like you in court!”1) This is an excellent way for a patient to erode trust implicit in any decent patient-doctor relationship...I wonder how long it takes them to burn through their "providers.".
Probably a mid level that had to google what the medicine even was before coming back.No comment necessary.
1) This is an excellent way for a patient to erode trust implicit in any decent patient-doctor relationship...I wonder how long it takes them to burn through their "providers."
2) Uh, it's my note and for better or worse it's basically part of the practice of medicine now...patients don't get to practice without a license.
not yet at leastNor do they get to author their own charts.
Nor do they get to author their own charts.
not yet at least
I had a guy recently tell me in his first sentence he’s a med-mal attorney who “usually only sees people like you in court!”
In the grand scheme of demands we get from patients, "please document that you didn't do x", has to be on the more benign end.
Patients ask for stuff all time time, whether reasonable or not. If this was an unreasonable request, then the appalling thing is that someone caved in.
Yep. That’s the great part about being an actual physician. I am sure of my management and have no problem documenting it at the request of a passive agressive patient. I suppose if you are faking it then a patient calling you out would make you shudder.Probably a noctor.
At what point do we get to say, "I think you have undermined the trust necessary to have a good doctor-patient relationship, so I am going to decline your request that I be your doctor. Have a nice day, sir."I had a guy recently tell me in his first sentence he’s a med-mal attorney who “usually only sees people like you in court!”
It's an interesting question, because in the outpatient world we do this all the time. In the ED it's a little tougher, because of EMTALA, but there's no law anywhere in the States that I know of, that says you have to be someone's doctor, forever. In the outpatient world, you hand them a discharge letter and then you're done (except for 'emergencies' in the next 30 days). You don't even have to have a reason. (State laws can vary on all this).At what point do we get to say, "I think you have undermined the trust necessary to have a good doctor-patient relationship, so I am going to decline your request that I be your doctor. Have a nice day, sir."
I would say "sure," and then tell her she'll have access to my documentation as soon as I hit the sign button.
Wouldn't document "I refused" but would say something that patient requested a certain med, didn't feel it was clinically appropriate (and might even quote stuff if it's detrimental), and leave it at that.
The use of "provider" is annoying. Was it a physician, NP, or PA?
I hope that you prescribed him a really strong laxative.I had a guy recently tell me in his first sentence he’s a med-mal attorney who “usually only sees people like you in court!”
Yet another reason I'm grateful to have a chief who doesn't let me hear about any patient complaints unless A: I genuinely screwed up, or B: it's so comical he can't help but let me know so that we can both laugh about it. The latter generally makes it to our monthly meetings as well.Let's be real though: If the patient files a written complaint, it can cause us a lot of grief... especially if you are just another pair of scrubs to admin folks.
It costs me 2-5 minutes to look up the chart if I forgot the person and 30s to write a polite sounding email. Having said that I get very few and admin likes me because of good pgs and other shiny factory worker thingsLet's be real though: If the patient files a written complaint, it can cause us a lot of grief... especially if you are just another pair of scrubs to admin folks.
Which is why I’ve jumped ship to a job with less toxic admin and micromanaging medical directors.Let's be real though: If the patient files a written complaint, it can cause us a lot of grief... especially if you are just another pair of scrubs to admin folks.
Part of the job of a good medical director is to shield you from every complaint. Yea, if you cussed a patient out, you're gonna hear about it. If somebody is griping because of their wait, because they saw you eating at the doc station, because you didn't give them pain meds, because you didn't give them antibiotics, because you didn't smile enough, etc., then well, they get a form letter response telling them their concern has been investigated and we hope they entrust us to continue caring for them in the future.Which is why I’ve jumped ship to a job with less toxic admin and micromanaging medical directors.
People exert the power they have (or don't). Think of the displacement that is put upon the kids working the Mickey D's drive though. On Google, nobody knows you're a dog.We had fun the other night reading the google reviews of our ED - one person mentioned how one of our intake people was rude and condesending - funny thing is that this lady is the sweetest lady anybody has ever met in their life.