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Favorite Pet Peeves
Started by geauxg8rs
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1. Chronic benzo scripting.
2. Dumb ass family MDs using Oxycontin in a high risk population as their "go to drug".
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I have "fi-bo-myalgee"
Surgeons: "The patient has cardiac/pulmonary clearance."
The specialists perform risk stratification. Not clearance.
The specialists perform risk stratification. Not clearance.
How long have you had this pain?
"Oh for a while now"
And how long is 'a while'?
"Oh, for some time."
Days, weeks, months?
"No, longer than that."
Years, decades?
"No, not that long"
Or,
When did your pain start?
"Well, you see doc, it was back in 1957 it was, and I was-a workin on ma daddy's farm. And you know back in those days we didn't have none of them new fancy tractors. You know the kind with them air-conditioning and GPSers? Yeah, we just had a plain-ole simple tractor. So one day, I was supposed to go out plowing the far field, the one that takes the longest to get to because the old bridge across the river got washed away a few years back. So you know I gotta go out on the highway and drive around town to get to it. So anyway, I was driving, and you know where Smith's Diner used to be? No? Well it was on the corner of Main and 5th Ave. It was a really good place to go out for Friday dinner..."
😴
"Oh for a while now"
And how long is 'a while'?
"Oh, for some time."
Days, weeks, months?
"No, longer than that."
Years, decades?
"No, not that long"
Or,
When did your pain start?
"Well, you see doc, it was back in 1957 it was, and I was-a workin on ma daddy's farm. And you know back in those days we didn't have none of them new fancy tractors. You know the kind with them air-conditioning and GPSers? Yeah, we just had a plain-ole simple tractor. So one day, I was supposed to go out plowing the far field, the one that takes the longest to get to because the old bridge across the river got washed away a few years back. So you know I gotta go out on the highway and drive around town to get to it. So anyway, I was driving, and you know where Smith's Diner used to be? No? Well it was on the corner of Main and 5th Ave. It was a really good place to go out for Friday dinner..."
😴
Was it a Massey-Ferguson or a Ford 2600?
Oh, I used to drive both at a golf course before becoming a doc, and the Ford had the hydraulics and it leaked on the front end loader, so any time I was raising the bucket, I had to lean right or the hot oil would be sooting all over me. Those were the days. Then while I have them off guard, I put the peddle down and list what we are going to do.
"Where do you hurt?"
"All over."
"All over."
I hate being called a provider. It demotes me from doctor to provider, and simultaneously upgrades CNP's and PA's.
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Yup, my double diagnostic MBB follow by RF somehow became a series of 3 LESI to another doc. I cannot stand that type of misinterpretation.
Rrrrggghhh.
Rrrrggghhh.
I only hear "rotor cup" round these parts.
Another pet peeve regarding patients I have never seen before:
"I didn't fill out the paperwork because its in my file. You should have it."
Where is this mystical fricking file everyone talks about?
Just like the images. "They told me they sent them. You should have them. Have you looked at them yet?"
That "file" is probably in "the computer," the place where I can supposedly search and get a full medical history even though they've never been seen in this hospital system
mine=
From nursing-
"The patient pooped and it smelled kind of bad, so I sent it for c. diff."
"The patient had a semisolid bowel movement, so I sent it for c. diff"
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Intake forms that smell like smoke.
Patients who choose not to answer certain innocuous questions on my form. For example, they'll circle a pain number for "current" and "worst", but leave out "average" and "best". They'll leave the entire "related event" section blank, but then then check the box for "work related". They'll leave blank the pain diagram man that specifically instructs them to color in their usual painful areas, but then check several boxes in the adjacent section clearly labeled in bold "mark your SINGLE worst area". They'll leave the entire "pain better with" section blank (which includes a "nothing" choice), but write in "pain pills".
Our country is so screwed...
Do other countries do total freakin' ******* like we do?
Patients who choose not to answer certain innocuous questions on my form. For example, they'll circle a pain number for "current" and "worst", but leave out "average" and "best". They'll leave the entire "related event" section blank, but then then check the box for "work related". They'll leave blank the pain diagram man that specifically instructs them to color in their usual painful areas, but then check several boxes in the adjacent section clearly labeled in bold "mark your SINGLE worst area". They'll leave the entire "pain better with" section blank (which includes a "nothing" choice), but write in "pain pills".
Our country is so screwed...
Do other countries do total freakin' ******* like we do?
My favorites:
In response to what brings you in today, "It's in my file, look it up" at which point I respond, "I wish I had 6 hrs to sift though all the records of your ridiculous overuse of our healthcare system and wasted gov't money"
or
In response to where is your back pain, "It's my L4-5. It's in my chart"
or
"What? I'm not getting an injection day!?! They told me I was!"
In response to what brings you in today, "It's in my file, look it up" at which point I respond, "I wish I had 6 hrs to sift though all the records of your ridiculous overuse of our healthcare system and wasted gov't money"
or
In response to where is your back pain, "It's my L4-5. It's in my chart"
or
"What? I'm not getting an injection day!?! They told me I was!"
Telephone note today on a Medicaid patient referred by the county medical clinic because their pain is leaving town. I wrote for PT with F/u PRN. The note today says "The states she needs a RF on Tyl #3. Pt states Dr. X says he referrred pt to you so you have to write for it now."
I had to restrain myself from writing the reply I wanted to say.
I had to restrain myself from writing the reply I wanted to say.
Pt: "Well doc, you should already have my MRI. It was sent over to to you guys last week."
Me: "Well maybe it got lost in the mail. Where did you have it done? We'll call them back for another copy."
Pt: "I don"t remember. That big place next to Applebees"
Me: "Which Doctor ordered it for you?"
Pt : " I don't remember. Maybe it was my doc up in that clinic off the freeway. I don't know the name of it, but you should be able to look it up. It's in my chart"
Me: Hmmm (mentally I am imagining poking their eyes out with the pens in my white coat pocket)
Me: "Well maybe it got lost in the mail. Where did you have it done? We'll call them back for another copy."
Pt: "I don"t remember. That big place next to Applebees"
Me: "Which Doctor ordered it for you?"
Pt : " I don't remember. Maybe it was my doc up in that clinic off the freeway. I don't know the name of it, but you should be able to look it up. It's in my chart"
Me: Hmmm (mentally I am imagining poking their eyes out with the pens in my white coat pocket)
"but doc I hate needles"
Pt "those shots lasted a few months but they are so temporary, I'll just stick to my percocet"
Pt "those shots lasted a few months but they are so temporary, I'll just stick to my percocet"
I've cancelled or deferred many a MBB due to pt inability to understand what we are doing.
But they don't mind hardcore narcotics , right?
"Doc can't you just give me something for pain?"
"It starts with an Oxycontin"
The worst.
Anyone had a patient come in with "love" and "hate" tatooed on their hands?
Classic sign of trouble. RUN. FAST.
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The 30 y/o guy who comes in, makes eye contact, firm handshake and knowing smile, "Man am I glad to see you..." That just always equals trouble for me. In my mind I reply, "Not for long..." One time I think I accidentally said that out loud...
Also, when I ask the patient if he can point to where his worst pain is, he doesn't budge and stares at me with a straight face, "My L5/S1". "Okay, can you please point to your L5/S1 then?" SOB, these things really piss me off!
Also, when I ask the patient if he can point to where his worst pain is, he doesn't budge and stares at me with a straight face, "My L5/S1". "Okay, can you please point to your L5/S1 then?" SOB, these things really piss me off!
Or alternatively, "Can you point to where you hurt the most" and their finger/hand travels all over the body.
maybe they have a broken finger....
I did a LESI on a woman in her late 50s who had a tatoo right over my target that said "I suck coc_" and there was a little picture of what she sucks. I wonder if she even knows its there.
I had a kid throw a toy that hit me in the back of the head. Mom (the patient) was yelling, "See what I have to deal with! I can't take it!" This was her justification for demanding oxycodone. I was so happy when her and her whole family walked out the door saying, "Worst customer service EVER!"
Pure undiluted hilarious. 👍
Time to write a book !! ( under a pseudonym of course ).
My secretary is the best when it comes to crap like this. She informs patients that little bastards (ahem, children) are not allowed in the pain clinic, as some of our patients suffer from severe chronic headache.
A good administrator is worth her weight in gold.
These comments are hilarious!
Here's some of mine:
1. Patient's who bring non-pertinent stacks of records. Just today a patient who had a hip replacement 18 months ago brought in a 3-inch stack of paper from her hospitalization. Every progress note, every order, every lab, every scrap of paper from the entire chart was there. But the X-ray she had of her hip last week? No where to be found. "I didn't know you would need that today."
2. New patient: "I'm out of my medication and I need you to refill it - TODAY"
Me: "When did you last take it?"
New patient: "Last week."
Me: "What were you taking?"
New Patient: "Morphine 30 mg three times a day and Percocet 10 mg every 6 hours for breakthrough."
Me: "Do you have any record of receiving this dosage?"
Pt.: "No, but that's what I was taking and I really need it bad."
Here's some of mine:
1. Patient's who bring non-pertinent stacks of records. Just today a patient who had a hip replacement 18 months ago brought in a 3-inch stack of paper from her hospitalization. Every progress note, every order, every lab, every scrap of paper from the entire chart was there. But the X-ray she had of her hip last week? No where to be found. "I didn't know you would need that today."
2. New patient: "I'm out of my medication and I need you to refill it - TODAY"
Me: "When did you last take it?"
New patient: "Last week."
Me: "What were you taking?"
New Patient: "Morphine 30 mg three times a day and Percocet 10 mg every 6 hours for breakthrough."
Me: "Do you have any record of receiving this dosage?"
Pt.: "No, but that's what I was taking and I really need it bad."
I saw a woman in her early 20s today with LBP almost a year after an MVA despite PT, ... She looks clean and healthy (darn good actually) and doesn't want drugs. Spine surgeon who referred her to me did xray and bone scan and she has some facet arthritis which fit with her exam. I started to describe MBB/RFA and she tells me how needles freak her out at which point I see that her tongue is split!!! Who does that? The guy at the tatoo shop/piercing shop? I gave her a couple of Lidoderm patches.
Sorry but the wife and kids are gone and now I'm on a roll. When I first moved to this town someone must have spread a nasty rumor that I was a naturopath. An elderly blind woman comes in for LBP accompanied by her husband with Parkinson's. It looks like facet syndrome and so I discuss the MBB/RFA. They ask if I have a natural form of treatment. Huh? I'm getting a little cranky so I say that natural is to get old and arthritic and become less active because of the pain and die. They're not buying it, the husband's tremors are getting more intense. The wife is starting to wave her head like Stevie Wonder, so I ask her about her blindness which she attributes to cataracts. I mention that there is a neat little surgery for that at which point she says that they are trying the natural form of treatment for cataracts which is to stare at the sun and burn them out. Yowsa!!! She says she thinks its starting to work because the vision that she had before staring into the sun is just starting to return.
Then there was an 84 yo man with LBP who comes in for FU after his RFA. He looks me right in the eye and says that it didn't work. His wife is sitting in the corner and winking, so I turn to her and she says that he used to have to lay on a bag of ice for an hour every night before going to bed and he doesn't anymore. He gets a little intense and his comeover starts to flop and he says "yeah but I have an acreage to take care of and yesterday I had to move a 500 gallon water tank and that hurt like hell!" I treated the SI but didn't touch the attitude.
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That soooo chafes my @$$ when I get, especially when it is from docs in my own group!
"I'm not gonna lie, the only thing that works is percocet"
Yes, this one is definitely a pet peeve for me also!!
These are hilarious.
For me:
Doc I have a really high pain tolerance
I am really scared of needles so I need to be put completely under for my injection.
Pt: You know, I'm a nurse
Me: Oh really, where do you work?
Pt: Ive been on disability for 15 years and no one has been able to help me. But I really want to go back to work
For me:
Doc I have a really high pain tolerance
I am really scared of needles so I need to be put completely under for my injection.
Pt: You know, I'm a nurse
Me: Oh really, where do you work?
Pt: Ive been on disability for 15 years and no one has been able to help me. But I really want to go back to work
nurses are THE worst. they know just enough to be dangerous, but not enough to be reasonable....
