Talking to referral docs

[thiaeyemd]

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I have a question that I have asked before on the blog but haven't gotten response to yet. What is the best way to communicate to referring ODs when there is a major mismanagement issue. For example, I recently saw a basal cell that an ophthalmologist watched for six months as a "skin tag" before the patient came and saw me for a second opinion. I biopsied it and it was a basal cell. I called the guy up and said literally "Hey Mike I saw your patient Leslie Smith who came in for a second opinion.ended up biopsying the lesion and it was basal cell. What the *(#)@ were you thinking man? If there is a question ever just send it over to me or someone else. Its not a problem". His reponse literrally " Man, I totally dropped the ball on that one. It was a really bad call. Thanks for letting me know though". Its not like I am best friends with that guy or anything. We met once at a meeting two years ago for 30 secondas. Anyway, the next week he sent me two patients. I feel that with my OD colleagues I can't be that open or honest and I have to sugarcoat something like that with a "Hey basal cell can be really tough to diagnose" or "It could go either way in that situation..no one would fault you for that". If I hit an OD doc with what I said to the ophthalmologist they would either get defensive or say nothing and never ever send me a patient. What is the best approach in that situation?

 

[KHE]

I have a question that I have asked before on the blog but haven't gotten response to yet. What is the best way to communicate to referring ODs when there is a major mismanagement issue. For example, I recently saw a basal cell that an ophthalmologist watched for six months as a "skin tag" before the patient came and saw me for a second opinion. I biopsied it and it was a basal cell. I called the guy up and said literally "Hey Mike I saw your patient Leslie Smith who came in for a second opinion.ended up biopsying the lesion and it was basal cell. What the *(#)@ were you thinking man? If there is a question ever just send it over to me or someone else. Its not a problem". His reponse literrally " Man, I totally dropped the ball on that one. It was a really bad call. Thanks for letting me know though". Its not like I am best friends with that guy or anything. We met once at a meeting two years ago for 30 secondas. Anyway, the next week he sent me two patients. I feel that with my OD colleagues I can't be that open or honest and I have to sugarcoat something like that with a "Hey basal cell can be really tough to diagnose" or "It could go either way in that situation..no one would fault you for that". If I hit an OD doc with what I said to the ophthalmologist they would either get defensive or say nothing and never ever send me a patient. What is the best approach in that situation?

The problem here is multi-fold

First...you may not know "Mike" all that well but you are in the same fraternity. You're probably used to speaking to other MDs like that and probably being spoken to by other MDs like that.

With ODs, we're not used to that and we don't talk to each other like that. We tend to not give each other s*it, even if we deserve it.

Secondly, because of the difference in degrees, there is a real risk of coming off as paternalistic which most ODs won't respond to well at all. It doesn't happen with other MDs because you all have the same degree.

As to a solution to it, I'll think it over but probably what you've already said is going to be the best one...."hey....it's a tough diagnosis."

 

[thiaeyemd]

thanks for the quick response..you probably are right.