teddy bear sign

[tmvguy03]

If you were seeking opioids, don't you think you'd at least leave your teddy bear at home?...

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[lonelobo]

What else is the emotional support dog going to chew on then?

 

[tmvguy03]

What else is the emotional support dog going to chew on then?

She actually had a chihuahua in the room too!

 

[geauxg8rs]

What’s worse are the 30-40 year old
Men who show up with their mom. And when i ask if they are allergic to anything they have to ask their mom. So sad

 

[drusso]

What’s worse are the 30-40 year old
Men who show up with their mom. And when i ask if they are allergic to anything they have to ask their mom. So sad

I had one the other day who demanded that his mom rub his feet during a procedure...awkward.

 

[unchockey21]

I had one the other day who demanded that his mom rub his feet during a procedure...awkward.

Well don’t keep us waiting. Did you let her in the procedure room to do it? If so, was it better procedural sedation than Valium?

 

[lobelsteve]

New rules for 2018: Patient only in exam room for new patients.
New rules for 2019: No family in procedure suite.

For teddy bear girl: My nurse would have made her leave before I got to the room if she got past my screening process.
As the erosion of medicine continues, I cannot waste time on those I cannot help.

Question: Why would you let yourself be part of the psychiatric theater? If our treatment is optional (and it is), why put up with nonsense?
If I saw this person in public, I would be laughing (empathic on the inside?), and moving in the other direction. Mental health and counseling for her. Nothing for me to do.

 

[SSdoc33]

how about a rule that says you can only have 3 backpacks and 4 coffees at once, and you are not allowed to distribute your belongings in my exam room like you are moving in.

i just had a patient file a complaint because i wouldnt let her service yorkie into the procedure suite. the dog, btw, was wearing diapers because it was "too hard" for her to take it out to pee.

you cant make this stuff up

 

[DOctorJay]

New rules for 2018: Patient only in exam room for new patients.
New rules for 2019: No family in procedure suite.

For teddy bear girl: My nurse would have made her leave before I got to the room if she got past my screening process.
As the erosion of medicine continues, I cannot waste time on those I cannot help.

Question: Why would you let yourself be part of the psychiatric theater? If our treatment is optional (and it is), why put up with nonsense?
If I saw this person in public, I would be laughing (empathic on the inside?), and moving in the other direction. Mental health and counseling for her. Nothing for me to do.

as we have been swallowed up by orthopedics and central scheduling has been initiated our intake process has devolved. would you mind detailing your process?

 

[drusso]

Well don’t keep us waiting. Did you let her in the procedure room to do it? If so, was it better procedural sedation than Valium?

Of course. Just warned her about radiation and slapped some lead on her.

 

[lobelsteve]

as we have been swallowed up by orthopedics and central scheduling has been initiated our intake process has devolved. would you mind detailing your process?

Referral received and reviewed by me. PDMP printed ahead of this. If nothing I can fix or if I do not like the look of medlist, comorbidities, or prior providers, I tell them no or no to med mgmt.

 

[DOctorJay]

Referral received and reviewed by me. PDMP printed ahead of this. If nothing I can fix or if I do not like the look of medlist, comorbidities, or prior providers, I tell them no or no to med mgmt.

thanks Steve!
do you do this for ALL referrals? we have selected out self referrals (don't get me started) and anyone transferring from another pain physician only at this point for similar review.

 

[drusso]

Referral received and reviewed by me. PDMP printed ahead of this. If nothing I can fix or if I do not like the look of medlist, comorbidities, or prior providers, I tell them no or no to med mgmt.

In cases where its unclear what the "ask" is, concerns about sub-clinical addiction or psychiatric issues, or if there are markers for social determinants of health that would negatively impact adherence and follow through with clinic recommendations we triage them to the MSW for a biopsychosocial assessment.

In terms of preventing MD burn-out and reducing medico-legal risk it is important to screen out and deny those patients ASAP.

 

[lobelsteve]

thanks Steve!
do you do this for ALL referrals? we have selected out self referrals (don't get me started) and anyone transferring from another pain physician only at this point for similar review.

The only ones that can slip by are internal referrals. But the docs usually let me know about the patient ahead of time. We then see them once for assessment and if not someone I can help, they do not come back.

 

[emd123]

If you were seeking opioids, don't you think you'd at least leave your teddy bear at home?...

Oh, that's the worst!
Close cousin to the pajama sign.
Eeek!

 

[hyperalgesia]

how about a rule that says you can only have 3 backpacks and 4 coffees at once, and you are not allowed to distribute your belongings in my exam room like you are moving in.

i just had a patient file a complaint because i wouldnt let her service yorkie into the procedure suite. the dog, btw, was wearing diapers because it was "too hard" for her to take it out to pee.

you cant make this stuff up

Holy fk

Calling Dr House...

 

[tmvguy03]

Oh, that's the worst!
Close cousin to the pajama sign.
Eeek!

Agreed- actually she had the trifecta: Teddy bear, pajamas, service dog...
I think they threw in the purple highlights for free with her service dog.

 

[SommeRiver]

how about a rule that says you can only have 3 backpacks and 4 coffees at once, and you are not allowed to distribute your belongings in my exam room like you are moving in.

i just had a patient file a complaint because i wouldnt let her service yorkie into the procedure suite. the dog, btw, was wearing diapers because it was "too hard" for her to take it out to pee.

you cant make this stuff up

HAAAAAAA!

I walk into a room and there are folders from doctor visits 8 yrs ago spread everywhere and that pt gets a note in the chart that is PRISTINE. Also unlikely I will make a recommendation other than PT.

 

[hyperalgesia]

HAAAAAAA!

I walk into a room and there are folders from doctor visits 8 yrs ago spread everywhere and that pt gets a note in the chart that is PRISTINE. Also unlikely I will make a recommendation other than PT.

And they are like, "you didn't even read me records!" Grrrr...

 

[SommeRiver]

And they are like, "you didn't even read me records!" Grrrr...

...nooooo, but I read the writing on the wall which told more than those notes would.