Things I hate to hear patients say:

[GeneralVeers]

My cousin is a [not an EM] doctor in [insert state], can you explain everything to him/her so they can make sure you didn't miss anything?

*tries to hand me their cell phone

I refuse the phone on these people. I tell them we will do all of the tests and get some information. At that time if they still want me to talk to random doctor relative I will.

---

Members don't see this ad.

 

[turkeyjerky]

I refuse the phone on these people. I tell them we will do all of the tests and get some information. At that time if they still want me to talk to random doctor relative I will.

Sometimes you get valuable collateral information though. I recall one case where the patients daughter, who was present, swore up and down that she'd never had any respiratory problems before--thus entailing a large work up for her hypoxia, but her doctor son told me that she had 'end stage copd'

 

[smq123]

Sometimes you get valuable collateral information though. I recall one case where the patients daughter, who was present, swore up and down that she'd never had any respiratory problems before--thus entailing a large work up for her hypoxia, but her doctor son told me that she had 'end stage copd'

Once, I talked to a patient's cousin on the phone. He got the diagnosis right, just by listening to my history on the phone, when our specialists had been stumped for over a week. So sometimes it does work out.

 

[Apollyon]

Once, I talked to a patient's cousin on the phone. He got the diagnosis right, just by listening to my history on the phone, when our specialists had been stumped for over a week. So sometimes it does work out.

Yeah, "once". I NEVER talk on the phone to whomever, because, as I tell them, I don't know who is on the other end. Then again, you're FM, and we're EM.

 

[NITRAS]

Yeah, "once". I NEVER talk on the phone to whomever, because, as I tell them, I don't know who is on the other end. Then again, you're FM, and we're EM.

I feel like saying something smart alek about EM, but I'm too tired.

My experience with the "doctor relative" is about 50/50. If they work in a hospital setting (EM, hospitalist ect) they usually are pretty helpful. If they are largely clinic based, they usually asked for unnecessary consultations.

 

[smq123]

Yeah, "once". I NEVER talk on the phone to whomever, because, as I tell them, I don't know who is on the other end. Then again, you're FM, and we're EM.

True, that's fair enough.

 

[Apollyon]

True, that's fair enough.

The guy who responded to me, I don't get his point about making a dig at EM. I wasn't insulting FM. My point is, y'all have more continuity. By the very fact that your pts come back as scheduled, that establishes some trust.

 

[oneiroi]

Ready for discharge.

"What about my [new, potentially serious chief complaint I never mentioned]?"

 

[RustedFox]

The guy who responded to me, I don't get his point about making a dig at EM. I wasn't insulting FM. My point is, y'all have more continuity. By the very fact that your pts come back as scheduled, that establishes some trust.

And they have this nice little thing called "private practice", where if the patient is noncompliant/abusive/etc, then... its "bye bye".

 

[southerndoc]

Ready for discharge.

"What about my [new, potentially serious chief complaint I never mentioned]?"

I didn't hear them say anything.

 

[GeneralVeers]

I didn't hear them say anything.

I don't write down the new complaint. I basically just tell them that it's something they need to have their family doctor checked. Honestly if it's not serious enough that they mention it when they come to the ED, it's not that important.

 

[deleted859535]

I don't write down the new complaint. I basically just tell them that it's something they need to have their family doctor checked. Honestly if it's not serious enough that they mention it when they come to the ED, it's not that important.

This is increasingly what I do as well.

 

[WilcoWorld]

"I need yall to pop my arm again"
(pt has baseball sized abscess at IVDA site)

...aaannnnnnnnd I chose a different specialty.

Please add this to a new thread "Things I love to hear my patients say."

I love abscesses almost as much as I love honesty.

 

[smq123]

"Oh, I see a specialist for my <insert medical condition>"
Ok, great. What's his/her name?
"I have no idea. I think it starts with an S...?"
Well, then, where's their office located?
"I have no idea. It's next to a Panera, I think."

WTF. Do kidnappers blindfold you and throw you in the trunk of a car to bring you to your appointment? And you literally have no idea what your doctor's name is?!

<sigh>

 

[Redrox]

"Oh, I see a specialist for my <insert medical condition>"
Ok, great. What's his/her name?
"I have no idea. I think it starts with an S...?"
Well, then, where's their office located?
"I have no idea. It's next to a Panera, I think."

WTF. Do kidnappers blindfold you and throw you in the trunk of a car to bring you to your appointment? And you literally have no idea what your doctor's name is?!

<sigh>

I'll go one further than you on this. Had someone just this week "they told me I have a condition and it's going to kill me soon. Can't remember if it was in my lungs, liver, gut or somewhere else"


Edit:
Also, should mention it drives me nutso in general when patients start a sentence with "they said I have. . .."

Who is "they" ?

Your friends, coworkers, primary care doctor, receptionist at your PCP office, 2am on call nurse help line, oncologist, or voices in your head ?

'cause it makes a big difference

 

[oneiroi]

I didn't hear them say anything.

You have to make sure the RN didn't hear it either

 

[bravotwozero]

"Oh, I see a specialist for my <insert medical condition>"
Ok, great. What's his/her name?
"I have no idea. I think it starts with an S...?"
Well, then, where's their office located?
"I have no idea. It's next to a Panera, I think."

WTF. Do kidnappers blindfold you and throw you in the trunk of a car to bring you to your appointment? And you literally have no idea what your doctor's name is?!

<sigh>

I find it especially irritating when you're one dialysis and you don't know your nephrologist's name. I mean you're there 3 days per week! You should have some clue about who is managing your dialysis orders...

 

[AlmostAnMD]

I used to wonder about that, since the stereotype about dialysis patients not knowing their nephrologist seems to be very true in my area.

Then I realized it was a series of very bad and terrible decisions that ~led~ them to be ~on~ dialysis in the first place, this probably isn't the population to ever take note of these things.

 

[theseeker4]

I used to wonder about that, since the stereotype about dialysis patients not knowing their nephrologist seems to be very true in my area.

Then I realized it was a series of very bad and terrible decisions that ~led~ them to be ~on~ dialysis in the first place, this probably isn't the population to ever take note of these things.

Yeah, if they cared enough to keep track of who their doctors are, when and where they get dialysis, what meds they are supposed to be taking, what their other medical problems are, etc. then in most cases, they wouldn't be on HD in the first place.

 

[Redrox]

I find it especially irritating when you're one dialysis and you don't know your nephrologist's name. I mean you're there 3 days per week! You should have some clue about who is managing your dialysis orders...

This one I kinda get, they have like ten docs in the local nephro group and in clinic it's a toss up who'll see, also the names in medicine can be long and confusing.

 

[Fox800]

"I had 34 super-specialized surgeries done on my *insert organ* at the university medical center. My nephrologist, rheumatologist, pulmonologist, LOLologist are all there. Can't you just look up their records?"

After showing up to a hospital that they've never been to before, at 03:00. When asked why they didn't go to their typical hospital: "I don't know."

 

[CoolWhipp]

omg the tylenol cured my crushing chest pain. you cured me. can I have a work letter?

 

[Petypet]

omg the tylenol cured my crushing chest pain. you cured me. can I have a work letter?

sure you can go back to work now

 

[RustedFox]

sure you can go back to work now

This drives me nuts, too.
I get giving a patient a "work note" if they're the patient, but this practice is abused by 3+ family members all too often.

"I brought her here, and I don't want to work tomorrow.... Can I have a work note, too?"

"No, dude. You can work. You're not the patient."

 

[GonnaBeADoc2222]

Work notes don't bother me so much as my nurses do them and require zero effort from me.

Requests for tylenol/motrin scripts annoy the s*** out of me, especially when they are made while patient is typing away on iPhone X.

 

[AsianPersuasion]

Was dealing with a patient who had a facial lac from a fight. His face was draped over and the plastic resident was working on him.
Him: Hey, you're pretty adorable. Is it true what they say about Asians? You know, like, tight...?
Me: This is completely inappropriate and irrelevant to the situation that we are in.
Him: wow, you f**king b**ch!

I give you guys so much prop for choosing this specialty. On a scale of 1 to even, I literally can't.

 

[Dares Dareson]

Was dealing with a patient who had a facial lac from a fight. His face was draped over and the plastic resident was working on him.
Him: Hey, you're pretty adorable. Is it true what they say about Asians? You know, like, tight...?
Me: This is completely inappropriate and irrelevant to the situation that we are in.
Him: wow, you f**king b**ch!

I give you guys so much prop for choosing this specialty. On a scale of 1 to even, I literally can't.

I would have a real difficult time remaining polite if I heard that. But I guess there's really nothing you can do, right?

 

[BoardingDoc]

I would have a real difficult time remaining polite if I heard that. But I guess there's really nothing you can do, right?

You stop doing the repair and he is discharged from the ED. He is free to go somewhere else or let it heal by secondary intention.

 

[bravotwozero]

You stop doing the repair and he is discharged from the ED. He is free to go somewhere else or let it heal by secondary intention.

Totally doable as an attending, maybe more difficult as a resident...


Sent from my iPhone using Tapatalk

 

[RustedFox]

The ER is the single most abused place in all of healthcare.
It is a wretched pit of scum and villainy.

I actually said this to my med.exec committee recently in the appropriate setting. The reason for discussion had nothing to do with it; but the amalgamation of non-ER docs looked at me in silence. I wrecked their world. They need it.

 

[deleted859535]

The ER is the single most abused place in all of healthcare.
It is a wretched pit of scum and villainy.

I actually said this to my med.exec committee recently in the appropriate setting. The reason for discussion had nothing to do with it; but the amalgamation of non-ER docs looked at me in silence. I wrecked their world. They need it.

Amen. If I ever end up on such a committee, I'm gonna be "that guy." You know, the one that points things out a little... brusquely sometimes.

 

[migm]

You stop doing the repair and he is discharged from the ED. He is free to go somewhere else or let it heal by secondary intention.

totally agree, but is it defensible if you're the only show in town (ie the critical access hospital I work in with the nearest hospital 1 hr each way).

 

[bravotwozero]

You could also decide, that the patient was not tolerating his sutures very well, and just staple his face...


Sent from my iPhone using Tapatalk

 

[RustedFox]

You could also decide, that the patient was not tolerating his sutures very well, and just staple his face...


Sent from my iPhone using Tapatalk

Psych patients get staples. This way, they can't chew the sutures out. No joke.

 

[EMDOC17]

totally agree, but is it defensible if you're the only show in town (ie the critical access hospital I work in with the nearest hospital 1 hr each way).

I don’t work in a critical access hospital, had the same interaction (but similar), or know the legal aspect of this. Guy swore at me and told me and told me he was “going to kill me” if I didn’t “fix it right” he was also a douche before that. I stopped and discharged him giving him a list of other places he could go. He initially apologized then was escorted out by security after I said I still wouldn’t fix his lac.

We don’t have to take it. And if he sews me and wins so be it. I would discharge and then have a long MDM saying why I don’t feel comfortable for my safety and how I am threatened by the behavior and how I gave them other options even if it is an hour away.

 

[hamstergang]

And if he sews me and wins so be it.

This would be so much more interesting than you intended.

 

[alpinism]

Work notes don't bother me so much as my nurses do them and require zero effort from me.

Requests for tylenol/motrin scripts annoy the s*** out of me, especially when they are made while patient is typing away on iPhone X.

Motrin was my most common script in residency.

Me: Good news looks like you just a pulled muscle all the x rays were negative
Them: So what are you giving me for pain??
Me: You can take some Motrin for the next couple days
Them: But my mom got percoset when she was here last week??
Me: We don't give those medications for muscle strains
Them: Fine then I'll need a Motrin prescription

 

[Dr Mantis Toboggan]

Sounds like that was at an academic hospital. At that point the female surgeon taps out and you find the biggest male resident around to take their place (and who cares if it looks that great when it’s done).

 

[d2305]

Summon the PA for closure. The old one that doesn't tolerate abuse.

 

[WilcoWorld]

Was dealing with a patient who had a facial lac from a fight. His face was draped over and the plastic resident was working on him.
Him: Hey, you're pretty adorable. Is it true what they say about Asians? You know, like, tight...?
Me: This is completely inappropriate and irrelevant to the situation that we are in.
Him: wow, you f**king b**ch!

I give you guys so much prop for choosing this specialty. On a scale of 1 to even, I literally can't.

Hmm, wonder how such a nice person ever got himself into a fight?

 

[theseeker4]

Summon the PA for closure. The old one that doesn't tolerate abuse.

Med student. Preferably the brand new 3rd year who wants to go into radiology.

 

[Perrin]

Pt or family member: "I'm not telling you how to do your job, but..."

Proceeds to tell me how to do my job.

 

[GeneralVeers]

"Every other time I come the doctors give me dilaudid....."

 

[dadaddadaBATMAN]

You stop doing the repair and he is discharged from the ED. He is free to go somewhere else or let it heal by secondary intention.

as someone who got stuck suturing a drunk guy who was fortunately hep/hiv negative I now have many hard stops on lac repairs.

I hate them in the first place because they take me away from the department, if you're not going to be a model patient my threshold to walk is almost nil. Peds is the exception.

 

[southerndoc]

"Every other time I come the doctors give me dilaudid....."

Since the opiate shortage, we never restocked it in our ED. I can now look at them and say "I'm sorry, due to the recent opiate shortage, we no longer have it in stock in our ER."

 

[GonnaBeADoc2222]

as someone who got stuck suturing a drunk guy who was fortunately hep/hiv negative I now have many hard stops on lac repairs.

I hate them in the first place because they take me away from the department, if you're not going to be a model patient my threshold to walk is almost nil. Peds is the exception.

Exactly this. I'm not going anywhere near (nor would I let a trainee) anyone that is intoxicated and belligerent with a sharp instrument to do a procedure that requires focus, dexterity and involves significant risk of exposure (aka every procedure we do). I remember the time as a senior resident, one of my "model" attendings basically was forcing a med student to do a lac repair on such a patient. I looked at them with disgust and did the procedure myself...luckily I wasn't stuck. Last time I ever do that.

 

[RustedFox]

Patient: "Do you think if I went gluten-free that we could have avoided this?"

Me: "Madam; you have appendicitis. No."

 

[gutonc]

Patient: "Do you think if I went gluten-free that we could have avoided this?"

Me: "Madam; you have appendicitis. No."

But essential oils probably would have helped.

 

[Perrin]

“What do you mean I’m being discharged?”

Followed by one of these statements.

“My family doctor told me to come here and get admitted!”

Or

“You’re going to just send me home with chest pain, SOB, HA, [symptoms they denied or never mentioned initially]”

 

[AlmostAnMD]

I had a septic patient refuse antibiotics until we find out if there's gluten in it

I completely ignored the request for obvious reasons

but then the nurse starts freaking out and gets upset because she might be giving gluten to a gluten-allergic patient

out of overwhelming boredom I ask the pharmacist if it has gluten in it

apparently it did, and so does a few other antibiotics we carry

I don't remember which antibiotics it was because I still don't care, but apparently gluten-free antibiotics is a thing