It's What I do: I'm a Doctor

I’m sure I could get most of my colleagues in primary care to agree with me that there are many types of patients. Some are basically healthy and some are seriously ill; the others fall somewhere in between. We often divide these patients into further categories: patients we find endearing, ones we wish we could transfer elsewhere, and those that fall in between. I sometimes wish that we could have a network of primary care physicians who could trade patients when the doctor-patient relationship seems to be going south.

Maybe we could just put the patient we wished to dismiss on waivers and another office could accept the challenge and take that patient off our hands without an even trade. Dunno, but I don’t think that will ever happen.

Some patients just create problems when there’s a misunderstanding. A very nice 64-year-old gentleman, who was very thankful after I referred him to a surgeon for removal of his cancerous lung, walked into my practice on July 1 and insisted he had an appointment for refills. He was not scheduled in the computer, nor did it say anywhere in his chart that he had an appointment, but we worked him in. When I entered the room, I greeted him with a bit of sarcasm. “So, you thought you were scheduled today, eh?” He insisted he had today’s appointment card at home and couldn’t imagine how we had screwed up. I looked though his progress note cards stapled in his chart (Remember: I don’t have, and probably never will have, an EHR). Lo and behold, I found a card from a visit in 2009, July 1 to be exact. Somewhat embarrassed, he said he would apologize to my staff on the way out.

Then there was the patient who recently came in insisting that she never would have made an appointment for a Monday, despite what the date indicated on her card. That lasted until my receptionist pointed out that the card was from 2004. Can you put pack rats on the waiver list?

And then there’s this one (with apologies to Joe Friday):

This is the City. Tampa, Florida. I work here. I’m a doctor.

It was Wednesday, June 30. It’s hot as hell outside and there’s gushing oil contaminating the Gulf of Mexico. I was seeing another new patient, one who had decided to leave her previous doctor, but had not been put on waivers.

So you indicated that you take Vitamin D, right, Mrs. Jones?

Yes, I do.

Well, do you know how much?

I take two of them, doctor.

Yes, but do you know the strength, the dosage, how many units are in each?

No, but they come in a bottle.

Yes, ma’am, they do...