You may not be surprised to learn that I spend considerable time meeting folks, and some of those folks do not bowl me over with the force of their intellect.
Occasionally, somebody who does not otherwise impress me as being particularly dull witted, appears to decide that The Reveal is needful, NOW!, and therefore proceeds to impress me that they are, in fact, an idiot.
So, TINS, TIWFDASL, and I was interviewing some soul about his particular malady. As is my usual practice, I inquired about what symptoms had precipitated today’s office visit, duration of symptoms, what had been done prior to visiting me to address the symptoms, simply as a beginning.
So, this soul related that his symptoms had been treated on a couple of previous occasions, in the past month, and had transiently improved, and then returned. He had, so he told me, been treated with “an antibiotic”.
He did not know. “The antibiotic that they prescribed for me.” (as helpful as THAT is….)
“How long did the doctor have you taking that antibiotic?”
“Until it ran out.” (Certainly. Of course.)
I attempted to discern how long it had taken before the antibiotic had run out, since treating Malady “A” might call for a 5 day run of The Z Pak (boo! Hiss!), whereas Malady “B” might be addressed by 28 days of Doxycycline, for example. Ya know, just as if I cared what had elicited this gentleman’s symptoms, with an eye toward, oh, gosh, I don’t know, maybe TREATING HIM EFFECTIVELY, or something.
At this point, he felt it relevant to review some of the high points of his resume. For some reason.
“I’m college educated! I’m not an idiot!” (uh, sir? First, college educated maps poorly onto “not an idiot”. Not a very high correlation. Secondly, in circumstances where you wonder if it might be appropriate to reassure somebody that you are NOT an idiot, it is very likely that you are about to reinforce the impression, that you ARE an idiot. That certainly has been my experience in my own life, you may want to consider if there might be some parallels in your own.)
I somehow got back on track, and began my review of systems. At this point, he revealed that, in his estimation, “You are being dismissive of my concerns!”
HUH? Inquiries about your allergies, medications, and medical history are not “my attitude”. That’s how I attempt to avoid prescribing something to you that you either are allergic to (and you did not mention to my nurse….), or that might interact malignantly with your regular medications. For example, I dislike eliciting a GI bleed (stomach bleed: think bleeding ulcer) simply because you did not think that it was relevant that you take coumadin (a blood thinner), now that you are here for your orthopedic injury. Should I prescribe ibuprofen (popularly known as Motrin), that in combination with your coumadin might lead to a life threatening GI bleed, and I feel that to be a bad thing. Occasionally, that review of systems elicits something kind of important, like chest pain or difficulty breathing, that you forgot to mention, because your ankle pain is the only thing that (for some reason) you are concerned about.
But you are paying me to be concerned about that other, life threatening, stuff, and have the wit to not miss it.
3 thoughts on “The Reveal!”
You left out kidney failure from NSAID’s. And liver damage. But asking about Goody’s Powders is an aggravation and will lead to a bad rating.
Do what he wants and all will be well. It’s why you spent 9-10 years in training, right?
PS. Epic was sent by Satan to destroy human interaction.
Sort of. EMRs in general equally qualify. Fortunately, at this stage, I have several “templates”, in my mind, that I can run through. And, equally fortunately, can recall along with the findings. For several minutes.
But, yeah, I have seen younger colleagues carry their computers into the room with them. Makes me wonder what that interview looks like.
Joey: Epic is THE major employer hereabouts. Ya might wanna keep that Satan comment to yourself if you’re in town. 🙂
Reltney: The interview looks like a patient talking with someone playing a video game, I suspect. My doc does a good job of actually looking at me when I answer and then typing. I appreciate that it makes it clear she is actually listening.