Physician Exasperation From Around The Blogosphere
Some bloggers’ clinical vignettes speak volumes about why doctors are exasperated with their day-to-day work lives. Here are a few good ones:
From White Coat Rants:
A patient from a nursing home was transferred by ambulance to our ED with the following chief complaint:
Mental status changes not responsive to albuterol [an asthma puffer].
Of course now we’re stuck trying to figure out how much this patient’s mental status has actually changed. I never could figure out how in the heck nursing homes can determine that an essentially non-verbal patient is having a mental status change. She sat in the bed, watched me walk around the room and smiled. So was she blinking less, or what?
I was waiting patiently on the next ambulance run for a patient with nasal congestion unresponsive to Ex-Lax.
From Ten out of Ten‘s Medical Jeopardy:
Answer: Massive Diarrhea
Question: What is the end result of eating nothing but beans and peaches all day?
People are so weird.
From Musings of a Dinosaur’s Anything Else?:
The perils of the open-ended question in a new patient interview:
Me: Tell me about your health.
Patient: I have hypertension and a little arthritis in my knees.
M: Anything else?
P: No, that’s all.
M: What medications do you take?
[presenting bag full of bottles, we find:]
Cozaar
Hydrodiuril
Lipitor
Zoloft
Ativan
Ultram
Celebrex
M: Why do you take the Zoloft and Ativan?
P: Oh, the Zoloft is for anxiety and the Ativan helps me sleep.
M: Anything else?
P: No, that’s all.
M: What about this Lipitor?
P: Oh, I stopped that about three years ago. It’s just for people who eat a lot of fat in their diet. I don’t think I need it.
M: Ok. When did you last have blood work done?
P: About four years ago.
M: And when did you last see a doctor?
P: About four years ago.
M: Any other medical problems?
P: No, that’s all.
M: Are you allergic to any medicines?
P: I get a rash with penicillin, and oh yeah! I have this weird rash that comes and goes. I’ve seen all the specialists downtown and no one knows what it is.
M: Anything else?
P: No, that’s all.
M: Anything run in the family?
P: My brother had a heart attack when he was 42, and oh yeah! I have a 30% blockage.
M: When did you find this out?
P: About four years ago.
M: Anything else?
P: No, that’s all.
M: Do you need any of these meds refilled?
P: Just the Celebrex.
M: Most of these other bottles also say “no refill” on them.
P: Oh, I have more at home. I just dumped them out and brought the bottles.
M: How much more do you have at home?
P: About two weeks.
M: How about if I write refills for all of them.
P: Ok.
M: Anything else?
P: No, that’s all.
M: Can I do some blood work on you today?
P: Sure. Oh, and I see a cardiologist, rheumatologist and orthopedist too. Can you send copies to them?
M: No problem.
Anything else?
P: No, that’s all.
M: Are you sure?
P: Yes.
Do you know why dinosaurs have no hair? It’s because I pulled it all out this morning.
We really do need a common, interoperable medical record system.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
I’m not sure I’ve seen a better example of why personal health records will fail to protect patients than that exemplified by Dino’s writing. EMR maybe, but a PHR, unfortunately, will never suffice.