February 24th, 2010 by Happy Hospitalist in Better Health Network, Opinion, True Stories
Tags: Chronic Disease, Fear Of Death, Internal Medicine, Medications, Motivation, Non-compliance
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As a hospitalist I sometimes come across patients who, for what ever reason, refuse to take the medications prescribed by their in-patient doctors. Some patients refuse out of fear. Some doctor told them years ago that taking medication X would make them worse. Some patients refuse out of ignorance of their disease process. Most of the time however, they just don’t understand why the medication is necessary. Some patients just refuse out of stubbornness. And some patients refuse because they have a really good reason.
However, when you’re dealing with critical illness and the only thing that’s going to save your patient’s life is a treatment plan they are refusing, sometimes you have to be in their face with reality. So how do I handle situations with patients who have the capacity to make poor medical decisions but refuse life saving medications? How do I convince my hospitalized patients to take their medications I’ve prescribed? Read more »
*This blog post was originally published at Happy Hospitalist*
February 23rd, 2010 by Shadowfax in Better Health Network, Opinion, True Stories
Tags: Back Pain, Drug Seekers, ED, Emergency Medicine, ER, Migraine, Narcotics, Oxycontin, Pain Management
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The first seven patients I saw today were in the ED for:
- Dental Pain (ongoing for three years)
- Back Pain (third visit in one month, 18 in 2006)
- Migraine Headache (six visits in a month, and second ED visit in 18 hours)
- Back Pain (this one was legit)
- Chronic Recurrent Abdominal Pain (ran out of Oxycontin and doctor “out of town”)
- “Cyclic Vomiting Syndrome” (in which only narcotics stop the vomiting)
- Oxycontin withdrawal
Sometimes I wonder why I bother. I occasionally wish my job demanded something more than a valid DEA license, and decision-making skills beyond “yes narcs” and “no narcs.” It just drains the carpe right out of your diem to start the day off in a series of ugly little dogfights over drugs with people whom, to put it charitably, you have concerns about the validity of their reported pain. Read more »
*This blog post was originally published at Movin' Meat*
February 21st, 2010 by KerriSparling in Better Health Network, Humor, True Stories
Tags: Billing, Coding Error, Diabetes, Endocrinology, ePatient, Exasperation, Health Coverage, Health Insurance, Patient
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Yesterday, the mail arrived. There were catalogs for clothes (mmmm, can’t wait until May!), letters from friends, the crappy bills that keep arriving even though we didn’t forward them to our new address, and oh yeah, that one bill from my mail order pharmacy.
For a thousand dollars.
Dated January 30, 2009.
So, being the rational and patient woman that I always am, I ripped up the envelope it came in, cursing under my breath like my temperamental buddy, Yosemite Sam. Punctuated each tear of the paper with “fricka-frakin’ insurance bill dagnabit …”
And then I called the mail order pharmacy company.
“Thank you for calling Byram Health Care. Your call is important to us.” Read more »
*This blog post was originally published at Six Until Me.*
February 21st, 2010 by GruntDoc in Better Health Network, Opinion, True Stories
Tags: button, Emergency Medicine, Emotions, Game Face, Handling Sadness, Psychiatry, Psychology
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I’m going to make a button to wear at work. t’ll say “I’m really only a dick at work”.
I’ve written before about my ‘game face‘ and how it’s not me, not really. It’s a Business Me, and it’s how I get through life at work.
(Is that a cop-out? Do I do it because it makes me more efficient, a better doctor, smoother, faster, or do I do it because it builds a bit of a wall between me and my real self and lets me get through the day without getting emotionally attached to every patient and their family?) Read more »
*This blog post was originally published at GruntDoc*
February 21st, 2010 by Happy Hospitalist in Better Health Network, Humor, True Stories
Tags: Crickets, Critical Care, Doctor Humor, ICU, Internal Medicine, Physician Humor
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It’s 2:00 am in the emergency room. That’s when the real doctor humor stories comes out to play. By now I’ve sent two patients home from the ER, one of which I spent 90 minutes discussing why chronic abdominal pain management needed to involve an outpatient supratentorial component and why coming into the hospital would be a highly disappointing experience. By now I’ve also admitted two patients to observation status, one of which is a guy with uncontrolled diabetes who remembered me from a year prior and thanked me for telling him nobody else was going to live his life for him and he needed to take responsibility for his poor actions in life. By now I’ve also brought two patients in for full hospital admission, one of which was placed immediately on end of life cares for end stage COPD, the other of which who’s son got the wrath of my smoking lecture.
Once the work was done, the doctor humor came out to play. Read more »
*This blog post was originally published at Happy Hospitalist*
