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You Know It’s Time To Change Doctors When…

Have you ever thought you need to find a new doctor? Sometimes patients and doctors need to part their ways.  Some doctor-patient relationships are so good that gifts are exchanged.  Some are so bad that the doctor dismisses the patient from their clinic.

What about the patient who isn’t happy with the care they are receiving?  What about the patient who wants to find a new doctor?  Sometimes legitimate reasons exist.  Perhaps the patient and doctor do not agree on the recommended therapies.  When  the patient and doctor do not have the same goals in mind, sometimes it’s best for the patient to find a new doctor that can better work with their needs. Read more »

*This blog post was originally published at The Happy Hospitalist Blog*

Warning: Hippos Can Really Run Fast … Take Your Medicine

About a year ago I made a house call to an elderly widow which has left a lasting impact on me.

Our “trusting relationship” began twelve years earlier while I attended to her dying husband at home. She couldn’t find another doctor to come in to help.  Now it was her turn to need help, and like her husband insisted that she stay at home.  The woman was being cared for by her middle-aged granddaughter who remained her daily companion.

Both granddaughter and grandmother distrusted the health care industry and had formed many conspiracy theories. They believed in the power of healing through “the Lord” and natural remedies, especially vitamins. I admired their fierce independence while holding my tongue on the magical and, in my opinion, misinformed views of the science of medicine. Both tried, in vain, to convince me that I should use the vitamins and other products they endorsed for my patients.  I smiled obligingly, yet made no move to implement these ideas while pondering the paradox and danger of being invited into the “trusting circle” of such divergent world views. Read more »

Doctor Versus Drug Seeker: Doctor Wins

My genius partner, RKM, was lately confronted by a patient seeking pain medication.  Due to a very nice system instituted by the state of SC, providers can search for their patients’ prescription histories.  Turns out this individual had received multiple narcotic prescriptions from multiple providers all over the state, and had done it using at least three separate addresses.

Ever the resourceful doc, my partner confronted this patient with the following information:

‘Sir, it appears that you have been the victim of identity theft!  Fortunately, we were able to discover that someone has used your information to obtain narcotics under false pretense!  But rest assured, we have contacted the authorities and we’ll catch the SOB who did this to you!’

He was met, I am told, by wide-eyed, open-mouthed silence.

No prescriptions were dispensed.  Though it is entirely possible the patient will be needing a big bottle of Jim Beam for his nerves, and adult diapers for irritable bowel, for the next several weeks.

Bless you, RKM, for the theatrical, perfectly passive-aggressive genius you are!

Edwin

*This blog post was originally published at edwinleap.com*

A Sure Sign Of Diabetes

You know you’re a diabetic when …

Diabetes MacAttack!

… a few blood stains on the computer power button are almost expected.

*This blog post was originally published at Six Until Me.*

Insurance Rules And Overprescribing Expensive Drugs

I have yet another example of how third party insurance rules obstruct efficient patient care. I was asked to see a patient with fibromyalgia who was asking about about the drug Lyrica she heard about on television (one example of how direct to consumer marketing increases health care expenses).  Lyrica is about the only medication approved by the FDA to treat fibromyalgia.  I don’t know if it really works or if it’s just an expensive placebo effect.

Maybe fibromyalgia is all in the head, and that’s why this medication works.  I don’t really care.  I know it’s FDA approved, which means it has more going for it than most pharmaceuticals used for off label purposes.  At least doctors who prescribe Lyrica for fibromyalgia aren’t going to get charged with homicide for prescribing medications for unapproved reasons. Read more »

*This blog post was originally published at The Happy Hospitalist Blog*

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