Annoyed by long wait-times at the clinic?

[Aristus]

Me too!

I can't help noticing, however, that the patients who complain the loudest are also usually the ones who insist on giving me the James Michener-version of their History of Present Illness.

Just give me the bullet-points. I don't need to know the color of your first car, or who your next-door neighbor's cousin married.

Believe me, I'd love to slow down and have a friendly chat. It's just not possible. Not when there are other exam rooms full of patients checking their watches and tapping their feet impatiently.

Clinic starts in twelve minutes...

Have a good day, everybody!

[In_The_Wind]

1. No. It's become part of life ... hurry up and wait.

Just so you know ... he arrived for his appointment 15 minutes early (as usual ).

[Aristus]

2. Hey!

[In_The_Wind]

3. Hey yourownfineself. How are things in the 100 acre woods?

[Aristus]

4. Ha!

I'll be careful not to sneeze, then...

[magical thyme]

5. I had one of our regulars wanting to know why I'm not married

that was after he wanted to know where I live, and then am I married to so and so in that village, because everybody knows everybody for villages around. I'm the transplant, so I get grilled.

So anway I said, "I already have 2 dogs, a cat, 3 birds and a horse, what do I need a husband for?"

The doctor looked up from the fluid he was draining from the guy's gut and quietly said, "That's great!"

I've had a secret crush on that doctor for 3 years. More than anybody I've ever met in my life, he simply embodies empathy.

Of course, my crush dissipated somewhat when the peritoneal fluid showed up an hour later in the lab for a cell count and diff, because it was a weekend and I was running the whole lab alone for the next 2 hours. Luckily there wasn't a white cell to be found, so the diff was not an option. Even better, only the memory of the empathy remained, so he's back at the top of my list for now.

[Aristus]

6. Whew!

What is it with some people? My patients never ask personal questions. Or is it because I'm male? Do people think it's more acceptable to ask questions like these of a woman?

[magical thyme]

7. it's the first time I've had a patient ask personal questions

and while it didn't horribly upset me in the moment, it did afterwards when it had a chance to sink in, because this is the hospital where I was stalked by a brain-damaged, alcoholic janitor for a year.

And yes, I think it is because I am a woman, and a transplant, in a rural area where the locals all know each other.

At the moment I'm upset because I was making a gram stain last week and a doctor came in with a spec he wanted to check for crystals and then leave for a gram stain. So he was babbling on about inanities (much like your patients) while I'm trying to do my work.

And then he switched to babbling about the spec and suddenly starts poking me in the back, saying, "This is the spot I got the specimen from. Right about here" while digging his finger into my back!!!!

While I'm standing over the sink trying to decolorize a gram stain!!!!!!

I guarantee he would NEVER have done that to a man.

[Aristus]

9. I agree.

That was exceptionally unprofessional of him. Two no-nos combined in one. First: touching you without your permission; two: disrupting an exacting, pains-taking process.

If he does it again, is there anyone to report him to? I worry that, this being a rural, insular area, anyone you complain to would back the doctor instead of you.

[magical thyme]

10. exactly.

"I worry that, this being a rural, insular area, anyone you complain to would back the doctor instead of you."

That's what happened when I complained about the lab assistant who told the janitor that I was going to have coffee with him. She was 25 years with the lab; I was 3 months with the lab and a transplant. I was "punished" by being forced to work 13 hour night shifts with only 2 nights training (no training with the best night tech, who's a man) -- even though I'd told them during my job interview that nights were a problem due to health issues but I thought I could do them in an emergency.

As a result, he stalked me with impunity for nearly a year. I know of 4 lab assistants and techs he approached for information; only 1 answered him appropriately. The others encouraged him! I couldn't go to the bathroom or the cafeteria or anywhere outside the lab without him showing up, following me, getting in my face, yelling across the cafeteria at me, etc. It was so consistent (and creepy ) it was almost as if somebody was was letting him know when I had left the lab. Then it dawned on me that some idiot LA could have been texting him because they would see me walk out the door... Apparently they thought it was "cute" that he had a crush on me.

It peaked the evening I was alone in the lab and had 4 critical chemistries within 1/2 hour: a pre-intubation ABG, a cord blood gas, a critical K, and the post-intubation ABG (which was still critical). Each critical needs to be repeated, the ABGs not only are manual to run but require manual entry into LIS, and of course the criticals all need to be called. The computer is right in the doorway to the chemistry room. Instead of mopping someplace else while I was obviously running and reporting ED tests, 4 times he shoved me into the computer while entering and exiting the room. I had nobody to report it to, and no time anyway.

The next time I came to the lab, he physically blocked me from entering, forcing me into a "conversation." So I told him to "fuck off."

It wasn't until somebody cruised by my house at about 5mph staring at me that I finally was able to get rid of him. Instead of complaining through "channels" (which had worked *so* well the last time), I asked another cleaning person to describe his vehicle and explained why. It wasn't him, but it turned out that *her* job was in jeopardy because they were downsizing and she was already having a hard time keeping up with the workload. So she took the info I gave her back to the right person. He was gone within a couple weeks, and mercifully moved several states away.

Still, I went through *hell* for a year before it was resolved. I don't think it would go my way ever with a doctor.

[pipi_k]

8. I honestly had to laugh

at this...

I can't help noticing, however, that the patients who complain the loudest are also usually the ones who insist on giving me the James Michener-version of their History of Present Illness.

James Michener is one of my favorite authors.

In telling the story of Hawaii, he started back a billion years or so when the earth's crust was forming

[Chan790]

11. Yes, but...

I'd suffer that and most any other indignity for a NP, PA or Physician that actually listened to me. I haven't had a physician in 20 years that actually pays attention and wants to address the issues I can about addressing.

Conversely, they can want to harp on the issues I don't consider issues (like my weight) but that's not going to get me to share those concerns or accept recommendations...I'm happy at this weight and if my physician can't accept that, then I'll find one that can. I like being fat...I lost the weight, looked like shit and regained it on purpose.

[Aristus]

12. I agree. Listening is important.

The point of the OP was that I need to listen to what is relevant to a patient's current situation.

I had a patient yesterday who got caught up in telling me what kind of dog his brother had. I managed to steer him back to the topic every time he started to bunny-trail. But it eats up a lot of clinic time...

[Chan790]

13. Fair enough. n/t

[Phentex]

14. I love my doctors but it was a challenge to find ones

that I felt comfortable with. Now that I'm older, I'm not taking crap from anyone so if they are disinterested, dismissive, pushy (like some dentists) or make me wait forever, that's the last time they see me.

I LOVE my GP. She's no nonsense and frankly she keeps up with my concerns better than I do, lol. She's part of a large practice so I think she has more time for her patients.

I love my gyn and my dentist. I recently saw an orthopedic surgeon and he had a great bedside manner. Same for a new dermatologist.

I know a clinic is a very different situation and you are seeing so many more patients. But with many practices today, you can email your issues ahead of time so that your doctor knows exactly what to expect before you come in.

I think it's perfectly OK for you to tell someone you'd love to keep talking to them but you have other patients to see. It's all in the way you do it.

[Aristus]

15. I'm not ashamed to say I love my patients. (Most of them.)

There are some whom I've been seeing in one capacity or another for nearly ten years now. (I started at the homeless clinic in 2005 when I was still a Medical Assistant). There are a number of my patients whom I consider friends, and I think they reciprocate that feeling.

I'm proud to say that a lot of my new patients, at the end of their first visit, usually say something like: "Wow! You really listen!"

And I do. My goal is to practice good medicine, which requires listening carefully to the patient (as long as they are staying on topic, of course...) My biggest fear is diagnosing and treating the patient incorrectly when a little more question-and-answer would have pointed me in the right direction.

I'm sure there are providers out there who are so confident in their diagnostic acumen that they can afford to ignore what their patients are saying. I don't plan on becoming one of those...