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Insult upon injury?

So I wrote a week or so ago about the patient who called me for a refill of a medication, then when I said she needed to be seen by a doctor she scheduled with a specialist instead of me.  OK, so one way or another she’s taken care of, right?

Nope, she calls in again yesterday for the same medication.  Again I refused it, and offered to see her; when my nurse got ahold of her she said “oh, I have that specialist appointment today”.

I guess she was hoping I’d forget the conversation from a week ago, and would give her the med and she’d be able to skip the specialist appointment. Of note, I’d have seen her within a day or two of the original call.  Instead she’s waited a week – if she truly has this problem she self-diagnosed, she’s been sick for a week now.  Where’s the sense in that?

As long as I’m griping, I’ll mention the patient who was asked to come back in to follow up initial treatment for a rather serious problem.  She skipped the appointment and then called on the phone to “ask a few questions”.  I offered her an immediate appointment; she scheduled the appointment, no-showed again, and called again asking for advice by phone.

Phone medicine is infamous for leading to bad diagnoses and patient harm.  This woman has a serious problem; she needs a professional to help her with that problem.  And, call me crazy, but I think that professional deserves to be paid for delivering that help.



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