Random Acts of “It’s not my job”

There are lots of days when I do things in my office that are really not my job.  I’m sure other doctors do the same thing.

I have a long time patient that I see quite frequently.  I have been trying to convince her that blood sugars “around 300” are not normal.  I had her do a urine test recently that was positive for alcohol!  I freaked out, until the lab asked me “Is the patient diabetic?”  It seems that sugar in the urine will turn to alcohol and make that positive.

I convinced her we needed to check her HgbA1C last visit.  This is a test of how much sugar is stuck to your red blood cells.  The real name for it is glycosolated hemoglobin or hemoglobin A1C.  Hers was almost twice the upper limit of normal.

So today, I, the gynecologist, spent almost two hours with this nice woman.  I first explained why she needed to get her sugar under control.  I want her to live for a while longer.  Then we went over what medications she used to take, and I wrote prescriptions. 

Then my patient said she was having problems with her breathing.  She has chronic bronchitis with an allergic component.   She hasn’t been able to see the “clinic” about this, either.  We went through all the different medications for this, looking up prices at the same time.  You see, she also has no insurance.  Since these are medications I don’t use all the time, I have no idea what they cost.  I was enlightened, to say the least.

Mrs. Train Wreck said that her previous “clinic provider” had told her that she could stop all her diabetes medications since her blood sugar was normal.  I’m not sure who made the mistake – the patient or “the provider”.  Since she sees a different person every time at her “clinic”, never has a scheduled appointment, never gets any continuity of care and nobody explains anything to her, it is entirely possible that someone did say something along those lines.

Remember, though, the “clinic” care is free.