Special Requests

It’s Not Just Business When It’s MY Practice

Most offices will try to accommodate your time constraints.  However, you have to remember that office hours are set to work around our lives.  Most doctors and their staff members have other responsibilities.  We schedule around school events, church events, family gatherings, appointments, and other obligations.

Some offices that have lots of doctors set aside certain nights or weekends to see people who work regular hours.  If your doctor is a “solo” doctor, it is a bit more difficult.  I can’t trade off with someone else.  There’s nobody but me.

Some patients make special requests about their appointments.  I sometimes bend the hours for established patients.  I will see patients earlier or later than “standard” hours.  I might see patients without my staff if needed.  I even meet patients at the office on rare occasions.  These are exceptions.  It only works for me because I am in solo practice.  I don’t have an administrator breathing down my neck. 

One of my long time patients called this week.  She is a teacher.  She is dedicated to her students and doesn’t like to take time off from class for appointments.  She requested an appointment time that is later than our regular last appointment.  This particular patient and I get along fine, but she drives Princess a bit crazy.  I think she reminds her of all of her high school teachers. 

Princess didn’t want to give her a late appointment because she has kid stuff to do that day.  I decided that if my kids need the car, they can come get it, and someone can come rescue me from the office at some point.  I’ll just sit here and write something for the blog. 

I don’t do this for new patients.  They don’t always show up.  Then I sit here for nothing.  I also don’t do it for someone who has missed appointments or been late in the office.  If you don’t respect my time, I can’t respect yours.  This patient will be there.

The older I get, the more flexible I get.  Ten years ago, I probably would have fussed about the time, too.  Plus, my kids are pretty independent nowadays.  Mr. Impatient will want to know why Mommy is late, but he can handle it!

Soap Opera - Doctoring in a Small Town

This week we have been dealing with another patient / family “issue”.  Princess got a phone call yesterday from a fellow who demanded to speak to me.  It always amazes the both of us how many people think you can call a doctor’s office and get put through directly to the doctor.  But that’s another post.  Anyway, the caller (TC) wanted to report that the grandson of one of our patient’s (OP) saw her trying to sell her prescription medications.  He stated he was the boy’s father.

Our protocol when we get a report like this is to call the patient.  We have them come to the office with all their pills within 24 hours.  If the count is correct, we don’t get terribly concerned, though we do monitor them more closely.  When Princess finally got through to OP’s mother (PM), PM said that she had been expecting our call. 

The family was “in court for nine hours” yesterday.  The boy in question lives with his grandmother (OP).  His deadbeat mother (DB) has been getting his assistance check and keeping it for herself.  DB does not support the child. She does not work.  DB evidently has multiple schemes to obtain controlled substances, money that she does not have to work for, etc.  DB has an apartment with her boyfriend and her sister.  TC was her boyfriend, not the boy’s father.

This same group (DB, TC and the sister) had created problems for another patient (P2) we have because she refused to sell them her medication.  P2 had to move and has quit two jobs so far to get away from their harassment.  She has a protective order keeping the whole group away from her.  It doesn’t work very well.  P2 says she feels like she needs to go into the witness protection program. 

I don’t write soap operas, but I feel like I could feed ideas to a few of them.  Both these patients travel over 30 miles to come here because the “group” has caused problems with so many doctors in the town they live in that no doctor there will see them.  I wish I had known that before they came here. 

I’m not sure how big a town you have to be in to not have to deal with this kind of stuff. 

A Rewarding Day at the Office

It’s Not What She Thought It Was

I saw a very nice woman today as a new patient.  She scheduled an appointment for “endometriosis problems”.  Since this can be tricky, I scheduled a long visit.  Good thing.

In my experience, patients with chronic pain tend to get frustrated.  They want to get their “side” of the story out before they think the doctor is going to stop listening.  This is because a lot of doctors DO stop listening and because CHRONIC problems tend to be very frustrating.  They go on and on….

I had to keep going back to her story.  It didn’t add up to endometriosis.  I reached into my magic left hand drawer (where I keep all the neat information sheets, forms, etc) and pulled out a questionnaire for a problem called “interstitial cystitis”.  This is a very painful condition of the bladder – which sits right in front of the uterus.  (The plot thickens, my friends)  Most people score under 10 on this “test”.  My lovely patient got a 27!

Her examination (yes, Virginia, I did one of those, too) showed that her bladder was tender – the cystitis thing – but her pelvic organs were totally not tender.  It’s hard to have endometriosis when none of the organs that usually have it are tender, and the time patterns just don’t fit.

I may not be the brightest bulb on the tree, but I was taught to take time and figure out what’s wrong with my patients.  There is a medicine that is specific for this condition.  It does not require surgery.  It should not require narcotics and muscle relaxers.  She was also on the wrong hormone treatment if she did have endometriosis. 

Could I do all this in 15 minutes?  No.  Do I want to practice 10-15 minute medicine?  No.  Was my day rewarding?  Absolutely!

Medical Office Quandaries

I’m so glad that I usually don’t answer the phone at my office.  My receptionist takes a lot of interesting phone calls.  She earns her Diet Pepsi hourly.

I am a gynecologist.  That’s a doctor that deals exclusively with women and women’s problems.  So, when a man calls the office, it’s either a

·         salesman

·          husband

·         wrong number

·         member of my family – husband or kid

So when a man calls the office and asks to make an appointment, my receptionist is a little confused.  She asks what they want to make an appointment for.  She is thinking it might be a business thing. 

No.  These men want to make a medical appointment.  She has to gently explain to them that they have called the wrong kind of doctor.  Since she is a nice person, she will often ask the nature of their problem and give them a referral.

We joke between the two of us that she should tell them that they don’t have the correct parts.  If we’re having a silly day, we get really specific. 

She got three calls in one day last week.  I love to listen in.