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. 

The Pneumonia Shot

*Free Medical Care –Stuff Doctors Offices Do For Free That Takes Time

This morning a woman called my office asking about a pneumonia shot for a family member.  Mr. Phone Caller (Mr. PC) is a patient at the local Veteran’s Administration Clinic.  He is in his 80s.  Evidently there is no problem getting flu shots, which he has done.  Their policy is that you have to see your “provider” (I hate that word) to get your pneumonia shot. 

Mr. Phone Caller last had a pneumonia shot in 2006.  He can’t get an appointment with his new “provider” until February.  Mrs. Phone Caller is very worried.  She sounded older, and seemed to be quite concerned that he might die without the shot immediately. 

We don’t have pneumonia shots this year.  We didn’t do many two years ago, so we stopped carrying them.  When we did, we gave them to anyone who needed one.  I think that’s why Mrs. PC called.  

Princess talked with her first.  She suggested that Mrs. PC call the local Health Department.  She did and got “the run around”.  She called us back.  I spoke with her and promised we would call around and see what we could do. 

Princess called one medical practice and I called another.  The practice I called wasn’t really interested in giving a vaccine to someone who wasn’t an established patient.  The practice Princess called said they would see the gentleman.  Mrs. PC will have Mr. PC there sometime within the hour.

All of this took about 15 minutes of non-continuous discussion and phone calls.  Mrs. PC is not a patient of ours.  Mr. PC is not either.  They have no charts.   No paperwork was done.  We generated no charges.  Mr. PC will get his pneumonia shot.  Mrs. PC will feel better because he is protected.  The only thing we get out of this is a little bit of knowledge and a couple of warm fuzzies. 

*Free Medical Care may become a series.  These are things that are done in a medical office that are not paid for.  This is mostly for your information, but sometimes I just need to vent.