One day back from vacation and I get a clinic patient with a butt rash. It's the exception that proves the rule: I've written before that whenever it's a young guy coming to the clinic, it's because there's something wrong with his penis. There is no other reason an uninsured guy under the age of 50 goes to a free clinic to see a doctor. Except, apparently, for a rash on his butt.
At first I thought he was a test patient-- they've said that they will sprinkle test patients into clinic throughout the year, so our progress can be evaluated. The test patients are prepped with answers to all of our possible questions, and armed with a checklist to mark us against ("did the doctor do a complete and thorough physical examination?" / "did the doctor wash his hands?" / "did the doctor explain the possible side effects of the medication?"). It's sort of fun to know that somewhere along the line, we'll get a couple of fake patients. It's like trying to figure out which section on the SAT is the experimental one, which won't count. Anyway, this guy just seemed so textbook-- he was too quick with all of his answers, and much too excited to be sharing. "I just got out of a relationship, and I'm concerned my girlfriend may have been cheating on me, and could have given me a sexually transmitted disease. I had gonorrhea a few years ago, but it was effectively treated with medication." Thanks. And he was just a little too clinical with a couple of answers. "We use protection approximately 75% of the time." Are you keeping a log?
So when I went to talk to the supervisor before going back to examine the patient, I told him I thought this might be a test patient, and handed him the file. He laughed. "Trust me, you will never have a test patient with a butt rash." Oh. Well, I guess that makes sense.
Went back in, examined his rash, and sent him off with some cream that will hopefully clear it up. I understand why outpatient medicine gets looked down upon by the specialists-- it doesn't take a genius to deal with butt rashes-- but, hey, I helped him, I don't have to worry that he's going to die overnight, and I got to leave the office before 5. Is it worth looking at butt rashes to get out in time for dinner? I don't know, but it might be.