* * Anonymous Doc

Tuesday, June 28, 2011

Lots of comments on the previous post-- the most recent one (June 28/12:57) seems to have it right. Yes, you should be able to get your records. Yes, ethically suspect. But likely not actionable. Doesn't help if the patient is told to follow up in three months and never does, doesn't see any doctor for years, no one else ever has a chance to look at the chart.

* * *

Moving on... residency tip #374... one of my interns, talking to the attending:

"Yeah, I'm definitely not looking forward to my next rotation, I hate working with all of those douchebag attendings."

"Which attendings do you mean?"

"Oh, you know, Dr. [Smith] is a huge douchebag."

"Dr. Smith is one of my closest friends."

* * *

"I never used to have heart failure," said the patient.

"Yeah, it starts to happen to people around your age, unfortunately."

"No, you don't understand, I never had a problem with my heart."

"Yeah, I know."

"So I don't understand. I never had a problem."

"Yeah, these things happen over time."

"But nothing happened to cause it. So I don't know where it came from."

"Yeah, these things happen, lifestyle factors, genetics, over time things happen to everyone."

"Well, I never used to have it until I got that echocardiogram. I think that caused it."

"The echo diagnosed it, it didn't cause it."

"Yeah, I don't know about that."

"People aren't born with heart failure. These things happen. It doesn't help that you're 150 pounds overweight, sedentary, high blood pressure, diabetes. We can put you on medication, but there are also lifestyle changes you can make."

"Being overweight didn't cause this. I've been overweight my whole life."

"And it may be that at some point it starts to catch up with you."

"Well, I've been overweight for years and it's never caused any problems."

"It contributed to the high blood pressure and the diabetes."

"Those aren't real problems."

"No, they are. They can be serious."

"But nothing was ever wrong with my heart."

"Unfortunately, now something is."

"I think the echo caused it."

"That's not something that makes sense, from a medical perspective."

"It makes sense to me."

"I wish you didn't feel that way."


  1. Oy. Don't you wish you could write a RX for a basic A&P class?


  2. (*Sighs*) Sometimes when I read your posts, I can't even believe some of these conversations have actually occured.

    I'm not in the healthcare field but I know at least as much, and often more than the people with whom you've had some rather unfortunate discussions (and as a result, I feel undeniably smarter than a lot of people).

    But more than that, the time you take with your patients shows you care. Not all professionals are that way but it is noticed and appreciated. That's all.