"My doctor said he sent you the blood work."
"I'm sorry, I didn't get it."
"He said he faxed it."
"What number did you give him?"
"I don't know. It's not my fault if he didn't send it."
"I'm not blaming you. I just want to try and see the blood work while you're here. The reason I asked what number is because I don't know my fax number here at the clinic, so I don't know where you got a number-- but if I know the number, I might be able to ask someone and figure it out. Do you know where he faxed it?"
"No."
"Do you know who gave you the fax number?"
"No."
"Did you call to get it, or did you ask someone on the way out last time?"
"I don't know."
"Do you have your doctor's phone number so I can call him?"
"No."
"How do you call him if you don't have his number?"
"It's in my phone at home."
"Do you know his name?"
"I can't remember."
"Can you call me when you get home and give me his phone number so I can call him and get your blood results?"
"No."
"Why not?"
"I don't know."
"No, surely you can call me with his number when you get home."
"I don't want you to bother him."
"I just want to get the blood results, so I can see what's going on. Doctors call each other for these things all the time. I'm sure it will be fine."
"No."
"What are you saying no to?"
"You can't call him."
"Why can't I call him?"
(Patient takes a deep breath.)
"Because I didn't have the blood test, okay? I didn't do it. I forgot, I didn't feel like it, I don't know. All you people want is for me to do things. I'm busy. I can't keep doing things."
"I just wanted to see what's going on in your body so I can help you."
"I don't need your help."
"Then why did you come to your appointment?"
"I didn't want to cancel."
"Next time you need to get the blood work done. And you shouldn't lie about the blood work. It doesn't help anyone."
"I didn't want you to be mad at me."
"I'm just trying to help you. We can do your blood work here, if you like."
"No."
Friday, July 29, 2011
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Patients sound exactly like clients.
ReplyDeleteI'm betting his insurance plan has denied coverage for bloodwork previously, and charged him hundreds of dollars out-of-pocket. Just a guess. It happened to me, once; BC/BS decided they wouldn't pay, and there was nothing I could do but appeal, which they denied.
ReplyDeleteOr he's afraid of the results. Or he's nuts.
You can lead a patient to the lab, but you can't make him get blood drawn.
ReplyDeleteAs an MS3, what's impressive to me about exchanges like this is that they serve as a reminder to NEVER accept vague answers from patients. You have to drill down until you get raw information. It's hard to do that under time pressure in outpatient medicine (the rotation I just finished), but its so necessary.
ReplyDeleteA lot of these exchanges are actually textbook (i.e. perfect) examples of "how to interact with difficult patients".
Thanks for writing.