The Patient Advocate

Sorry for the gap in posting.  Was on vacation this week, with limited Internet access.  And no pager.  Fortunately.  Back for the holiday weekend.

"I'm told you wanted to transfer your mother?"

"Yeah, we were talking to the patient advocate and she told us we should."

"What?"

"We were telling the patient advocate that we were worried about our mother, and she said there are better hospitals in the area, and we might want to transfer her to one of them."

"The patient advocate said that?"

"Yep."

"Interesting.  So when did you want to transfer her?"

"Now."

"Did you talk to the other hospital about accepting the transfer?"

"No."

"Have you looked into an ambulance to get her there?"

"No."

"Is there a particular doctor you know over there?"

"No.  We were hoping you could take care of all of that for us."

"We can certainly work with the other hospital to arrange the transfer, but you need to contact a doctor over there and start the process."

"Do you have the phone number of a good doctor there, who would be better than you at treating her?"

"Honestly, I don't know anyone over there."

"I guess we can just ask the patient advocate."

"Okay."

The Physical Therapist Is A Fictional Character

A family asks to talk to a doctor.  I'm just a consultant on the patient, but I'm there, so I'm the one they get.

"Doc, we're frustrated because he's been here a week and still hasn't seen physical therapy."

"I do see that the order was put in five days ago.  I can put in a call to physical therapy and see why they haven't come yet, but I'm not sure what else I can do about that."

"That's not an answer."

"No, it's not, but let me give them a call and see if I can get them to come sooner than they might otherwise."

"It's been a week."

"I understand."

"Is there actually physical therapy, or is it just a lie you tell people, so we stop asking about it?"

"There is actually physical therapy.  I've met some of the physical therapists.  They are actual people."

"Hard to believe that."

"I understand that you're frustrated."

"When we asked the nurse, she said she'd never seen physical therapy come see a patient."

"I have to imagine she was joking."

"She didn't seem like she was joking."

"Then maybe someone misunderstood.  I don't know why physical therapy hasn't come yet.  I assume they're very busy.  But I don't know.  I will call them."

"You'd better do more than call them."

"I will talk to the physical therapy director."

"While you're at it, can you talk to the director of nursing and get us a new nurse?"

"I don't know that I can get you a new nurse.  If you're having a problem with your nurse, you can ask to speak to the nurse manager."

"More people to speak to?  This is ridiculous.  I want to speak to another doctor."

"I can have another doctor speak to you.  I'm not the primary doctor for your father, but I am familiar with his case.  That's why they had me talk to you.  I know you're frustrated.  You have a right to be frustrated.  Do you have any medical questions?"

"Yes.  Why does he need physical therapy when he's walking fine?"

"I thought you were upset he wasn't getting physical therapy."

"No, I'm upset that we were told we're entitled to physical therapy, and we're not getting it.  This is a different question, about why he would need physical therapy."

"Perhaps he doesn't, and that's why physical therapy hasn't come."

"If we're entitled to physical therapy, we want physical therapy.  If it's part of the package, we definitely want it."

"There's not a package.  Your father is supposed to get the treatment he needs."

"We also need some more of those toothbrushes that were in his room."

"You can ask the nurse for toothbrushes."

"We don't like the nurse."

"I don't have any toothbrushes."

"When is physical therapy coming?"

"I'm going to have you talk to a different doctor."

"I'd like to speak to the [p]resident"

I'm on call in the hospital and I get paged that a patient's family wants to talk to me about a patient I consulted on earlier.  I stop by the room.

"Are you the president?"

"Pardon?"

"Are you the president of the hospital?"

"No.  I'm the fellow who saw your mother earlier today."

"My wife has a brother who is a doctor, and he told me I should always make sure I speak to the president, because the president will be most familiar with the patient."

"I think you probably misheard.  He probably said resident."

"No, he said president."

"I think he said resident."

"Why would I want a resident of the hospital to know about my mother's condition?"

"Residents are the doctors who are most involved with the medical plan.  I was a resident until last year, and now I am a fellow.  The attendings are the doctors in charge of the decision-making.  That's just the hierarchy of the team.  The hospital president is not involved in patient care."

"He should be.  I want to speak to him, like my wife's brother said."

"I'm sure he said resident.  I can get the resident to stop by after rounds."

"The young woman we spoke to before?"

"Probably."

"She didn't seem like she was the president of anything."

"She wasn't the president, she was the resident."

"I'd rather wait for the president."

I Have Most of My Parts

96-year-old patient.  Female.  Complaining of stomach pain.

"I'm just going to see if there's any tenderness, okay?"

"I didn't know you were going to be touching me."

"I'm sorry, is that okay?"

"Yes, but I would have put on a little more makeup."

"Let me know if you feel anything."

"Oooh.  Yes, that hurts."

"And how about here?"

"Yes, that hurts too."

"I didn't see anything in your chart... have you had any surgeries in that area?"

"Surgery?  Like what?"

"Have you ever had any ovarian issues, have you had a hysterectomy, anything like that?"

"Well, I don't get my period anymore."

"No, I wouldn't expect that you would."

"And the doctor said I can't have any more children."

"Right, but is that because of any procedure you may have had, even if it was years and years ago?"

"Now that you mention it, I think they did take something out."

"Do you know what they took out?  Did you have a hysterectomy?"

"To be honest, I don't know.  I'm not really sure what's inside me anymore."

"Okay, I'm going to send you for a scan to see what's inside of you, and to make sure there's nothing concerning going on.  Obviously we don't want to look for problems at your age that it's better not to find, but I just want to see if we can figure out if there's a reason why you're so tender down there."

"You don't think that doctor was wrong and I'm pregnant."

"No, I don't."

"Okay, that's a relief."