"So, I took a look at your blood results, and unfortunately I'm going to need to talk to the surgeon who's planning to perform your procedure next week -- I don't know that it's going to make sense to have the surgery until we figure out why your numbers are so abnormal."
"But I really want the surgery."
"Of course, but it's a non-urgent procedure, and if it has to wait a week or two, just so we make sure it's safe, I think we should do that."
"It's already on my calendar."
"I would think it would be. Since it's scheduled for next week. But I don't want you to end up in a situation where the surgery doesn't go well or there's a complication that could have been avoided. Your platelets are really low, and I'm not sure why."
"But I want the surgery."
"I know. And I want you to have the surgery. But I want you to have it safely."
"Why are you telling me I can't get the surgery?"
"I'm trying to explain. Your lab values were abnormal. I want to repeat the labs and see if maybe there was an error, or something wrong with the sample. But if these are the numbers, I think the risks of the surgery outweigh the benefits right now, and I'll want to talk to the surgeon and get his thoughts."
"He knows I want the surgery."
"Sure. But sometimes we need to push things back to be safe."
"Why can't someone else have their surgery pushed back if there isn't room on the schedule?"
"This isn't about the schedule. I'm trying to explain why you may not be a good candidate for surgery right now, given the blood work. But let's not get ahead of ourselves. I'll take some more blood and see what the results show."
"Do you really think you should be taking so much blood from me right before I'm having surgery?"
"Okay, I'm going to have another doctor come in and explain this better."
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The patient's quite right. Why the hell didn't you explain to them what the test results actually meant, in lay language?
ReplyDelete"The test results show you have low platelets, which means there may be a problem with your blood clotting. It's not safe for us to operate until we figure out what's going on. The first step is to repeat the blood test in case something simply went wrong with the first one."
I think you intended to publish this as an example of a stupid patient, but all it really shows is that [i]you[/i] need "another doctor" to come in and give the explanations you should be giving.
There are at least 2 levels of simplification in there, and at any rate, the patient's assumptions about scheduling conflicts were completely arbitrary. I'm not really sure why you would assume that this blog post contained an exhaustive list of every attempted explanation, or why you think that a poor explanation would lead someone from "may not be safe to operate due to a test" --> "we have a busy schedule"
DeleteGotta agree with anon doc here. The gist was that he explained that it was unsafe for surgery and the patient misconstrued it to be a scheduling problem. If the patient failed to understand that, bringing in platelets and clotting problems would only compound the problem.
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