Wednesday, October 08, 2008

Things that frustrate me

As an endocrinologist, there are some things that frustrate me. Yes, yes, I know, you have your reasons, and perhaps I'm just being unsympathetic, but allow me to vent:
  1. Patients with diabetes on complex insulin programs, who come for their visits not bringing their meter, logbook and have no foggiest idea how their numbers usually run. I know, to forget is human nature, but really, if you're coming with no numbers for us to go over, then you're just going to be wasting your time. I'm going to be billing you anyway, but you're likely not going to get much out of our meeting simply because I would not be able to give you any firm advice on insulin adjustments
  2. Patients with a list of symptoms and another list of normal blood tests, who come to be because they're obsessed that despite the normal values, "their hormones must be imbalanced to cause all their symptoms". And those symptoms range from weight gain to fatigue to knee pain to an annular rash on their right shin. I wish it was that simple, but often, it isn't. And while I'm not downplaying anyone's symptoms and I know it's bothersome, I'm sorry, if your TSH and T4 are normal then it's not your thyroid. I don't care what Oprah says, but until research proves that earlobe itchiness is a hormonal disorder, don't expect me to have all the answers to your problems. I'm a good listener, yes, but I'm not going to have all the answers.
  3. Patients who don't show up for their appointments. My time is just as important as yours. If you're not planning to show up, don't make the appointment and keep other patients waiting. I'm due to see Mr. T tomorrow who has no-showed 3 previous times. I'm fully expecting him to not show up again tomorrow, and if that's the case I'm going to refuse to ever see him again.
  4. Patients who come late. Our appointment cards tell them to come 15 mins early. And so if they're 15 mins late to see me, really, they're 30 mins late for their appointment. I'm going to contradict myself, I know, but I do sometimes run late myself. I try not to, but sometimes patients are more complex than expected and you end up starting on the next one 5 minutes late. But, on the flipside, if each of my 12 patients were to come 15 mins late, then the last patient of the day's going to have to bring a sleeping bag for his visit. And it pisses me off that you make my other patients suffer and wait just because you decided to pick up a lattĕ on your way here.
  5. Patients who lie. Yes, lie. Not about simple stuff like eating a Big Mac last week. We all do that sometimes. But like the patient I saw yesterday who is trying to file a lawsuit against someone else, who suggested I 'tweak' my notes and make the other party seem more guilty. You know, the very manipulative kind of person. In a nice way, I basically told him to go to hell. And dutifully documented the request he made of me. I'm suspecting his lawyers won't be asking me to be his expert witness.

Thankfully, the majority of patients I see aren't like that. And most of those who sometimes break the above rules often are not malicious about it, and are no repetitive.