RANT - Talk to Your Patient

Sean G., M.D. -

Mel u do realize u said "The man" was told to give himself an epi pen 4x a day....I think your losing it brother! We are getting old! I agree totally with the rant. I had a similar experience with an ortho out here in Scottsdale...lets call him "the man" . I sought the man when I ruptured my quadriceps tendon doing Jiu Jitsu. The Man was highly recommended by another Jiu Jitsu mate. The Man was well known as doing a number of professional athletes in local and not so local professional baseball, basketball, hockey and football teams. He did a decent job on my repair. Unfortunately during rehab I developed Chondromalacea Patella and subsequent arthritc issues in that knee(I scar pretty heavily and the knee cap never really aligned exactly right post op and all the quad building work with the mis aligned patella led to chewing up the cartilage in the knee). I started seeing a Naturopath and got PRP and prolotherapy with good results on other issues but the post quad tear knee kept swelling when I resumed Jiu Jitsu 7 months later. I was interested in a scope to see what was going on, and my Naturopath was pushing for me not to have cartilage debrided as he believed he could help with RIT and felt it was best to leave what cartilage I had intact, I developed a sort of Bakers Cyst that was medial on my knee. I went back to the man who I had seen religiously for my follow ups, paid with decent insurance and paid all my copays at the time of service and also endured long waits despite having scheduled appointments(usually an appt took 3 hours there with about 15 min being with the doc). I did this w/o complaint. When I saw the Man for pre op eval of the cyst and the joint effusions I expressed my desire to side w the naturopath on the cartilage issue and clarified that it was important to me not to do a debridement in the traditional scope sense. There was a NJM artical from like 2002 that showed arthroscopic debridement no better then placebo/sham surgery for OA, so I believed my naturopath was on the right track. Well a few weeks before the surgery I got word from The man's office manager of the date of surgery, this was left on my voice mail. I was to be consented for dx scope cyst removal possible meniscectomy, AND debridement surgery! I had clearly expressed I did not want Debridement. I called the Man, and was passed along to the office manager who also was unavailable. I would get her voice mail. I left several messages over a weeks time that I did not want debridement surgery even on the table. I did not want to take a chance that it would be done, so I did not want the paper work generated. No response from anyone. The surgery date approached. I played phone tag with the office manager(a nurse) who did not seem to understand my concern. I repeatedly requested The Man return my call. 3 days before surgery I was unable to speak to The Man, so after I got settled in on a night shift about 8 pm I considered...I have been a patient forv a couple of years, paid my bills all on time, waited patiently w/o complaint in his office as he was routinely behind on appts, and referred a few pts his way from my ER practice and my jiu Jitsu experience. I basically sung The man's praises any time a jiu Jitsu brother had an ortho issue or a patient in the ER. I thought...."Physician Courtesy right?" I'll see if he is on call...after all I have tried to speak to him thru the proper channels for over a week. Its also only 8 pm, no big deal. I would certainly take a call on my day off from a colleague if he had a question I could answer...I called the Man's service and he was on cal. I explained that I was Dr Gorman, a patient of his and I had surgery this coming Monday and I had a question about it(It was Thurs night). I had tried the nl avenues for over a week and never got a call back, could The man give me 5 minutes of his time? The service said, "sure they would be happy to page him". The service called back a half hour later and said The Man had told them to tell me to call during normal business hours. I replied ...Yeah I have done that for a week and casn't ever talk to him" The service replied..."He said if you call tomorrow at 9 am he will talk to you". I call tomorrow at 9 am ...and guess what I get put off to the office manager again. I tell her I did not want debridement surgery...and she literally yelled at me..."THEN DONT SIGN THE CONSENT FOR IT!" Is that what you bothered the on call doctor about last night!!!!????" I was like "Cheryl, I don't want the paperwork on my stretcher theb day of surgery, and yes I called him on cal cause I am a doc, I thought maybe some professional courtesy?" She replied..."we know your a doc Sean you remind us every chance you get"....This was amazing as it is so untrue. I pretty much never mention I am a doc except for when other docs are talking to me and the only reason I do it then is because I feel stupid speaking to a patient in lay terms only to find out later they are an MD, so I usually would mention it to make communication easier, but I never tried to use it to get any special treatment, except that one time asking to talk to the on call doc at a reasonable hour when every attempt to speak during normal business hours failed. I told Cheryl to cancel my surgery and I would find a doctor who was willing to speak to his patient before operating on him. Didnt think that was too much to ask. Sorry about the long post, had to vent.

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