bike mike Posted January 30, 2019 Share Posted January 30, 2019 So I recently had a patient come in who was recently diagnosed with a TIA. She has a h/o PAF and refuses AC other than low dose ASA. When I saw her I went over the risk of thromboembolic stroke with PAF without adequate anyicoagulation. That is when she told me that her naturopath who “used to be an MD” told her that her symptoms of facial droop and aphasia were due to “lack of oxygen in her blood because of a lack of protein” and that she didn’t have a TIA and that “no offense, you don’t know as much as her because she used to be an MD”. Yeah, I’m just a knuckle dragging PA.....what do I know? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted January 30, 2019 Moderator Share Posted January 30, 2019 and that pt is fired.... Link to comment Share on other sites More sharing options...
kadiah Posted January 30, 2019 Share Posted January 30, 2019 Whew. Yeah, I'd get insta-rage at that. I always say the hardest part of the job is the acting and poker face that goes along with patient satisfaction, but this one probably would have made me crack. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted January 30, 2019 Moderator Share Posted January 30, 2019 “Then why TF are you here and not there?” Link to comment Share on other sites More sharing options...
TheFatMan Posted January 30, 2019 Share Posted January 30, 2019 There is probably a very good reason she USED to be an MD and is now an ND (Not a Doctor). Link to comment Share on other sites More sharing options...
CAAdmission Posted January 30, 2019 Share Posted January 30, 2019 8 hours ago, bike mike said: “no offense, you don’t know as much as her because she used to be an MD”. Link to comment Share on other sites More sharing options...
Moderator ventana Posted January 30, 2019 Moderator Share Posted January 30, 2019 the certified letter would be going out to her asking her to find another provider same day.... Link to comment Share on other sites More sharing options...
CAdamsPAC Posted January 30, 2019 Share Posted January 30, 2019 I always ask why are you here if you are being "cared for" by one of these voodoo doctors? I don't care to have conversations with fools when others need my time and efforts. Link to comment Share on other sites More sharing options...
CornellSPA Posted January 30, 2019 Share Posted January 30, 2019 Usually its not worth the fight....document document and move on!!!!!!!!!!!!!!!!!!!!!! Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted January 30, 2019 Administrator Share Posted January 30, 2019 This gave me an idea: intake paperwork, documenting patient behaviors that constitute an irrevocable breach of the patient-provider relationship that, if performed by the patient, would be a patient-initiated termination of the provider/patient relationship. * "Use of non-medical sources for medical advice: Patients who bring up Dr. Oz, Dr. Mercola, or anyone purporting to be a Naturopathic Physician during the course of clinical conversation, other than to collaboratively ridicule their nonsense..." I'm only half kidding. Link to comment Share on other sites More sharing options...
sas5814 Posted January 30, 2019 Share Posted January 30, 2019 I just think of this as the herd thinning itself out and getting stronger...and smarter. Link to comment Share on other sites More sharing options...
cbrsmurf Posted January 30, 2019 Share Posted January 30, 2019 I know everyone is tired of naturopaths and all that, but serious question: does this warrant a neuro assessment, brain imaging, or screening for dementia in this possibly delusional patient? Link to comment Share on other sites More sharing options...
sas5814 Posted January 30, 2019 Share Posted January 30, 2019 Nah... never underestimate people's ability to believe what they want to believe. It is their reality. PT Barnum said it is immoral to allow a sucker to keep his money. Link to comment Share on other sites More sharing options...
bike mike Posted January 30, 2019 Author Share Posted January 30, 2019 6 hours ago, CornellSPA said: Usually its not worth the fight....document document and move on!!!!!!!!!!!!!!!!!!!!!! This was my approach....and then I just laughed inside a little. You can't get upset about this kind of stuff. There are certain people that want to go to a provider (I'm using this term loosely) that will tell them what they WANT to hear. Link to comment Share on other sites More sharing options...
UpperLeftPAC Posted January 30, 2019 Share Posted January 30, 2019 1 hour ago, bike mike said: This was my approach....and then I just laughed inside a little. You can't get upset about this kind of stuff. There are certain people that want to go to a provider (I'm using this term loosely) that will tell them what they WANT to hear. You're better than me, I would have died inside a lot. Link to comment Share on other sites More sharing options...
Probasesteal Posted January 31, 2019 Share Posted January 31, 2019 On 1/30/2019 at 10:44 AM, CornellSPA said: Usually its not worth the fight....document document and move on!!!!!!!!!!!!!!!!!!!!!! This x 100. I once had a poorly controlled diabetic, he'd bring his large sweet tea and breakfast biscuit with him to eat after his fasting labs. He wouldn't do his part, sometime took his medicine and largely ignored my recommendation for a baby aspirin. Guess what, he had a stroke in his 50s. He later blamed it on me, in the hallway none the less, "look there's the guy that caused my stroke". My SP acquired him and guess what? Another stroke.. My SP, who is a good friend, took my advise and discharged him a few months later for non-compliance. Document and I mean multiple paragraphs of your attempts to treat per EBM guidelines. You are likely going to see this patient again unless you are able to discharge them. Rage after the visit to whoever has any sense, it's not worth it in the exam room. Link to comment Share on other sites More sharing options...
sk732 Posted February 1, 2019 Share Posted February 1, 2019 Had the person said to me what they said to the OP, I'd likely respond "Well, then I take it that I won't be seeing you again anytime soon?" I didn't worry too much about patient satisfaction surveys - my waiting room was almost always full. I did used to get a lot of requests/demands for tests ordered by voodoopaths from folks - here the voodoopath can order the test, but it comes out of the patient's pocket, as it needs an actual licensed MD/PA/NP to order tests on the public's dime - in other words, there needs to be an actual reason to order them. If I had a nickel for every wannabe heavy metal victim, sub-sub-sub-sub-acute hypothyroid or adrenal fatigueite that would show up, I would have retired my first six months out in civvy practice. Typically, the appointment would start something like this - "My (voodoopath of choice) thinks I have "imaginary condition X" and says that I need this test done and that you HAVE to order it for me". "Well, Dr I Lost My Real Medical License can't actually tell me to order any test, much less one that I don't think is needed or indicated - for me to do this is actually FRAUD against the Provincial Health Ministry. If he/she/it feels you need this test and so do you, you go to the lab and pay for it out of pocket...however, since we still have a few minutes, I can take your history, examine you and I'll order what I feel is actually indicated if you so wish..." I always liked that sallow colour they turned when I told they wanted me to help them commit a crime and I wasn't interested...and then would get really put out that I wouldn't order the nuclear heavy metal screen the ND felt was needed to justify charging the patient through their arse for chelation therapy they didn't need. Link to comment Share on other sites More sharing options...
UpperLeftPAC Posted February 2, 2019 Share Posted February 2, 2019 Voodoopath. [emoji1787][emoji1787][emoji1787]Sent from my Pixel 2 using Tapatalk Link to comment Share on other sites More sharing options...
sk732 Posted February 2, 2019 Share Posted February 2, 2019 8 hours ago, UpperLeftPAC said: Voodoopath. Sent from my Pixel 2 using Tapatalk I suppose I should change the "ND" to "VD"...but people might get the wrong idea. Link to comment Share on other sites More sharing options...
CAdamsPAC Posted February 2, 2019 Share Posted February 2, 2019 On 1/31/2019 at 11:02 PM, sk732 said: Had the person said to me what they said to the OP, I'd likely respond "Well, then I take it that I won't be seeing you again anytime soon?" I didn't worry too much about patient satisfaction surveys - my waiting room was almost always full. I did used to get a lot of requests/demands for tests ordered by voodoopaths from folks - here the voodoopath can order the test, but it comes out of the patient's pocket, as it needs an actual licensed MD/PA/NP to order tests on the public's dime - in other words, there needs to be an actual reason to order them. If I had a nickel for every wannabe heavy metal victim, sub-sub-sub-sub-acute hypothyroid or adrenal fatigueite that would show up, I would have retired my first six months out in civvy practice. Typically, the appointment would start something like this - "My (voodoopath of choice) thinks I have "imaginary condition X" and says that I need this test done and that you HAVE to order it for me". "Well, Dr I Lost My Real Medical License can't actually tell me to order any test, much less one that I don't think is needed or indicated - for me to do this is actually FRAUD against the Provincial Health Ministry. If he/she/it feels you need this test and so do you, you go to the lab and pay for it out of pocket...however, since we still have a few minutes, I can take your history, examine you and I'll order what I feel is actually indicated if you so wish..." I always liked that sallow colour they turned when I told they wanted me to help them commit a crime and I wasn't interested...and then would get really put out that I wouldn't order the nuclear heavy metal screen the ND felt was needed to justify charging the patient through their arse for chelation therapy they didn't need. I respond if this fraud wanted you to have the study done they should have ordered it. If the person is their patient there's no reason for me to be involved and I have no business ordering tests. Link to comment Share on other sites More sharing options...
sk732 Posted February 3, 2019 Share Posted February 3, 2019 3 hours ago, CAdamsPAC said: I respond if this fraud wanted you to have the study done they should have ordered it. If the person is their patient here's no reason for me to be involved and I have no business ordering tests. They did order these tests...just the patients didn't feel they should have to pay for them, though they don't seem to understand that they have to pay for the chelation therapy they don't need, thyroid meds they don't need, then the AFib meds they WILL need from taking all the extra thyroxine they're now taking for no reason, etc, since their Blue Cross or Green Shield won't. Link to comment Share on other sites More sharing options...
hrubenstein Posted February 3, 2019 Share Posted February 3, 2019 You should be asking names of these people and calling the board that licenses naturopaths. This is flat out dangerous. Link to comment Share on other sites More sharing options...
Boatswain2PA Posted February 3, 2019 Share Posted February 3, 2019 The board that licenses these dangerous quacks are.....full of other dangerous quacks whi do the same stupid stuff. Link to comment Share on other sites More sharing options...
Moderator ventana Posted February 3, 2019 Moderator Share Posted February 3, 2019 I have only been approached by patients a few times on this - mostly with Chiro's requesting Xrays I have never said yes - I nicely explain that we (medical professionals) are all licensed and responsible for our own practice and testing. If the Chiro wants xrays they will need to order it..... then simply refuse. I am not getting involved in someone else's questionable assessments and treatments.... Link to comment Share on other sites More sharing options...
ravenspac Posted February 7, 2019 Share Posted February 7, 2019 I love when patients dont want to listen. I think they expect me to convince them....They give me the shocked face when I tell them they are free to see another provider, have a nice day Link to comment Share on other sites More sharing options...
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