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What is your least favorite kind of patient?

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For me, it’s the one who when you walk in the room are choking from the cigarette smell, but they are on chronic pain meds (oxycodone qid, morphine) and have another slew of medical issues that would improve if they cut down on their smoking. 

Which patients drive you absolutely crazy?

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Fibromyalgia/chronic Lyme/chronic fatigue/adrenal fatigue.

Oh, and "low t".  

Also people who don't want screening anything but then act surprised when colon cancer eats up their insides.

I can handle "flu shots make me sick" people, I just document their nonsensical gibberish and move on.

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Stupid ones. 

 

Prime example. Mom just came in at 9AM with 2 kids for "sore throat" and they both scream and kick and one threw a soda on the floor after shaking it all up (soda at 9AM) and mom is trying to bribe them into behaving. Not the kids fault. They are learning that misbehavior pays.

That kind of stupid.... 

Edited by sas5814
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32 minutes ago, sas5814 said:

Stupid ones. 

 

Prime example. Mom just came in at 9AM with 2 kids for "sore throat" and they both scream and kick and one threw a soda on the floor after shaking it all up (soda at 9AM) and mom is trying to bribe them into behaving. Not the kids fault. They are learning that misbehavior pays.

That kind of stupid.... 

Was it sore throat x 2 hours?

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1 hour ago, thinkertdm said:

Fibromyalgia/chronic Lyme/chronic fatigue/adrenal fatigue.

Oh, and "low t".  

Also people who don't want screening anything but then act surprised when colon cancer eats up their insides.

I can handle "flu shots make me sick" people, I just document their nonsensical gibberish and move on.

Those don't bother me because we don't do any of that in the UC. Had a 41 year old chronic back pain patient yesterday on Duragesic, Hydrocodone, Xanax, an implanted spinal device  and Neurontin come in for back pain. Sorry sis....

UC can be a giant pain but this is one of the upsides.

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22 minutes ago, sas5814 said:

Those don't bother me because we don't do any of that in the UC. Had a 41 year old chronic back pain patient yesterday on Duragesic, Hydrocodone, Xanax, an implanted spinal device  and Neurontin come in for back pain. Sorry sis....

UC can be a giant pain but this is one of the upsides.

Let me guess, "allergic" to nsaids, only thing that works is something that starts with or rhymes with...

 

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Hopeless, helpless patients with treatment resistant depression who keep shooting down their treatment options. These patients are so frustrating for me. I'd rather deal with borderline personality.

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22 minutes ago, thinkertdm said:

Let me guess, "allergic" to nsaids, only thing that works is something that starts with or rhymes with...

 

Congrats! You advance to final Jeopardy!

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the entitled ones who demand things and think they know something

 

"I want an MRI for my 2 days of back pain after raking the yard all day"

"I want an xray for my elbow pain after playing gold"

 

of best yet

 

"My attorney told me I needed an MRI"

 

 

earlier in my career i might try to educate them, now I just move on 

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the ones who think because an "advice nurse" told them they need an mri and an LP today that they are actually going to get one for their 15 minutes of hand tingling after waking up sleeping on their arm.

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13 minutes ago, EMEDPA said:

the ones who think because an "advice nurse" told them they need an mri and an LP today that they are actually going to get one for their 15 minutes of hand tingling after waking up sleeping on their arm.

oh yea.... I had one a couple of months ago who came in because the tele-doc told her she might be septic. She had a cold.

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5 minutes ago, sas5814 said:

oh yea.... I had one a couple of months ago who came in because the tele-doc told her she might be septic. She had a cold.

Love it. 

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1. obese patients with bad odor. Had a female patient yesterday. Oh boy! glad I don't do gyn.

2. patients demanding narcotics 

3. new patients who say... "can I have a card with your name?" when they don't get the meds they demand. 

 

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My verbal jujitsu for people wanting expensive imaging is to say "well, we COULD do that, but I don't think that's the best use of your money..." and most of them will listen. Alternatively, I'll say "Well, I don't order that all that often here in primary care, and I usually let the specialists do that, so they make sure they get exactly all the right options and views..."  Both are substantially true, and seem to go over with the patients better than "no!"

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Patients that try pulling a race card when they're not getting the care they demand exactly when they demand it when they show up in an ER with 3 not really sick grandkids because they "thought they needed a check up" on a busy holiday Friday night...

 

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Has a mild cold.  Came in to get antibiotics to "get ahead of it" or "nip it in the bud".  No one walks away happy.

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Besides the ABX and Opiate crowd, and the "I read this on Google so all I need is..." gang... The ones who swear they have something gravely wrong with them even though we've put them through a battery of tests and they have seen every specialist under the sun INCLUDING "Functional Med" and CAM docs...

 

Oh and...

 

The ones with the appt slot right before lunch or right before knock off time and shows up 15mins late for a 20 min visit... (my current place's policy is it's ok for them to be up to 20mins late before we can no show them... One of the reasons why I'm leaving)

 

Sent from my SAMSUNG-SM-G891A using Tapatalk

 

 

 

 

 

 

 

 

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Here's my unfavorite patients from both of my specialties...

Cardiothoracic Surgery:

The 20 y/o somethings  where we replace their valves from all the meth use "I promise Ill get better"....find significant other injecting them post-op with meth...then they demand pain RX's out the ass, come back 2 months later with endo again....

The 4 month post-op that demands pain RX's....tells me that pain is a vital sign....(thanks nursing admin for making this a prob.)

The "my "insert family member" is a nurse and said you should be doing this

The "I won't follow your post-op instructions....my friend had this done" and then 3 weeks later sternal dehiscense...yay

Urgent Care:

The 2'fer, 3'fer, and even 4'fer....somehow the visit goes from one person and multiplies....usually with snot nosed bratty kids

To echo everyone else, the "I know whats wrong, you just give me what I want" crowd

Smelly people.... I call these folks "allergic to soap"

Obese people with arthritic complaints...lose weight, it may help some (call me an asshole I'm just being forthright)

Narc seekers who think we are stupid "I need the "Lorco's????" Oh you mean Naproxen?

The patient with cold symptoms for literally 1 day.... and sore throats that they swear is strep...but its not...here's your bill

The patient that has a family member in healthcare, I serve a UC right next to a major college campus, hald the kids I see on the weekends have a parent who's a "doctor"....AKA had one who's mom was an NP....in derm phone in during the visit and was on speaker the entire time tell me that my diagnosis of gonorrhea (confirmed by labs) was only a UTI.... her angel wouldn't do that....and addressed herself as Dr.... not trying to start a battle so whoever reads this and gets their panties in a wad chill out.

 

 

 

Edited by TheDude
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The ones that show up at 7:58 to my Urgent Care with a problem that's been going on hours or days...some times weeks.

 

We close at 8:00 and they know it.

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2 hours ago, Cideous said:

The ones that show up at 7:58 to my Urgent Care with a problem that's been going on hours or days...some times weeks.

 

We close at 8:00 and they know it.

We tell them to come back tomorrow.  Non-emergency cases (anything short of an actively bleeding lac or chest pain) get turned away at 15 minutes until close.

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52 minutes ago, rev ronin said:

We tell them to come back tomorrow.  Non-emergency cases (anything short of an actively bleeding lac or chest pain) get turned away at 15 minutes until close.

We're the same, though patients are told the last appt. is 30" before doors lock.

Edited by GetMeOuttaThisMess

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21 hours ago, rev ronin said:

We tell them to come back tomorrow.  Non-emergency cases (anything short of an actively bleeding lac or chest pain) get turned away at 15 minutes until close.

We, I, anyone at the company I work for would be fired instantly if we told a patient that. 

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4 hours ago, Cideous said:

We, I, anyone at the company I work for would be fired instantly if we told a patient that. 

yup...here too. We had a big kerfluffle a few weeks ago because we locked the door at closing time after a patient said she was on her way but might be a few minutes late. Nope.

 

Patient complained. Guess which way the bean counters went.

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