surgblumm Posted February 25, 2019 Share Posted February 25, 2019 The obnoxious patient that is offering you the opportunity to diagnose a disease although you are not a doctor. Their feelings of superiority are sometimes overwhelming and their smirk and response to your questions and then your diagnosis demonstrates that they were smart enough to rulke out the other causes that you have mentioned and then ask to speak to the real doctor. Its been a long time since I have personally experienced this but yet it is memorable. Link to comment Share on other sites More sharing options...
CAAdmission Posted February 26, 2019 Share Posted February 26, 2019 Least favorite kind of patient? That's easy. The conscious ones. Link to comment Share on other sites More sharing options...
ArmyVetDude Posted February 26, 2019 Share Posted February 26, 2019 18 hours ago, surgblumm said: The obnoxious patient that is offering you the opportunity to diagnose a disease although you are not a doctor. Their feelings of superiority are sometimes overwhelming and their smirk and response to your questions and then your diagnosis demonstrates that they were smart enough to rulke out the other causes that you have mentioned and then ask to speak to the real doctor. Its been a long time since I have personally experienced this but yet it is memorable. This is why they need to get rid of that "assistant" in our title. They disrespect us like we are just assistants or doc's secretaries Link to comment Share on other sites More sharing options...
CAdamsPAC Posted February 26, 2019 Share Posted February 26, 2019 # 1.Those who tell me that their neighbor, friend or family member told them that the medicine they were prescribed isn't "what I was given for that" so they stopped taking it and want "what they got". #2. The unruly dirty mob of children ( maybe it just seems like a mob)brought in for impetigo and "check their ears". Link to comment Share on other sites More sharing options...
Probasesteal Posted February 26, 2019 Share Posted February 26, 2019 2 hours ago, CAdamsPAC said: # 1.Those who tell me that their neighbor, friend or family member told them that the medicine they were prescribed isn't "what I was given for that" so they stopped taking it and want "what they got". #2. The unruly dirty mob of children ( maybe it just seems like a mob)brought in for impetigo and "check their ears". I once gave a lady Omnicef 300mg (I can't remember the condition). She was upset that her husband was given Amoxil 875 at the urgent care and his dose was stronger!!! I can't even remember what I did, but I laughed about it for awhile. Link to comment Share on other sites More sharing options...
Reality Check 2 Posted February 26, 2019 Share Posted February 26, 2019 My days are better at the VA - yes, challenging Internal Medicine patients with poly pharmacy but worth the challenge. My least favorite private family practice patients were entitled - "I paid my copay, you give me what I want". I have some folks at the VA who spend the first few minutes of their visit ranting about the VA and telling me how horrible it is and they "only come to keep their assignment". Hard to carry on once someone tells you that you suck, they have no confidence and will be mad the entire time. I try to count my small victories daily and grasp those moments when a patient tells me they feel better talking to me and maybe they will give me a chance. Wouldn't go back to private family practice at this point for anything - the mill of 25 patients a day in 10 minute slots - yeah, I am DONE with that. Link to comment Share on other sites More sharing options...
PAMEDIC Posted February 26, 2019 Share Posted February 26, 2019 My biggest problem patients (apart from the ones already mentioned) are the scammers. The ones seeking secondary gains and oddball advantages through me. For example, I had one patient who wanted me to write a note for them that said they couldn't work for the next year due to a little rib pain. The note was to get out of a job's training and return to work program being offered by the state. They were furious when I said I wouldn't/couldn't do that. In the end, I gave them the Social Security contact information and instructed them to apply for disability. Patients asking for doctor's notes for companion animals. If there is a legitimate reason, sure. The problem is that I have never seen a legitimate case. It is usually people just trying to bring a pet into an apartment. Link to comment Share on other sites More sharing options...
PAMEDIC Posted February 26, 2019 Share Posted February 26, 2019 Another would be my "medicalized" patients. An example would be a patient that years ago had a provider who thought they may have RA and are now convinced they have it. I have to explain that it was probably on their differential and it was tested for but that doesn't mean they have it. The smoking and obesity are more likely culprits but they don't want to hear that. So many patients seem to desperately cling to their perceived medical diagnoses to justify their unhappy unsuccessful lives. I'm not saying it is Munchausen syndrome because they often do have some issues. It is just that their whole identity seems to be wrapped up in a very tentative diagnosis and doing anything to actually redirect the issues and fix the problem is often met with stiff resistance. Link to comment Share on other sites More sharing options...
sas5814 Posted February 26, 2019 Share Posted February 26, 2019 Psych patients that present with vague non-linear complaints who can't be pinned down and can't be satisfied because they don't know what is wrong but often know what they want. The tangential conversations make me want to scream. Disclaimer: I don't do well with psych patients in general. I'm too linear and literal and they are.....not. Link to comment Share on other sites More sharing options...
Reality Check 2 Posted February 26, 2019 Share Posted February 26, 2019 Ok, I narrowed it down. My worst nightmare patient is a borderline personality disorder female. Yep, that is the one. Reality is optional and flexible and suicidal threats are a tool of the trade. Yep, those suck. Link to comment Share on other sites More sharing options...
thinkertdm Posted February 26, 2019 Share Posted February 26, 2019 1 hour ago, Reality Check 2 said: Ok, I narrowed it down. My worst nightmare patient is a borderline personality disorder female. Yep, that is the one. Reality is optional and flexible and suicidal threats are a tool of the trade. Yep, those suck. Only have four women on my panel of a thousandl, the two I've seen are sane and elderly, and I haven't seen the other two. Sounds like you won the lottery! I've found mine: the one who says: I've tried nothing, and I'm all out of ideas. Link to comment Share on other sites More sharing options...
bike mike Posted February 27, 2019 Share Posted February 27, 2019 On 2/25/2019 at 12:17 PM, surgblumm said: The obnoxious patient that is offering you the opportunity to diagnose a disease although you are not a doctor. Their feelings of superiority are sometimes overwhelming and their smirk and response to your questions and then your diagnosis demonstrates that they were smart enough to rulke out the other causes that you have mentioned and then ask to speak to the real doctor. Its been a long time since I have personally experienced this but yet it is memorable. This. I can’t stand the patient that doesn’t trust a word I say because I’m not an MD. Had a pt with poorly controlled HTN the other day who didn’t want me to titrate one of his meds since I didn’t originally prescribe it. Yeah, I used to work in critical care cardiology....I think I can handle titration of antihypertensives. When he refused my recommendations I got out of there ASAP. Not gonna waste my time. Link to comment Share on other sites More sharing options...
kargiver Posted February 28, 2019 Share Posted February 28, 2019 Borderline Patients. All else pales compared to them. G Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted February 28, 2019 Moderator Share Posted February 28, 2019 cannabinoid hyperemesis syndrome...."it's not the weed, man". this is getting so common. it is almost every shift now....haldol is the remedy...drug em until you like em.... Link to comment Share on other sites More sharing options...
Reality Check 2 Posted February 28, 2019 Share Posted February 28, 2019 2 hours ago, EMEDPA said: cannabinoid hyperemesis syndrome...."it's not the weed, man". this is getting so common. it is almost every shift now....haldol is the remedy...drug em until you like em.... and the gynecomastia from pot use isn't the weed either..... deep sigh Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted February 28, 2019 Moderator Share Posted February 28, 2019 33 minutes ago, Reality Check 2 said: and the gynecomastia from pot use isn't the weed either..... deep sigh had a pt last weekend who said they were allergic to haldol. so we took them to the bar(benadryl/ativan/reglan) then got them a cab(compazine/ativan/benadryl) Link to comment Share on other sites More sharing options...
Guest Paula Posted March 1, 2019 Share Posted March 1, 2019 6 hours ago, EMEDPA said: had a pt last weekend who said they were allergic to haldol. so we took them to the bar(benadryl/ativan/reglan) then got them a cab(compazine/ativan/benadryl) have you ever just put them in a hot shower or bath? Link to comment Share on other sites More sharing options...
Guest Paula Posted March 1, 2019 Share Posted March 1, 2019 The patient who comes in (again) for multiple complaints of fatigue and wants a full work up (again) and says "I know it's not my PTSD, depression and anxiety and don't you dare suggest I see a counselor". Full work up is negative (again). Patients finally calls back weeks later and asks for a referral to mental health (so maybe the patient will finally become healthy!). Link to comment Share on other sites More sharing options...
thinkertdm Posted March 1, 2019 Share Posted March 1, 2019 23 minutes ago, Paula said: The patient who comes in (again) for multiple complaints of fatigue and wants a full work up (again) and says "I know it's not my PTSD, depression and anxiety and don't you dare suggest I see a counselor". Full work up is negative (again). Patients finally calls back weeks later and asks for a referral to mental health (so maybe the patient will finally become healthy!). In my experience, they keep coming back. Over. And over again, just knowing that I'm keeping the answer in a locked drawer in my desk. Around the fifth or sixth time, they usually come with Dr. Go Ogle and a list of rare diseases that are a. highly unlikely, so not considered in the first place, or b. Made up diseases that use bizarre reference values on common labs, that "most doctor's don't even know about". In fact, the made up diseases category deserves a whole topic in itself. Chronic Lyme, fluorescent light syndrome, multiple drug sensitivity, adrenal fatigue... Link to comment Share on other sites More sharing options...
sk732 Posted March 1, 2019 Share Posted March 1, 2019 37 minutes ago, Paula said: have you ever just put them in a hot shower or bath? Last guy that we tried that with that kept drinking the shower water...then yacking it up...wash rinse repeat until we said "stay the phuque out of the shower, here's some stuff for you and stop smoking up". The last part wasn't received well, since it couldn't possibly be the dope Link to comment Share on other sites More sharing options...
Reality Check 2 Posted March 1, 2019 Share Posted March 1, 2019 The Perfect Storm Borderline pot smoking Dr Google loving hypochondriac with a sister chiropractic naturopath allergic to all NSAIDs adrenal fatigue Chronic Lyme Dz Hypertensive Diabetic smoker with an FMLA form....... At 4:30 pm..... It has been a long day and I am a tad punchy Link to comment Share on other sites More sharing options...
Joelseff Posted March 1, 2019 Share Posted March 1, 2019 The Perfect Storm Borderline pot smoking Dr Google loving hypochondriac with a sister chiropractic naturopath allergic to all NSAIDs adrenal fatigue Chronic Lyme Dz Hypertensive Diabetic smoker with an FMLA form....... At 4:30 pm..... It has been a long day and I am a tad punchyI think I saw this pt today! HahahaSent from my SAMSUNG-SM-G891A using Tapatalk Link to comment Share on other sites More sharing options...
sk732 Posted March 2, 2019 Share Posted March 2, 2019 I think most of us see one of them daily... Link to comment Share on other sites More sharing options...
kadiah Posted March 2, 2019 Share Posted March 2, 2019 I've been getting a string of patients who are IN SO MUCH PAIN that they refuse to let me examine them. It's funny how quick they change when I tell them I'm just going to document refusal of examination and I therefore can only really "guess" as to what's really wrong with them. Link to comment Share on other sites More sharing options...
sk732 Posted March 2, 2019 Share Posted March 2, 2019 Triage note shows 10/10 abd pain but has a positive Tim Horton's Sign... SK Link to comment Share on other sites More sharing options...
Recommended Posts
Archived
This topic is now archived and is closed to further replies.