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Reality Check 2

Who do you see when you are the patient?

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Who do you, as a practicing PA, see as your primary care provider?

How is your relationship? Can you talk professionally and share knowledge?

Is your professional knowledge respected? Can things be discussed in a nonjudgmental manner?

I recently had a less than stellar interaction with my newly assigned PCP after mine went to full time teaching. New one is an internist and probably young enough to be my kid.

I felt completely disrespected from the absolute lack of introduction and NO handshake to the poo pooing attitude toward any of my medical concerns and medications. 

I am a once a year patient. NO ER visits. No controlled substances. No on-call phone calls. Stuff is controlled and I have a couple of specialists who take care of special things on a once a year basis. 

Two issues of concern for this visit and both shot down without investigation - told I should not try to self diagnosis - it was actually the start of a hopeful discussion on my part . She NEVER EVEN TOUCHED ME. Obviously did NOT read any of my chart and had a dismissive body posture and never made eye contact. 

I left. 

Deep Ugly Sigh

Back to searching for a new PCP.....

Would love to hear what others have experienced.

 

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I see an MD, who was recommended by an MD colleague.  Very good, knowledge wise; he was able to explain some concerns to me.  Respectful. 

I refuse to see an NP after a few bad experiences with multiple NP's.

In general, I feel pretty much the same way as you.  Don't dismiss my concerns, even if they are the craziest thing you've heard all day.  Acknowledge my feelings, then do your best to explain them without making me feel like an idiot.

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I go to both the VA and a local military base as I have a PCM at each.  

My VA experience has generally been terrible.  New PCM every year, most of them never touched me, and most have been FMGs with extremely poor communication ability in English.  I just went to them because it is convenient to have the VA mail me my mobic and lidoderm patches.  However for past two years I have had an NP who has listened well and performed a decent PE.  

My military PCM also changes every year, and I've had docs, PAs, and NPs, and never been really impressed with any of them.    I go to them for referrals for any specialty care I need (usually ortho).  Seems mostly to be a bureaucratic position....

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1 hour ago, Reality Check 2 said:

She NEVER EVEN TOUCHED ME.

 

I hate to blow it up like this

 

But you need to get a copy of your chart - see if she documented a PE section

If she did you need to have a very frank discussion with both her and her employer (if it is corp medicine)

This is fraud and lying and above just not giving a $$it it is just horrible medicine.  

Your relationship with her is toast, and you need a new PCP, but stop this ignorant over confident schmuck from practicing in a way that hurts all of medicine

 

As for me I see a Doc at the VA that is an older PCP, only seen 2 times but he is nice and spends time, maintains eye contact and listens.  would not have it any other way

 

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Your post hit a cord with me and I will try to summarize from the good and the bad from my saga. From a background perspective, I am 64 and have been in excellent health my entire life. As I've mentioned here before, on Jan 11th of this year, this all changed with it was discovered I was in severe renal failure (BUN of 165, Creatinine of 12.5 and K of 6.9). To make a long story short, I was admitted to ICU and after about a week a final dx was made of Multiple Myeloma with associated renal failure from the overproduction of light chain plasma proteins. I had to go on dialysis, did aggressive induction chemo and moved to Seattle in May for a stem cell transplant. I returned home in August.

1) Local Care Last Year: Now, with that background, I will say the old healthy me, I had a great relationship with my (MD) PCP. My wife picked him for me (she is in the local hospital admin and choose him as he was the chief of staff). He respected me and we "talked shop" and he respected my opinions. I would have been happy to have seen a PA if there was one available.

2) Summer Care at Seattle's Cancer Care Alliance: During my stay in Seattle, I had excellent care. Most the time I was seen by a PA, including during my stay in the hospital for several weeks. I had a deep respect for their knowledge, as for the "world class" attending (MD) and they respected my opinions and concerns. So, for about every 3-4th visit with the PA I would also see the MD. They would have me make many of the clinical decisions (which the choice was not clear) based on the papers written (and they would give me references if I had not already read them).

3) Back Home: This is where things get strange. I started to follow with a local oncologist as the Seattle program cannot do long-term follow up. He is very focused on the maintenance chemo, while I have many complicating factors from the disease and transplant. He refuses to discussed these and I am left on my own (for example my ANC dropped from 1700 to 200 in five days and then I developed a facial cellulitis. I had to call my Seattle doctor to get help as he didn't see what my concern was. She was very concerned and started me on Leaquin, saying that if I lived in Seattle she would have admitted me.) I've had several such issues including a HGB dropping to 8 and me calling and begging for transfusions. So, he doesn't show my clinical judgment much respect and dismisses my concerns and doesn't want to think outside his narrow box.

I had made an appointment to go back and see my PCP before this time (late August). The main concern then was that the mega dose of steroids (95 MG of pred) was causing me to have hypertension. My Seattle PA had started me on carvedilol for this and it was not working (systolic 180-190 and diastolic 110+). It was a bizarre appointment back with my PCP. The last time he saw me,  in Dec 2018, I was his best buddy, and in a great state of health. Now, with post stem cell transplant, cancer, renal failure, graft vs host disease, steroid dependent, hypertension, AND peripheral neuro-motor injury from uremia, he seemed pissed I was even coming to see him (suddenly I had become a train wreck, not of my own device.) He made me wait in his exam room for over an hour and came in with an attitude of why the hell are YOU here. I, in response to his attitude, said, simply help me with my blood pressure (I can't prescribe for myself) and I will not ask for anything else. He said no. He said it was outside of his expertise and he wasn't getting involved, then he left after calling me the wrong first name. Fortunately, once I tapered off the steroids, my B/P returned to normal. But I feel like I am on  completely on my own now because I am so sick. My oncologist won't help me, my PCP doesn't want to get involved, and I can't go back to the great people in Seattle. If would love to have a PA or MD or ARNP who cares and is willing to give me some help but I don't think our system is set up for that anymore.

That is my view of the health care system now as a patient. I think my present providers hope I die soon to leave them the hell alone. I can't imagine treating my own patients like this, but maybe I should have, to have make the big bucks with 4 minute appointments (not really).

Edited by jmj11

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Thanks Ventana - I WILL get a copy of my record and check on the billing. 

I am going to ask for my copay back.

Got an appt with my husband's PCP who is now also seeing one of our grown up kids. He seems to respect me in the room with my family members but not afraid to point out knowledge points or his insight. 

I could never treat a patient like she did me. Even the basics - INTRODUCE YOURSELF and shake my hand. Tell me something about yourself since I have never seen your face before and know ZIP about you - the person I would like to entrust with my care. RESPECT my level of knowledge as well.

Some of my patients are retired Flight Surgeons, full bird colonels who are physicians and EMTs or medics who have seen some wild stuff.  I respect their thoughts. Some of my patients are tin foil wearing and a bit odd - I listen to them too.

EVERY patient deserves the respect as Thinkertdm said - spill your crazy and let me process it - there are nice ways to tell folks they are off base or misinformed.  

jmj11 - I am so sorry to hear of your journey and all the issues. I hope you are being heard and doing well.

Thank you all for the feedback. Let's keep up the good fight and the good work - set the bar high!

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Who do you, as a practicing PA, see as your primary care provider?

How is your relationship? Can you talk professionally and share knowledge?

Is your professional knowledge respected? Can things be discussed in a nonjudgmental manner?

I recently had a less than stellar interaction with my newly assigned PCP after mine went to full time teaching. New one is an internist and probably young enough to be my kid.

I felt completely disrespected from the absolute lack of introduction and NO handshake to the poo pooing attitude toward any of my medical concerns and medications. 

I am a once a year patient. NO ER visits. No controlled substances. No on-call phone calls. Stuff is controlled and I have a couple of specialists who take care of special things on a once a year basis. 

Two issues of concern for this visit and both shot down without investigation - told I should not try to self diagnosis - it was actually the start of a hopeful discussion on my part . She NEVER EVEN TOUCHED ME. Obviously did NOT read any of my chart and had a dismissive body posture and never made eye contact. 

I left. 

Deep Ugly Sigh

Back to searching for a new PCP.....

Would love to hear what others have experienced.

 

That was me 3 weeks so. She (PAC less than 2 years out) tried to order a PSA on me at 30yo. She didn't read my chart at all. She needs to come spend a day with me in the clinic. A lot to learn about learning and being a CARE provider. Just realized why my patients love me.. personality and knowledge goes a long way

 

Sent from my SM-N975U1 using Tapatalk

 

 

 

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Your post hit a cord with me and I will try to summarize from the good and the bad from my saga. From a background perspective, I am 64 and have been in excellent health my entire life. As I've mentioned here before, on Jan 11th of this year, this all changed with it was discovered I was in severe renal failure (BUN of 165, Creatinine of 12.5 and K of 6.9). To make a long story short, I was admitted to ICU and after about a week a final dx was made of Multiple Myeloma with associated renal failure from the overproduction of light chain plasma proteins. I had to go on dialysis, did aggressive induction chemo and moved to Seattle in May for a stem cell transplant. I returned home in August.
1) Local Care Last Year: Now, with that background, I will say the old healthy me, I had a great relationship with my (MD) PCP. My wife picked him for me (she is in the local hospital admin and choose him as he was the chief of staff). He respected me and we "talked shop" and he respected my opinions. I would have been happy to have seen a PA if there was one available.
2) Summer Care at Seattle's Cancer Care Alliance: During my stay in Seattle, I had excellent care. Most the time I was seen by a PA, including during my stay in the hospital for several weeks. I had a deep respect for their knowledge, as for the "world class" attending (MD) and they respected my opinions and concerns. So, for about every 3-4th visit with the PA I would also see the MD. They would have me make many of the clinical decisions (which the choice was not clear) based on the papers written (and they would give me references if I had not already read them).
3) Back Home: This is where things get strange. I started to follow with a local oncologist as the Seattle program cannot do long-term follow up. He is very focused on the maintenance chemo, while I have many complicating factors from the disease and transplant. He refuses to discussed these and I am left on my own (for example my ANC dropped from 1700 to 200 in five days and then I developed a facial cellulitis. I had to call my Seattle doctor to get help as he didn't see what my concern was. She was very concerned and started me on Leaquin, saying that if I lived in Seattle she would have admitted me.) I've had several such issues including a HGB dropping to 8 and me calling and begging for transfusions. So, he doesn't show my clinical judgment much respect and dismisses my concerns and doesn't want to think outside his narrow box.
I had made an appointment to go back and see my PCP before this time (late August). The main concern then was that the mega dose of steroids (95 MG of pred) was causing me to have hypertension. My Seattle PA had started me on carvedilol for this and it was not working (systolic 180-190 and diastolic 110+). It was a bizarre appointment back with my PCP. The last time he saw me,  in Dec 2018, I was his best buddy, and in a great state of health. Now, with post stem cell transplant, cancer, renal failure, graft vs host disease, steroid dependent, hypertension, AND peripheral neuro-motor injury from uremia, he seemed pissed I was even coming to see him (suddenly I had become a train wreck, not of my own device.) He made me wait in his exam room for over an hour and came in with an attitude of why the hell are YOU here. I, in response to his attitude, said, simply help me with my blood pressure (I can't prescribe for myself) and I will not ask for anything else. He said no. He said it was outside of his expertise and he wasn't getting involved, then he left after calling me the wrong first name. Fortunately, once I tapered off the steroids, my B/P returned to normal. But I feel like I am on  completely on my own now because I am so sick. My oncologist won't help me, my PCP doesn't want to get involved, and I can't go back to the great people in Seattle. If would love to have a PA or MD or ARNP who cares and is willing to give me some help but I don't think our system is set up for that anymore.
That is my view of the health care system now as a patient. I think my present providers hope I die soon to leave them the hell alone. I can't imagine treating my own patients like this, but maybe I should have, to have make the big bucks with 4 minute appointments (not really).
I don't have much to say, just really really strong feelings of sadness

Sent from my SM-N975U1 using Tapatalk

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4 hours ago, jmj11 said:

Your post hit a cord with me and I will try to summarize from the good and the bad from my saga. From a background perspective, I am 64 and have been in excellent health my entire life. As I've mentioned here before, on Jan 11th of this year, this all changed with it was discovered I was in severe renal failure (BUN of 165, Creatinine of 12.5 and K of 6.9). To make a long story short, I was admitted to ICU and after about a week a final dx was made of Multiple Myeloma with associated renal failure from the overproduction of light chain plasma proteins. I had to go on dialysis, did aggressive induction chemo and moved to Seattle in May for a stem cell transplant. I returned home in August.

1) Local Care Last Year: Now, with that background, I will say the old healthy me, I had a great relationship with my (MD) PCP. My wife picked him for me (she is in the local hospital admin and choose him as he was the chief of staff). He respected me and we "talked shop" and he respected my opinions. I would have been happy to have seen a PA if there was one available.

2) Summer Care at Seattle's Cancer Care Alliance: During my stay in Seattle, I had excellent care. Most the time I was seen by a PA, including during my stay in the hospital for several weeks. I had a deep respect for their knowledge, as for the "world class" attending (MD) and they respected my opinions and concerns. So, for about every 3-4th visit with the PA I would also see the MD. They would have me make many of the clinical decisions (which the choice was not clear) based on the papers written (and they would give me references if I had not already read them).

3) Back Home: This is where things get strange. I started to follow with a local oncologist as the Seattle program cannot do long-term follow up. He is very focused on the maintenance chemo, while I have many complicating factors from the disease and transplant. He refuses to discussed these and I am left on my own (for example my ANC dropped from 1700 to 200 in five days and then I developed a facial cellulitis. I had to call my Seattle doctor to get help as he didn't see what my concern was. She was very concerned and started me on Leaquin, saying that if I lived in Seattle she would have admitted me.) I've had several such issues including a HGB dropping to 8 and me calling and begging for transfusions. So, he doesn't show my clinical judgment much respect and dismisses my concerns and doesn't want to think outside his narrow box.

I had made an appointment to go back and see my PCP before this time (late August). The main concern then was that the mega dose of steroids (95 MG of pred) was causing me to have hypertension. My Seattle PA had started me on carvedilol for this and it was not working (systolic 180-190 and diastolic 110+). It was a bizarre appointment back with my PCP. The last time he saw me,  in Dec 2018, I was his best buddy, and in a great state of health. Now, with post stem cell transplant, cancer, renal failure, graft vs host disease, steroid dependent, hypertension, AND peripheral neuro-motor injury from uremia, he seemed pissed I was even coming to see him (suddenly I had become a train wreck, not of my own device.) He made me wait in his exam room for over an hour and came in with an attitude of why the hell are YOU here. I, in response to his attitude, said, simply help me with my blood pressure (I can't prescribe for myself) and I will not ask for anything else. He said no. He said it was outside of his expertise and he wasn't getting involved, then he left after calling me the wrong first name. Fortunately, once I tapered off the steroids, my B/P returned to normal. But I feel like I am on  completely on my own now because I am so sick. My oncologist won't help me, my PCP doesn't want to get involved, and I can't go back to the great people in Seattle. If would love to have a PA or MD or ARNP who cares and is willing to give me some help but I don't think our system is set up for that anymore.

That is my view of the health care system now as a patient. I think my present providers hope I die soon to leave them the hell alone. I can't imagine treating my own patients like this, but maybe I should have, to have make the big bucks with 4 minute appointments (not really).

Good gawd.  This is what it's come to.  I am so very sorry.  

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6 hours ago, ventana said:

But you need to get a copy of your chart - see if she documented a PE section

If she did you need to have a very frank discussion with both her and her employer (if it is corp medicine)

This is fraud and lying and above just not giving a $$it it is just horrible medicine. 

It's entirely possible to document an 8 system physical exam without touching the patient: Alert+Oriented, NC/AT, sclera anicteric, external ears and nose unremarkable, trachea midline, breathing unlabored with symmetric chest rise, no jaundice or rash, moving all four extremities normally and patient walks without mechanical assistance.  Boom.

Good medicine? Not if there's a complaint remotely informed by a physical exam.  Fraud? Not if it's accurate.

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7 hours ago, jmj11 said:

your post

This is maddening and saddening at the same time. Keep trying to find a provider who cares.

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 I am not sure where I would be without my PCP who is an MD.  I developed a heinous pain condition 6 years ago and was suicidal due to the pain level and nobody knowing what was wrong with me.  He also did not know what was going on but continued to support me in my quest and provided narcotics to manage my pain.  He makes me feel like I'm his only patient!!

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Why should the provider have to shake your hand?  How does a hand shake improve the care that you are getting?  Will a handshake help the provider to diagnose any illness that you have?  All a hand shake does is possibly spread disease.  It adds nothing to the quality of care you are getting.

I do find it frustrating to go to any health care provider, as I feel that they are talking down to me.  I can deal with this from an actual provider, but I don't like when an MA is lecturing me about a blood pressure of, say, 98/64.  This BP is normal for me, it's fine, you're only an MA so don't feel that you know more than me.  My gynecologist was trying to tell me how to do a breast self exam.  I'm like "I know how to do breast exams; I've done them on plenty of women.  I'll be fine," but he wasn't listening.  So many people in health care assume that their patient couldn't possibly have any healthcare knowledge.

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7 minutes ago, Photograph51 said:

Why should the provider have to shake your hand?  How does a hand shake improve the care that you are getting?  Will a handshake help the provider to diagnose any illness that you have?  All a hand shake does is possibly spread disease.  It adds nothing to the quality of care you are getting.

I do find it frustrating to go to any health care provider, as I feel that they are talking down to me.  I can deal with this from an actual provider, but I don't like when an MA is lecturing me about a blood pressure of, say, 98/64.  This BP is normal for me, it's fine, you're only an MA so don't feel that you know more than me.  My gynecologist was trying to tell me how to do a breast self exam.  I'm like "I know how to do breast exams; I've done them on plenty of women.  I'll be fine," but he wasn't listening.  So many people in health care assume that their patient couldn't possibly have any healthcare knowledge.

 

So yeah, for he record I never shake my patients hands.  I come into the room, make eye contact and introduce myself as I put some hand sanitizer on for them to see.  Usually I smile and ask them what brings them into urgent care.  Dealing with infectious disease all day, especially during flu season, I find hand shaking to be a terrible habit.  I've not had one complain yet.

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I usually don't shake hands at the beginning but shake hands at the end.  A firm handshake and look 'em in the eyes.  I feel it tells patients there is a human being, not a machine taking care of them.  It gives them confidence.  That they aren't in a vacuum, or alone.  When you are stricken down with a disease, any disease, you feel alone.  More alone than anything. Many patients are worried that this is the end, especially having nothing else to fall back on. 

Letting them know they are not alone, that you are with them is very therapeutic.  True, hands spread disease.  That's what pants are for, to wipe your hands on.

All joking aside, it's just a thing.  A cold isn't going to take you out, and when you are seeing fifty patients a day, no need to shake everyone's hand.  I actually don't see that many with colds, most of my patients are vets who benefit from long term relationships. 

You don't even need to shake their hand.  Turn away from the computer, and look at the patient, in their eyes.  Nod your head, like you're listening.  Ask questions.  Administrators and retail medicine have taken away the most important part of medicine, the human part. 

Any schmoe can prescribe a medicine.  But very few can actually say, "I hear you.  You are suffering, and I feel that.  Hell, I've been there too.  I want you to know, it won't last forever, and I will do what I can to help you". 

 

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3 hours ago, Photograph51 said:

Why should the provider have to shake your hand?  How does a hand shake improve the care that you are getting?  Will a handshake help the provider to diagnose any illness that you have?  All a hand shake does is possibly spread disease.  It adds nothing to the quality of care you are getting.

I do find it frustrating to go to any health care provider, as I feel that they are talking down to me.  I can deal with this from an actual provider, but I don't like when an MA is lecturing me about a blood pressure of, say, 98/64.  This BP is normal for me, it's fine, you're only an MA so don't feel that you know more than me.  My gynecologist was trying to tell me how to do a breast self exam.  I'm like "I know how to do breast exams; I've done them on plenty of women.  I'll be fine," but he wasn't listening.  So many people in health care assume that their patient couldn't possibly have any healthcare knowledge.

I shake hands.  I disinfect about 100 times per day, too.  Often, in front of the patient so they are aware.  I don't introduce myself unless it's a new patient because most of my patients have known me for years!

Also, I never assume medical knowledge when I'm caring for a fellow health care worker.  I don't know what gaps they may have in their knowledge.  I usually say something like, "I know that you already know this, but..."  I don't want to disrespect their knowledge, but they need to hear it from me.

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For those commenting on the handshake issue - YES, I get the infection thing. But, my point is......

YES, it DOES affect the interaction with the provider. NOT acknowledging a patient's existence with even a common courtesy sets a poor tone for the encounter - I get more polite interaction with the kid at the local coffee hut than I got from this internist.

NEVER saw her before, know ZERO about her - the corp med did NOT put her bio online. She did nothing to set the tone for the interaction - no introduction - such as - "Nice to meet you. I know you were a patient of Dr X and she went to full time teaching. I would like to hear about your needs and concerns". Instead I was another sheep in the herd of her daily patients with no more concern for me than someone in line with her at the bank. She mumbled that her name was Dr Y and went into my med list as though I was nothing more than a statistic.

Common decency and politeness are professional necessities. I have worked with my share of colleagues who have borderline Tourettes or appear to be on the autism spectrum for social capacity but interpersonal skills are necessary to work with patients - Especially patients never seen before. Instill some confidence. Show some empathy. Be human.

Then we get to the point of having no respect for any knowledge I might have - whether I am a plumber or experienced provider. 

And, I do shake a lot of hands and wash them a lot and offer hand sanitizer to the patients as well.

And, yes, some patients hug me.

So, back to original post purpose - as a medical professional do you have a good relationship with your own PCP?

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4 minutes ago, Reality Check 2 said:

So, back to original post purpose - as a medical professional do you have a good relationship with your own PCP?

Assumption, unfounded: we all have PCPs.

I don't.  My PCP retired.  I have colleagues who write scripts for me, which are duly documented in the medical record, but they are helping me look out for myself, not actively caring for me as a patient. Is it optimal? Not in the least.  I say this knowing full well there are probably plenty of others here who are doing this for many or all of their health care needs, likely too embarrassed to admit what I just did.  For me, it's about time, money, and quality: Why would I want to pay hundreds of dollars and waste my time (see everyone else's gripes, above) to get care not arguably better than from the NP who shares my office on the days I'm not there?

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11 hours ago, rev ronin said:

It's entirely possible to document an 8 system physical exam without touching the patient: Alert+Oriented, NC/AT, sclera anicteric, external ears and nose unremarkable, trachea midline, breathing unlabored with symmetric chest rise, no jaundice or rash, moving all four extremities normally and patient walks without mechanical assistance.  Boom.

Good medicine? Not if there's a complaint remotely informed by a physical exam.  Fraud? Not if it's accurate.

true but if she is documenting things lik CV and REsp Exam it is fraud - the EMR with the template exams have made this problem.  I just about NEVER use them - I type every exam      would not surprise me if she documented a wildly fraudulent exam 

 

One job many years ago I was one of the lowest producers in the ER - I watched the other providers and quickly resigned - many many of them were never touching patients - ie even for ankle sprains and strains - then documenting complete exams - like head to toe exams - then upcoding the visit - truly fraudulent and illegal and immoral and just bad medicine.  I knew I would never be able to match their production numbers.  Soon after leaving the MD director almost lost license for not looking at things, contract was pulled from the company and a HUGE staff turn over occured 

 

13 hours ago, Cideous said:

Good gawd.  This is what it's come to.  I am so very sorry.  

agreed

4 hours ago, Cideous said:

 

So yeah, for he record I never shake my patients hands.  I come into the room, make eye contact and introduce myself as I put some hand sanitizer on for them to see.  Usually I smile and ask them what brings them into urgent care.  Dealing with infectious disease all day, especially during flu season, I find hand shaking to be a terrible habit.  I've not had one complain yet.

I have to bring up 'human touch'   the geri patients are so craving for human touch (who really every touches them, holds their hands, lays a hand on their shoulder????  just about never!)   it is kind simple gesture that goes miles and miles towards building relationships

just wash your hands!  Think about it - you can work in a septic tank with no gloves on (if skin intact) and just wash hands off you are are fine - touching someone is not going to get you sick

 

 

our system is so broken it is insane

we need to be able to see 10 patients a day in PCP and do a great job and then it will change, but 20 patient days are crappy 

 

 

 

 

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I feel very fortunate after reading these posts.

My PCP is a DO I've seen for probably 15 years.  He's made a huge difference in my life by diagnosing and treating the hypothyroidism that had me so fatigued at the end of PA school that I had to nap after school just to have enough energy to eat supper.  I see him yearly for my annual physical and check of my chronic conditions.  We talk as physician to respected patient.  We both acknowledge that we're knowledgeable medical generalists with some overlap.  He's way more knowledgeable on management of chronic conditions; I am on acute conditions as he is a PCP (very good) and I do EM.

As for hand shaking and touching patients: I try to shake the hands of all my patients (have to be a bit creative when they're handcuffed) and all of their adult family members.  I also try to touch them while I'm talking to them and also with my unused hand while auscultating lungs & hearts.  After I leave the room I head right to the sink and soap and water wash my hands - no alcohol gel for me.

Mike, I'm so sorry that your old PCP doesn't feel he can continue to help you.  I'd be a bit scared if you were my patient, because of how complex you are, but at least I think your old PCP could have had a phone conversation with your oncologist about how to help, what to watch for, etc.

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Ok, not to beat a dead hand shake horse here but....

Agreed, humans desire human touch, but it does not need to be in a way that is 100% absolutely designed to spread infection and disease.  

Hand shaking was designed to show the person you are meeting that you are not carrying a weapon.  I think that is a given in a medical encounter.

Just because I don't shake hands doesn't mean I don't touch my patients, I do.  A gentle hand/tap on the shoulder of a patient after a deep breath...a tap on the arm as I say goodbye....all perfectly meet that need without giving me pink eye.  LOL

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I worked with a neurologist once, who was privately verbal that he didn't like patients, any of them. He was a very high producer, seeing new consults in 15 minutes and billing for 90 all day long. When I saw patients that he had seen, they told me that he never touched them during their new patient consult. That didn't seem possible and I thought they must be embellishing. Then one day (long story) I left all my medical equipment in another office in another city and this neurologist was not there that day. I borrowed his equipment, reflex hammer, ophthalmoscope,  stethoscope and etc. Then the cleaning person had put them all in a drawer in MY exam room, where I was using them, at the end of the day. This neurologist came back to work and it was weeks later that I discovered his equipment still in my drawer. He had never used them or even missed them. Then it dawned on me that the patients were telling the truth. But the system loved the guy because he brought in the most $$$.

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45 minutes ago, ohiovolffemtp said:

 

Mike, I'm so sorry that your old PCP doesn't feel he can continue to help you.  I'd be a bit scared if you were my patient, because of how complex you are, but at least I think your old PCP could have had a phone conversation with your oncologist about how to help, what to watch for, etc.

 

it is amazing that some doctors only function with in what they know 100%

I am almost 20 years out of school and a moderately smart guy (but thats it)

I am faced almost daily with things the I am not 100% on - I read and learn and partner with the patients to always be expanding my knowledge.  I just don't understand how you practice medicine with out always learning and challenging yourself....

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4 hours ago, Reality Check 2 said:

NEVER saw her before, know ZERO about her - the corp med did NOT put her bio online. She did nothing to set the tone for the interaction - no introduction - such as - "Nice to meet you. I know you were a patient of Dr X and she went to full time teaching. I would like to hear about your needs and concerns". Instead I was another sheep in the herd of her daily patients with no more concern for me than someone in line with her at the bank. She mumbled that her name was Dr Y and went into my med list as though I was nothing more than a statistic.

 

My prior PCP just left, sounds like she moved to your neck of the woods. Seriously, word for word, action for action (or lack thereof)

Good luck!

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I have to bring up 'human touch'   the geri patients are so craving for human touch (who really every touches them, holds their hands, lays a hand on their shoulder????  just about never!)   it is kind simple gesture that goes miles and miles towards building relationships
just wash your hands!  Think about it - you can work in a septic tank with no gloves on (if skin intact) and just wash hands off you are are fine - touching someone is not going to get you sick
 
 
our system is so broken it is insane
we need to be able to see 10 patients a day in PCP and do a great job and then it will change, but 20 patient days are crappy 
 
 
 
 
Homie I see 30 plus in urology

Sent from my SM-N975U1 using Tapatalk

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