Specialists Are Jerks

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                It is a well-established fact in medicine that specialists are jerks. (To my friends and partners who are specialists, I am not talking about you. I am talking about those other specialists. To my fellow Family Practice colleagues who would like to split hairs and say that Family Medicine is a specialty, I with a resounding eye-roll say, whatever.)

                I had a patient encounter the other day with a woman who has had cancer. Twice. She just moved to a new area. She has not been to the doctor for three years because of financial concerns. When we discussed what her oncologist and her surgeon had recommended for ongoing surveillance for her cancer, she informed me that she had previously been getting MRI’s every other years but her last one was three years ago due to her finances.

                This protocol is not a frequent protocol, but is also not unusual given specific circumstances. I have about four other patients undergoing the same post-cancer protocol. It is one that should be decided by a team of oncologists and surgeons based on the genetics of the tumor and the patient’s prior treatments. None of this is information I have access to, and requesting records and compiling them can take months. This lady in front of me is already a year late for her screening. Did I mention she has had cancer twice?

                So, I order the test. Then I get a call back saying that a certain radiologist needs to speak to me before he can allow the test to go forward. I think this is a little odd, but try calling him back, and stay on hold for thirty minutes only to be informed that he has left for lunch. I leave him my direct phone number so he can reach me easily without any problems.

                The specialist calls me back. And here is the conversation

Specialist Jerk: I don’t understand this protocol. I have never heard of this before.

Me: Oh, really, well I have a few patients who are on this protocol. It isn’t usual, but it isn’t all that uncommon.

SJ: Well I have never heard of it.

Me: Well it is the protocol she has been following from her oncologist and her surgeon.

SJ: What kind of procedure did she have? What are her tumor markers? What was the pathology on the tumor?

Me: I don’t have her records yet, and that may take months to get, and she is late for her screening. We have cleared it with insurance and they are ready to pay for the test.

SJ: I think you should get her established with a surgeon here and an oncologist before we order the test.

Me: Well, considering she is broke, I’m not sure she is going to want to pay for two office visits before paying for an expensive test.

SJ: Well I am not going to let you order the test.

Me: Ok, well, that’s fine, I will just document in her record that you will not allow the test to be ordered, although I recommended we continue with her protocol.

(This may seem like a perfectly reasonable, benign comment to the layperson, but I assure you, that this is basically the medical equivalent of saying, “I will be happy to testify against you on this subject.” It is a like the equivalent of medical napalm, but he left me little option)

SJ: (getting irate) OH REALLY, IS THAT THE WAY YOU WANT TO DO THINGS? LISTEN SWEETIE, I KNOW YOU’RE FRUSTRATED.

Me: Well, yes I am a little frustrated. I am just trying to do the best thing for my patient, and you asked me to call you regarding this, and you didn’t give me your direct line, so I was on hold for thirty minutes and then was informed that you left for lunch.

SJ: LOOK, I HAVE BEEN AWAKE SINCE SEVEN, AND I AM ALLOWED TO TAKE A LUNCH.

Me: (thinking about how my baby got up at 2 am and then again at 5 am, and then I went to work at 7am, and spent my lunch trying to get ahold of him) Yes, I agree you are allowed to take a lunch, but it is a basic courtesy to give another physician your number when you are requesting a call back. That is why I left my direct number for you.

SJ: I DON’T HAVE YOUR DIRECT NUMBER. I DON’T EVEN KNOW WHAT YOU ARE TALKING ABOUT.

Me: I left it with Christy. That is how you just got a hold of me.

SJ:   WHO’S CHRISTY?

Me: Your nurse.

 

                And that proves my point that specialists are jerks (again to my specialist friends… not you silly). If that wasn’t enough, he then contacted people at my office to complain about me. I am wondering if he is going to have his mother call to complain about me next, that is if he can remember her name.

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5 Comments (+add yours?)

  1. Julia Brooks
    Jun 26, 2014 @ 04:48:23

    How many times have I seen this kind of crap! Little did he know who he was messing with. And “Sweetie” was not the thing to say to you when you aren’t happy! You get ‘em girl!!

    Reply

  2. Cristi G.
    Jun 26, 2014 @ 12:06:19

    I’m sure that your patient is grateful for the effort you put in. I think that most of us don’t realize how much crap our doctors have to put up with sometimes. Good for you for trying, I think it would be a riot if his mother did call!

    Reply

  3. ekpreston
    Oct 20, 2014 @ 19:31:44

    Thank you for being one of those doctors who will fight for their patients. Unfortunately, such wonderful people are becoming fewer and fewer nowadays as it is (or at least seems to be) becoming in vogue not to care. Thank you for caring, and thank you for the follow. I look forward to reading more of your posts.

    Reply

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