Please and Thank you or IT'S IN THE CHART!

In the last year and a half, I've spent far more time than I ever envisioned I would on the other side of the proverbial (or not so proverbial) exam table.



There are some (and these people annoy me endlessly) who say I'm going to be a better physician as a result from what I've learned by being a cancer patient. Hate to disappoint those folks (NOT) but what did or did not make me a good physician has not changed. And, saying something like that implies you know something about the type of care I provided in the past. I've not ever heard someone who actually knows that first or even third hand say something like that. I think what might have changed is my level of tolerance. I have absolutely no tolerance for substandard medical care of any sort.



Can you tell I had a medical appointment today? LOL



Today's appointment is reminiscent of when one of the ob/gyn residents made rounds on me when I was in the hospital last fall after my marathon surgery (a little review for those that might not know or remember... I had a bilateral mastectomy, tissue expander placement, port removal, and bilateral salpingo-oophorectomy... and a few other smaller procedures). It was so obvious that this resident did not bother reading my chart before he walked into the room. He clearly had NO idea what specific surgeries I had and by what approach. This was the very next morning after the surgery. Not a time when I was up for teaching, but I moved into that mode very quickly.



This may come as a shock to some, but there is actually a reason, aside from insurance requirements and possible lawsuits, why we keep medical charts in the first place. {warning: I'm feeling the sarcasm come on}. Did you know that physicians actually kept records BEFORE there ever were insurance companies in the first place? :P This is so very basic, but the first thing you do, before you even enter the room, is you read the chart. It's like a good book. There's so much information and background in there. It's why we, as patients, fill out all those forms. As a physician, I respect the time someone spends filling them out. I still ask the questions though because I often get more tidbits of relevant info. When I am a patient, I expect the same courtesy. Not only is there important information in there that the patient has written, but you can {more sarcasm} actually find out what the previous physicians have found/prescribed/thought/planned, etc. If, perchance, one does not look at the chart before entering the room, one looks at it after introducing oneself to the patient. It's like saying please and thank you. It's basic, basic, basic.



So, that's what happened again today. When it happened with that resident, he obviously reported it to his superiors (I would not let him take off a dressing because I DIDN'T HAVE ONE TO TAKE OFF!!!! LOL). He must have been a good guy because he let them know that I was not pleased and why. I first explained that he needed to read ANY chart before he walked into a room, no matter what his superiors told him to do. I also explained that I understood the pressure to get everything done as I had been an ob/gyn resident at the same hospital, but that not looking at the chart is inexcusable and something someone should have told him long before. I rarely ever pull the doctor card, but when I am complaining about medical care I think it shows where I am coming from. I used to be involved in teaching students and residents, but I am not now. Honestly, I think this is the sort of thing, like please and thank you, that should not have to be taught at this level.



Today, however, I was not seeing a resident. I went to see a podiatrist, someone who has been out of training at least as long as I have. I did not see the podiatrist I normally see. Instead, I saw his partner. When I am seeing a practicing medical provider of any sort, I have basic expectations. If it is the first time I am seeing you, I expect you to introduce yourself and I expect you to read my chart. "Have I seen you before?" is not usually a question for the patient, but if it is, and the answer ends up being "no," that's your cue to LOOK AT THE CHART. Sadly, I am no longer an uncomplicated early 40-something with a single straight forward problem. I have a nice little problem list. You should be aware of that when you speak to me about my medical issue, ideally before you even enter the room. I do not expect to have to give you a full detailed history in the middle of the appointment or even at the end of the appointment because a) IT'S IN THE CHART and b) IT'S IN THE CHART. Your opinion becomes worthless if you don't know my medical history and current medical problems. You just wasted my time and my money. Maybe. I've already complained to the office about this and do not plan to pay for an appointment where not only was nothing done, but the advice given did not apply to situation.

Totally ruined my day.

And, it reminded me why I stick to physicians who come recommended by other healthcare professionals. This is not the first time I've seen a partner who was not up to snuff. It shouldn't have to be this way. As I mentioned before, when I am in the patient role, I don't bring up the doctor card. I expect the same care as anyone else. Days like this make me wonder though. This office clearly does not realize I'm a physician (even though IT'S IN THE CHART, lol) but maybe they should. Maybe I need to give my name as Dr. Ackerman and sign in that way. It should not have to be that way... and it won't be. I will not see this podiatrist again. I'll stick to the one that actually looks at the chart.

Am I too picky? Are my standards too high? I don't think so.