Health care provider, frustrated with patient's or guardian's attitudes

[FSUDisneyGirl]

I agree with some others, what you said/ the way you acted was a bit rude and unprofessional. You could have spoken in a more pleasant/ professional way.

Additionally, I agree with others that YOU do not have to know the history of a million patients. However, if it is that hazardous to you as a pregnant woman, there should be procedures in place to mark files of patients who may pose a hazard to certain staff, or you (meaning the office, not you personally) should have procedures in place to identify any potential problems before you enter the room, so there are no awkward situations.

Or, you could just wear a mask!

 

[RitaE]

So, when are people suppose to take responsibility for their actions. I as you all keep reminding me tell me it is my responsibility to know the history of every one of my thousands of patients. Yet Grandmother with 1 grandkid, who was explained by me and the doctor previously, that I or the other PA should not see him, while pregnant, can't possibly remember that? How is that fair.

I'm not quite sure what you mean by the patient taking responsibility for her actions. She had a sick child in her care and she took him to the Pediatrician's office for treatment. On what planet is that not responsible?

If you spoke to the family as reported here you were beyond rude and unprofessional.

Yes, your pregnancy is a priority - but is it your responsibility to take the measures necessary to protect your baby. It is NOT the responsibility of your patients to do that for you by not daring to appear in front of you as patients.

You could have and should have handled the situation so much better.

 

[MK2thcleaner]

The point isn't that they are on Medicaid. I am sure you all think I hate poor people now. I am talking about feelings of "entitlement" which we see a lot in our practice.
We also have people every day playing with games, answering their phones, and going on smoke breaks, leaving their kids in the room. This irritates me, and is not proper etiquette for any medical office to have to deal with.

The entitlement issues of which you speak have little to do with income and insurance status. I am also a healthcare provider, see very few if any people who are on state aid and an unbelievable amount behave in rude ways when it comes to appreciation of my time!

I have to agree with the PP's who say that your behavior was unprofessional. I would be hurt and embarrassed if I was the grandma. You continue to blame her, but what if the front office staff made the mistake of scheduling the child with you? Does the office know not to schedule any patient with this diagnosis with you? I'm sure you'll learn something from this whole situation. I make mistakes everyday, none of us are perfect. Hopefully you'll develop a system to keep something like this from happening again.

 

[moon]

Nope, sorry, when she recognized the child in question, she should have politely excused herself from the room and went the to physician and explained the situation.

No need to say anything to the grandmother about the Herpes.

I feel awful for the Grandmother and even more so for that poor little boy.

 

[southernbelle_amy]

As a fellow healthcare provider, I can certainly sympathize with your handling of that situation. What many people can't remember is that we are of no help to the public if we become ill or injured ourselves while dealing with a problem. "


Dan thanks for the support. You are so right, that if we (healthcare workers) all get sick, we are no longer valuable to the patient. Just last week I saw a girl with a 104.9 fever that ended up with H1N1. After discusing the patient with my doctor, she was like I can go in so you don't get more exposed, to little to late, I just went ahead and finished seeing her.

 

[C.Ann]

I am not even that mad at GM, but I just think it is a sad case of how selfish people can be, when we (Healthcare providers) are doing the best we can. I work where ~80% of the patients are Medicaid, and a lot of them do have a sense of "entitlement", like we are just there to serve them. I also thought about if something were to happen, it's not as though, she is going to pay for it or even care. Although, my tax money is helping paying for his treatment. (of course health care policy, is not what I want to debate). I try for my sanity and my patients to not become cynical, but in these situations it is very hard. Sorry this is so long, but it really just bothered me. Vent over.

The point isn't that they are on Medicaid. I am sure you all think I hate poor people now. I am talking about feelings of "entitlement" which we see a lot in our practice.
We also have people every day playing with games, answering their phones, and going on smoke breaks, leaving their kids in the room. This irritates me, and is not proper etiquette for any medical office to have to deal with.

Based on your statements above, I tend to agree with the posters below.. Perhaps you should take a leave of absence until after you have had your baby..

As a PA you should know that herpes simplex is NOT airborne. If you use good technique and wash your hands before and after examining the patient, you will not get herpes. The combined incidence in the general population of herpes simplex I and II exceeds 80%. If you are that anxious about contracting an infectious disease, maybe its time to start your maternity leave.
I covet my tax dollars as much as anyone, but it is NO ONE'S BUSINESS how a patient's bills are paid. I would hope that you would treat the Medicaid patient with every bit of respect that you would treat your self paying, Blue Cross Blue Shield patient as well as your "dead beat" patient. When someone brings their sick child to you for care, you are there to serve them. If you aren't; find another job. Yes, you owe the family an apology. Your attitude conveyed disgust, even if it wasn't your intention.

I'm not quite sure what you mean by the patient taking responsibility for her actions. She had a sick child in her care and she took him to the Pediatrician's office for treatment. On what planet is that not responsible?

If you spoke to the family as reported here you were beyond rude and unprofessional.

Yes, your pregnancy is a priority - but is it your responsibility to take the measures necessary to protect your baby. It is NOT the responsibility of your patients to do that for you by not daring to appear in front of you as patients.

You could have and should have handled the situation so much better.

 

[My sister's princess]

I don't think you were in the wrong..... If the grandmother had been spoken to before then really you shouldn't have been put in that situation in the first place. If we all took a little more responsibility for ourselves it would make the Dr.'s and PA's jobs much easier.

As for the entitlement comment, I understand what you mean, no flames here

 

[lsyorke]

It sounds like this was discussed ALOT in the practice. That being said, why would anyone book the child if you were the only one seeing patients that day?
You knew that "someone" in the family had a history of Herpes, it is your responsibility to find out which member of the family is in the exam room.

I couldn't agree with Dawn more...proper universal precautions would have protected you without the drama. As medical professionals we walk to situations all day, every day that have the potential to cause illness. It is OUR responsibility to protect ourselves. In the office you have the advantage of a medical record and should use it....in the mall you have no idea who you are standing next to.

So many patients don't understand the impact of their diseases on others, that's why we are trained to do what we do to protect ourselves.

 

[princess momma]

I understand princess_momma about wanting your provider to know your past medical history, but alot of kids we do see repeatedly and once I see them in person, I usually remember, oh yay they do have this, or was last seen for such and such. If it comes up I do always check about a previous condition that they do have.

Again, in a perfect world every provider would have 10 minutes to review each patient's chart. The truth is we have 15 min per appt, and when busy some of these are double booked, so it just can't always happen.

If I could see only 15 a day, that would be fine, but again, people don't like to be told we can't see your sick kid for 3-4 days since we are so booked. It is the lesser of 2 evils.

I'm also a health care provider, although I've never worked in a clinic setting. I realize there's a time crunch and we have a huge problem with the system, so I can sympathize with that.

But I do always make the time to scan the chart for any pertinent info before seeing a patient. It's just part of being prepared for patient care.

I've checked my chart in the clinic and there's a list of diagnoses and procedures right in the front. It takes a minute, if that, to review it. Yet it rarely gets looked at.

 

[southernbelle_amy]

As a PA you should know that herpes simplex is NOT airborne”
- I never said it was airborne, just that it would be best for me not to examine him

“Did she know that they were scheduled to see you? If so, then they violated the previously held agreement that they would not see you until after you delivered.”
-She knew to ask to be scheduled with only the doctor from the previous visit. Which she didn’t. If they don’t specify, they see whoever gets to them first.

“she should have politely excused herself from the room and went the to physician and explained the situation.”
-excusing myself with no explanation seems ruder to me. There wasn’t anything really to explain to my physician, since it was already determined from the previous visit.

“Yes, you have chosen a profession where it is your job to serve people.”
- I agree but not to unnecessarily put myself or family in danger, especially when there is another option, such as the doctor coming in, within 5 minutes.

“You could have spoken in a more pleasant/ professional way.”
-I would like some leeway on what I said, it is hard to explain, and judge in words typed out.

I'm not quite sure what you mean by the patient taking responsibility for her actions.Grandmother with 1 grandkid, who was explained by me and the doctor previously, that I or the other PA should not see him, while pregnant, can't possibly remember that? She already was told I shouldn’t see him in the future.

I feel awful for the Grandmother and even more so for that poor little boy. He must have felt like PPs have said.....like a leper
-He is 6 months old, and will not be scarred for life.

 

[Lizzy2]

It is completely frightening to me as a patient that you cant find two minutes before walking in the exam room to look at my chart!! and if you had just taken those two minutes that you say you can't spare it would have saved all the minutes its now taking to make up for being so rude. Of course your priority is your unborn child but that is not the patients responsiblity, I don't care what you have discussed previously with them. Take some time off. You are in the wrong job.

 

[Mickey's Minion]

I hope I can explain this. I am a PA (physician assistant) at a pediatric practice. Honestly every day I expose myself to various illness, without much hesitation. However, I am close to 6 months pregnant so some illness I try or the nurses try to avoid, but sometimes we are unaware until it is too late.

Well today there was a kid that is about 6 months old whose chief complaint was cold and cough symptoms. Well, I went into the room, and recognized the kid. He has a history of neonatal Herpes Simplex.
Before his grandmother could start I asked, "Is he the one with a history of Herpes?". She immediately got defensive and said, "yes, but that is not what he is here for he has ............ etc". I said well, "I really think it was be best for the doctor to see him because I am currently pregnant, and due to his history". She was still agitated and said how he did not have a current rash, was asking if I had chicken pox before. I again said that I could get the doctor to see him as soon as I could, and finally left the room. And I in no means just ran out of the room.

I told my doctor about this, and then she even recalled that 2-3 month previously, when I had seen this patient before, we had discussed how myself and the other PA who is also pregnant should not see him until after we deliver. We had discussed this with the grandmother and mom.

So the doctor goes in within 5 minutes and sees the patient. She says that GM was "offended" because I acted like he had some "disease". Yet she did remember, that she was suppose to only schedule with the Dr, but had forgot. So my doctor would like me to call her and apologize. Although, she isn't mad at me. (Which doesn't even bother me that much)

What bothers me, is that if I knew I had a serious illness that could negatively effect someone, there is no way I would expect them to see me. Now, would I probably get infected by this kid? Probably not, however, if I did, and the fetus did, it can cause encephalopathy, prematurity, and death. This is serious stuff so why risk it.

I am not even that mad at GM, but I just think it is a sad case of how selfish people can be, when we (Healthcare providers) are doing the best we can. I work where ~80% of the patients are Medicaid, and a lot of them do have a sense of "entitlement", like we are just there to serve them. I also thought about if something were to happen, it's not as though, she is going to pay for it or even care. Although, my tax money is helping paying for his treatment. (of course health care policy, is not what I want to debate). I try for my sanity and my patients to not become cynical, but in these situations it is very hard. Sorry this is so long, but it really just bothered me. Vent over.

That is exactly what you are there for - to provide a service, even if they are on medicaid.

It is YOUR and the practice's responsibility to manage patients. The practice provides medical service. If one person cannot provide full service to all patients, then the practice and the health provider needs to make sure that it doesn't happen.

It is ludicrous to even believe that the responsibility falls even a little bit on the patient.

You chose a profession where you knew you would be in contact with ill people. I don't understand your irritation with ill people. Perhaps a career change is in order?

 

[Amelia Peabody]

Yikes OP! I'm sorry but I agree with you. What's with all the DIS'ers who don't have medical degrees lecturing her on medicine? I understand the other professionals may want to say something, but unless you have a medical degree.... nope, you can't be telling her "you SHOULD know.....".

Sounds like Grandma did get a word in when she asked about chicken pox. To me that sounds like she wanted you to take care of the kid if you had. Not her choice to make.

I would not have been offended.

 

[Mickey's Minion]

So, when are people suppose to take responsibility for their actions. I as you all keep reminding me tell me it is my responsibility to know the history of every one of my thousands of patients. Yet Grandmother with 1 grandkid, who was explained by me and the doctor previously, that I or the other PA should not see him, while pregnant, can't possibly remember that? How is that fair.

Nobody said you should memorize thousands of patients histories.
However, to remain professional, as soon as you entered the room and thought you recognized the patient, you could have glanced at the chart to confirm your suspicions and then excused yourself without having to insult the family.

 

[imnewhere]

You have the training, you have the gloves. I fail to see where it is their problem.

 

[southernbelle_amy]

You all may have great providers, I hope you do. But unless it is a specialist, you all are all "naive" to think your doctor knows your life's history, and never makes a mistake.
I was seen at the OB/GYN today and my visit was less than 5 minutes from a person I had never seen before. I had to ask are you okay with this or that since last time I had a problem with it, it wasn't like she knew. Maybe she should find a new career too.
As for that, I know I am good at what I do 95% of the time. I have rough days same as everyone else. And just because I am here to serve people, doesn't mean I like to get ran over.

 

[pipersmom]

So the doctor goes in within 5 minutes and sees the patient. She says that GM was "offended" because I acted like he had some "disease". Yet she did remember, that she was suppose to only schedule with the Dr, but had forgot. So my doctor would like me to call her and apologize. Although, she isn't mad at me. (Which doesn't even bother me that much)

What bothers me, is that if I knew I had a serious illness that could negatively effect someone, there is no way I would expect them to see me. Now, would I probably get infected by this kid? Probably not, however, if I did, and the fetus did, it can cause encephalopathy, prematurity, and death. This is serious stuff so why risk it.

I am not even that mad at GM, but I just think it is a sad case of how selfish people can be, when we (Healthcare providers) are doing the best we can. I work where ~80% of the patients are Medicaid, and a lot of them do have a sense of "entitlement", like we are just there to serve them. I also thought about if something were to happen, it's not as though, she is going to pay for it or even care. Although, my tax money is helping paying for his treatment. (of course health care policy, is not what I want to debate). I try for my sanity and my patients to not become cynical, but in these situations it is very hard. Sorry this is so long, but it really just bothered me. Vent over.

I can understand that you wouldn't want to be exposed to anything that could possibly harm your fetus, I'm sure all of us would feel the same way. With that being said, if her six month old gs was sick enough to make a Dr's appt for, thinking about who's pregnant in the Dr's office was probably the last thing on her mind, and she did tell the Dr she had forgotten. I don't particularly see anything selfish about it. As far as "entitlement" goes, my dd has a chronic illness, and is on medicaid (I would have to make a ridiculous amount of money to even pay her monthly co-pays). When I take her to the Dr's office, I do think the staff at the office is being paid to serve me (and her) and to give her the best care possible no matter what type of insurance she happens to have. The staff at the office, or even the hospital for that matter, may think I'm a b*tch on wheels, but quite frankly my daughter's health is more important to me than what anyone may think of me. There are too many parents who look at healthcare professionals as "gods" and infallible and don't question anything. I made that mistake before my daughter was diagnosed, I haven't made it since.

 

[IloveDMB]

I am a provider, and when I don't remember something about a patient, I do a crazy thing. I look in the chart!

Heaven forbid I miss something like an medicine allergy or a potential medicinal interaction.

 

[DawnCt1]

Yikes OP! I'm sorry but I agree with you. What's with all the DIS'ers who don't have medical degrees lecturing her on medicine? I understand the other professionals may want to say something, but unless you have a medical degree.... nope, you can't be telling her "you SHOULD know.....".

Sounds like Grandma did get a word in when she asked about chicken pox. To me that sounds like she wanted you to take care of the kid if you had. Not her choice to make.

I would not have been offended.

The OP doesn't have a medical degree either but she is charged with the responsibility of taking care of a sick child, and often that includes offering the family emotional support; not insulting them. Is she is unsure of what diseases are contagious and the method of spread, it may be time to brush up on infectious diseases; children carry a lot of them. Anyone who delivers health care should have a full understanding of universal precautions. That is basic.

 

[Allison]

The point isn't that they are on Medicaid.

You made it a point by bringing it up in a negative context.