Wednesday, May 7, 2008

Sorry, but I just have to complain...

There are two things that drive me absolutely bonkers when dealing with doctors from other specialties. Numero uno: I HATE it when they TELL me what to do when they are REQUESTING a consult. Numero dos: I HATE it when they tell the PATIENT what they think I should do.

Why the hell consult me then? Just do the damn thing yourself, if you know so much.

I mainly get it from the ER. The fastest, best, easiest way to bring out the raging bitch in me is to say to me when I answer a page, "You need to come down and do surgery on this patient." I'll tell you EXACTLY what YOU need to do. It involves you eating your fecal words. And perhaps a satisfying kick in the perineum, or as the high class folk call it, 'taint. Seriously. I am the gynecologic specialist. I decide who I take to surgery. I am THE 'taint specialist, aren't I? That's why you called.

Here's a tutorial for all you ER doctors who aren't reading this blog on what to say to a physician you are consulting, "Hello Lu, this is Jose. I think I have a patient here with a ruptured ectopic. Will you please come and evaluate her?" I will be halfway to the hospital by the time you finished saying "ruptured ectopic." You do not have to order me to do surgery. Because, half of the time, you are wrong, and she's just on her period and having the motherload of all menstrual cramping (or she's just really wanting to take a pregnancy test but didn't have $10 and a ride to Walgreen, so she call an ambulance at 2am to bring her to the ER instead. Happens all the time. For reals.) And half of those times, you've already told the patient that I, the gyn specialist who as yet to even LAY EYES ON HER, will be taking her back for surgery. Arghhh.

I was recently double teamed. I answered a page, basically one of my general surgery colleagues was calling to inform me that I was to take a particular patient to surgery . OK, I thought. This weird. I and several of my partners had been following her and deemed her issue non-gynecologic. So, no, I will not be taking her to surgery. His argument was, another doctor and he have decided that this WAS a gyn issue, so I HAVE to take her to surgery. Silly me, I thought I was the specialist in this field. I suppose if two psychiatrists, one dermatologist, and Joe Smoe on the corner of 8th street SAY its gyn, then it MUST be. Hand me the scalpel!

My answer to him was No, I am not taking this poor woman for unneccesary gyn surgery. I almost laughed when he sputtered, So you aren't going to take her to the OR? What are you going to tell the patient?

I was thinking in my head, YOU go talk to the patient. You made the mess.

Of course, at the end of the day, all this is B.S. What really matters is the patient and her health. My partner did go and explain everything to the patient and offered to help in anyway. She offered a myriad of medical treatments for the possible diagnoses on the differential. She offered the patient that someone from our practice would be willing to participate in the operation as a consult, should surgery decide to operate. And general surgery did end up taking her to the OR, and surprise! surprise! there were no gyn abnormalities, just general surgerical issues.

So I win. I may look young and inexperienced. I maybe short. Very, very short. I am woman practicing medicine in a good ole boy's club. But ain't nobody's gonna bully me into practicing bad medicine. So SUCK IT, BOYS!

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