A Tale of a Nightmare Patient and Bullets Dodged

The conversations started innocently enough, somewhere around May.  They weren’t anything out of the ordinary, someone describing symptoms and inquiring if I can help them.  No big.  And, as luck would have it, yes I could.

They didn’t schedule right then, but that’s not uncommon either.  After some very-sporadic back-and-forth, they finally scheduled; I think they might’ve moved their initial appointment a few times.

Some interesting and dysfunctional themes began to develop.

Things To Keep In Mind About Health-Related “Summits”

They came seemingly out of nowhere.  And suddenly, they were all the rage, especially among patients, who wanted to be sure I had watched and listened to every last one of them.  These summits are a double-edged sword – they could be a potential godsend, or a potential serious obstacle.  They can make or break the doctor-patient partnership, and/or a patient’s health.

Screening Patients, Part 6: Miscellaneous Red Flags & Difficult Situations

Welcome to the sixth and final installment of this post series on screening potential new (or possibly already-existing) patients.

In previous posts in this series, I’ve covered various potential “orange/red flags” to watch out for when evaluating new or existing patients in your practice, if for no other reason than to have prior notice that they exist, so that you as a doctor can take whatever precautions you feel might be necessary, ranging from a simple “okay, that’s good to know” to “refer them to a colleague–now”, or anything in between.

Today, I’m going to cover a variety-pack of situations or patient types that I consider to be on the latter end of that response spectrum – the “refer them out–now”.  Grab some popcorn and enjoy.

Screening Patients, Part 2: Personality Disorders

This is the second installment in a post series about screening potential new patients and the importance thereof.

As I stated in the first post of this series (but it’s an important enough statement that it bears repeating here), this isn’t meant to be judgmental, elitist, or exclusionary in any way.  What follows is strictly my personal opinion, which is an amalgam of my own clinical experience and my interpretation/opinions formed about the experiences of other doctors.  Nothing more, nothing less.

So if I’m not trying to pass judgment, cultivate elitism, or exclude anyone from getting care, what’s the point of this post series?  What’s the point of screening patients for various issues in the first place?  Why bother; why even consider it?

Screening Patients, Part 1: Readiness & Obstinance

Dear patients of the world, this post series is probably going to sound pretty judgmental.

I assure you, it’s not.  Falling into any one (or more) of the categories I’m about to talk about is not going to get you catalogued, reported, thrown out of an office, or barred from receiving care.

It’s just that some of the people out there present certain challenges to various types of doctors that these doctors need to be aware of, because doctors are human, too, and not knowing about these personality/history types of people can lead to serious physician burnout.

There’s No Such Thing as a ‘Simple Question’

At least, not in our office.  On its face, a question may appear to be a simple one.  The patient asking the question might think it’s simple.  But it’s probably not.

To be clear, the type of question I’m referring to are those that start with phrases such as “should I (do this or that)?”.  Or, “what type of (supplement, massage, exercise, food, etc) should I choose?”

Then & Now: 7 Years In Practice

Ever since we moved into our office around March 2010 and opened our practice the following month, both my partner (in both practice and marriage) and I have felt an overwhelming sense of a time-warp.

Somehow, time supernaturally speeds up the minute we walk through the office door, and returns to its normal clip the moment we leave.

This applies across all common measurement units of time, too–minutes, hours, days, weeks, months, and now, years.  Thus, even though it’s cliche to say that it’s hard to believe it’s been 7 years, we mean it: it actually is hard to believe.

Too Much Lab Testing, or Too Little?

You’ve heard the scenario.  Or maybe you’ve lived it.

“…and they ran all these tests on me…”

Or some variation on that theme.  A reference to “all that lab testing”, a “whole bunch of lab tests”, or something similar.

What the general public generally doesn’t understand is that so many symptoms overlap.  A single symptom could be a manifestation of a whole cluster of health conditions.