Monday, June 18, 2007

Problems With Patients

I am very sensitive about my interactions with patients since that godawful RateMDs.com came up. So I try to please everybody but sometimes you are stretched thin.

For example.

I saw a young lady in the pain clinic several years ago. We tried various therapies but eventually she ended up on oral narcotics and went back to her GP who took over prescribing. Several months ago she phone me stating that her GP had retired (true) and that she was waiting for an appointment to see a new GP (this is called a meet and great appointment). She asked if I would fax in a prescription for her. Remembering her and liking her, I was happy to do so. A few months later she phoned stating that she had missed her appointment with this GP and now would have to wait a few more months and you know what... So I faxed in another prescription. There was a third request stating she only needed a few pills until next week.

Finally last week she called with a convuluted story about seeing the long awaited GP followed by referral to someone else and involving missing an appointment of course. She couldn't remember the name of her new GP so I couldn't phone to verify this story. I told her that I had already faxed 3 prescriptions and that I was unwilling to fax another without seeing her. I told her if she could find the name of her new GP I would phone the GP on her behalf. She never phoned back.

A few months ago I saw a new patient with fibromyalgia. She came accompanied by another lady and the two of them sang my praises. This should have tipped me off. She was on a lot of non-narcotic medications and after some discussion I agreed to prescribe a short acting narcotic to tide her over. I gave her 100 pills and asked her to come back in 4 weeks. Just short of the 4 weeks I got a faxed request from the pharmacy for another 100 pills. Guess what...she no-showed for her next appointment. So in about 4 weeks I got another request for 100 pills with a note from the pharmacist saying she had missed her appointment because of an MVA, I refused to refill the prescription without seeing her again. She no-showed for her next appointment and presumably she and her friend are no longer singing my praises. I can only hope she doesn't have internet access.

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