Not On Fine Form Today

, , , | Healthy | September 16, 2018

(Our clinic gives out a Privacy Consent form to new patients, making them aware that the information given will be forwarded to their doctor when results are ready, and to medicare to claim their Bulk Billing. Our clipboards usually have about fifty forms on them, all the same. A patient comes to the desk with one and hands it to me.)

Patient: *cheerily* “Finally. Here you go.”

Me: “Thank you! Have a seat.”

(I take the top one off and get ready to scan it into his file when I notice the second is filled out, as well.)

Me: “How many did you…”

Coworker #1: *whispers* “Just let it go.”

(I flip through the forms. They are all filled out. Luckily there were only nine left on the clipboard. I’d hate to see what would have happened if there had been fifty like all the other clipboards. Not long after, [Coworker #2] is going through the draws beside me.)

Coworker #2: “I can feel your blood boiling.”

Me: “I just… I can’t. It’s… a shame. He was good-looking, as well. He’s just…. an idiot.”

Fluffy Never Did Like That Sheep

, , , , | Healthy | September 15, 2018

(Tapeworm infections are not uncommon in our area. Thankfully, they are easily treated, and in the case of dogs, easily prevented. Cats are harder because they can get the worms from eating infected rodents, but dogs cannot. Generally, when a dog has tapeworms, that means they have at some point in the past had fleas. The flea larvae ate a tapeworm egg, and then the flea grew up and the dog ate the flea. Every case of canine tapeworms I have ever diagnosed can be traced back to fleas. So, when I prescribe tapeworm medication, I also make sure the pet is on a monthly flea control — either drops or pills. I have just finished explaining this to a woman whose toy poodle has tested positive for tapeworms.)

Owner: “Well, that is impossible. [Cutesy name that is longer than the dog] has never had fleas. You said, ‘generally,’ so there is another way, right?”

Me: “Well, yes, but–”

Owner: “Then that is obviously how it happened. [Dog] is groomed regularly, and we have a maid service and a gardener, so there is absolutely no way she could have been exposed to icky bugs.”

Me: “Well, I mean, in theory–”

Owner: “Theory nothing! [Dog] is in pristine condition without any of those monthly drops that common mutts need. So, we will be treating the tapeworms she got by the other method, but we will not be taking flea medications.”

Me: “I’m sorry, ma’am, but there is just no way–”

Owner: “Look here, missy. I know [Head Doctor at the practice], and if I have to call him and tell him that you think my pedigreed poodle has fleas, nobody is going to be happy.”

Me: *sigh* “Okay, but I have one question for you.”

Owner: “Yes?”

Me: “How did she get the sheep’s skull open?”

Owner: “What?!”

Me: “If [Dog] didn’t get tapeworms from fleas, then the only way would be if she killed a sheep and ate its brains. So, please tell me, how did she kill the sheep?”

Owner: *blushes* “So… maybe there could have been one flea, once.”

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There’s No Dedication To Medication

, , , , , | Healthy | September 12, 2018

(I work in assisted living as a nurse, overseeing over eighty residents.)

Resident’s Daughter: “I’ve been thinking about talking to the doctor about stopping my mom’s [antipsychotic medication].”

Me: “Is there a particular reason you’ve been thinking about this?”

Resident’s Daughter: “Yes, after visiting her a lot I can see she’s been doing much better, and I don’t think she needs it anymore.”

(This specific medication stops hallucinations, delusions, etc., and the resident has been on it over a year without side effects.)

Me: “Yes, she is doing great; the medication is working great for her.”

Resident’s Daughter: “Well, I want her to stop the medication; she doesn’t need it anymore.”

(At this point the resident’s daughter is getting irritated, and there is no reasoning with her.)

Me: “Well, the doctor will need to fax us a signed order to stop any medications; you can call and request this. But I can’t just stop a medication without a doctor’s orders.”

(The resident’s daughter stormed off in a huff.)

The Last Time The Medicine Was A Steal

, , , , | Healthy | September 2, 2018

(I work in a retail pharmacy. One day a patient brings in a prescription for a blood pressure monitor. My coworker is taking prescriptions.)

Coworker: “I’m sorry, ma’am, but we can’t fill this. We sell them over the counter but we can’t bill them to insurance.” *tries to hand it back*

Patient: *upset* “Yes, you can fill them. I had one filled here a few years ago.”

Coworker: “We have never been able to fill blood pressure monitors; our company isn’t authorized to dispense medical equipment.”

Patient: *angry* “Then it must have been before you started here, but I had one filled at this store!”

Coworker: *getting frustrated* “I have worked at this store since it opened eleven years ago, and have been in the pharmacy for seven years, and we have never dispensed blood pressure monitors.”

Patient: “Yes, you have! The first time I brought a prescription in, the pharmacist showed me where they were, handed me one, and I walked out with it!”

Coworker: *shocked* “If you walked out with it, then you just walked out with it.”

Patient: “I am not a thief! I have never stolen anything in my life!” *stomps off*

(She called corporate on my coworker for “calling her a thief,” but we had already sent an email to our district manager detailing the incident, so nothing came of it.)

A Controlled Substance For A Controlling Patient

, , , | Healthy | September 1, 2018

Me: “Thank you for calling [Animal Hospital]. This is [My Name]. How can I help you?”

Client: “Hi, I just moved from [State] and need a refill of phenobarbital for my dog.”

(Phenobarbital is used as a seizure medication in dogs, and it is a controlled substance because of its potential for abuse.)

Me: “Okay, we actually can’t get you any medication without examining your dog, but I would be happy to set up an appointment for you. Then we can certainly get your dog some medication. We have a few appointments left today, or we could set something up at a more convenient time.”

Client: “I don’t want an exam; he just needs more of his seizure medication.”

Me: “Ma’am, we can’t prescribe him anything without an exam first.”

Client: “But he’s been on it for years; you can ask my old vet.”

Me: “Unfortunately, one veterinary clinic is not able to act as a pharmacy for a different veterinarian. We cannot give you any medication without examining your dog.”

(At this point my coworkers are starting to listen to my end of the phone call, amused as I repeat myself.)

Client: “But he just needs his medication.”

Me: “I’m sorry, ma’am, but a vet must have a relationship with a patient in order to prescribe any medication. It’s not just a clinic policy; if one of our doctors prescribed you medication without examining your dog she could lose her license.”

Client: “Ugh, how much would an exam cost?”

Me: “$46.”

Client: “I think I’ll call some other places first.”

Me: “Have a great day. Give us a call if you decide to come in for an exam.”

(I hang up the phone.)

Me: *to my watching coworkers* “She can call around all she wants, but she’s not going to find a vet who will prescribe a controlled substance to a dog he’s never examined.”

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