Death Is A Pre-Existing Condition

, , , , , , | Healthy | March 13, 2019

(I work for an insurance company. When people forget or lose their insurance cards, the doctor’s office often calls us to confirm if the insurance is up and running. I get one of these calls.)

Receptionist: “I am calling to confirm the insurance of a patient. It’s [Patient], born [date], living at [address].”

(I look up the data, double checking that I am really talking to a doctor’s office.)

Me: “Yeah, he was insured with us up to [date a few months in the past].”

Receptionist: “Well, do you know where he is insured now? He is sitting here, waiting for treatment.”

Me: “What do you mean, he is sitting there? According to my information, he died a few months ago.”

(Turns out, the doctor had two patients with the same name and birthday, and both were insured with us. And the receptionist called up the file just using that information. Only after we asked the patient for his address did we confirm that he was the other patient. I still wonder what went through his mind when the receptionist told him, “I have your insurance on the line; they say you’re dead.”)

Time To Take A Breather

, , , , | Healthy | March 13, 2019

(I am a medical assistant in a community health clinic, with a fully-stocked retail pharmacy on the premises. This patient uses our pharmacy and has been put on a strict refill schedule for his emergency inhalers due to extreme overuse. Normal use is a maximum of two of each per month. He had gone through nine of [Inhaler #1] in two months before the pharmacist contacted the doctor. The pharmacists have counseled him multiple times on proper use, and I’ve reached out multiple times to offer an appointment to address the root cause of his trouble breathing. He declines every time, claiming he needs his inhalers to breathe, that he’s going to have a coronary without them, and that we just want him to not be able to get enough oxygen. Every time I hear this rant, I note that it is extremely long-winded and that he can get through multiple run-on sentences without having to take a breath. His doctor has even called him personally to lay down the refill schedule and explain the cardiac-related consequences of continued overuse. I receive a voicemail from this patient, in which he goes on with another long-winded rant about how the doctor NEEDS to refill his medication. Because of a very well-documented refill schedule and the doctor’s notes that he will NOT refill early under any circumstance, as well as previous in-person discussions with this doctor about this patient, I don’t even need to ask the doctor to advise on the situation. I see that one [Inhaler #2] should be available for a refill, but [Inhaler #1] won’t be available for another week and a half; he’s literally filled it just a few days ago! I call the patient. This is part of the way into the call, and yes, he is yelling the entire time.)

Me: “With all due respect, the inhalers are only treating your symptoms. Continuing to use them at the rate you were doing so puts you at serious risk for a cardiac event, including a heart attack—“

Patient: “NOT GIVING ME MY INHALERS PUTS ME AT A RISK FOR A CORONARY BECAUSE I’M NOT GETTING ENOUGH OXYGEN. YOU PEOPLE JUST DON’T WANT ME TO BREATHE!”

Me: “Sir, we don’t want you to have a coronary, either, which is why we want to address the root cause of your condition.”

Patient: “NO. YOU STOP THERE. JUST TELL THE DOCTOR THAT HE NEEDS TO MAKE THE PHARMACIST FILL MY PRESCRIPTION! THEN THE PHARMACIST FILL BE REQUIRED TO FILL IT!”

Me: “[Doctor] can’t make the pharmacist do anything.”

Patient: “YES, HE CAN! ONCE HE WRITES THE PRESCRIPTION THE PHARMACIST IS REQUIRED BY LAW TO FILL IT!”

Me: “Sir, [Doctor] is a doctor; he is not a supervising pharmacist. He can only write the prescription. Pharmacies are allowed, by law, to question and even deny prescriptions at their own discretion for patient safety.”

Patient: “DON’T YOU INSULT MY INTELLIGENCE!”

(He didn’t get his inhaler refilled early. I later went down to the pharmacy and told the supervising pharmacist. He found it even funnier than I did!)

An Urgent Need For Details

, , , | Healthy | March 12, 2019

(In the UK, doctor appointments are generally booked in advance, although there are a few reserved for people who phone on the day for emergencies. The phone rings.)

Me: “Good morning, medical centre.”

Patient: “I’d like to make an appointment with a doctor, please.”

Me: “Okay, if it’s urgent, I can fit you in today, or if it’s not urgent I have an appointment in two days.”

Patient: “I don’t know if it’s urgent or not.”

Me: “Okay, well, if you give me a brief idea of what it’s concerning, I can help you decide.”

Patient: “It’s private. I’ll only discuss it with a doctor.”

Me: “Okay, fair enough. So, did you need an urgent appointment or can it wait a few days?”

Patient: “I’ve told you I don’t know if it’s urgent or not!”

Me: “As I’ve said, if you give me some idea of what it’s concerning—“

Patient: *interrupting* “It’s private! I’m not telling the receptionist!”

Me: “That’s fair enough but then I need you to tell me whether or not it’s urgent.”

Patient: “How many times?! I don’t know!”

Me: “Okay, I’ll give an example. If it’s just something like a sick note–”

Patient: *interrupting again getting increasingly angry* “I don’t need a sick note!”

Me: “It was just an example to help explain the difference between urgent and non-urgent appointments. If you don’t tell me which you need, I can’t book you in.”

Patient: “Well, how am I supposed to know if it’s urgent or not if you won’t tell me?!”

(They then hung up without ever having booked an appointment, or even given their name. I guess it wasn’t that urgent after all.)

The Hotel D’Mentia

, , , , | Healthy | March 11, 2019

(This happens when I am just 17 years old. I get a summer job, one of my first jobs ever, in a retirement home serving coffee and tea in the public living room during the afternoons. This interaction happens with one of the residents. She has Alzheimer’s but I do not know that at the time, and it is one of my first times interacting with someone in that condition.)

Elderly Lady: *very politely* “May I inquire if it is possible for me to stay in the same room one more night?”

Me: *a bit confused, since she lives here* “Um, this is not a hotel, so your room is yours, of course.”

Elderly Lady: “No, I booked a room here and I would like to pay for one more night’s stay, please.”

Me: *still confused* “But this is a retirement home; you live here.”

Elderly Lady: *suddenly a bit shocked and looking around* “Oh, my gosh. I am so sorry; I am in the wrong place! I will go to my sister’s house and stay with her tonight. Thank you.”

(With that, she walks out of the building and leaves me very confused and worried! I realize that this lady does not seem to have a full grasp of the present or reality and I go to find a nurse. I am worried the lady will get lost or injured. The nurse laughs and knows who I am talking about. She says that the lady will come back eventually by herself, as usual. I continue with my tasks but am still worried. When I am almost done with my shift, who would walk in but the elderly lady from before! I immediately walk up to her.)

Elderly Lady: *very politely* “Excuse me. I cannot seem to locate my sister’s house. May I inquire if it is possible for me to stay in the same room one more night?”

Me: “Of course, madam. Your room is ready for you; it is the same room as usual. You are welcome to stay as long as you like.”

Elderly Lady: *enormous smile on her face* “Why, thank you, miss. Such good service. I always enjoy staying here.”

(With that, she happily went to her room. I was so relieved she managed to come back. There was no benefit or point in arguing with her and trying to make her understand her circumstances; it would only make her feel scared, confused, and miserable. I felt that that would just be mean.)

An Ambulatory Story

, , , , , | Healthy | March 11, 2019

(A friend of mine has had problems with a stomach ulcer for some time. Today it’s causing a lot of pain, so he goes into A&E to get it checked.)

A&E Receptionist: “Since you haven’t been to the hospital with this problem for over a year, you need a referral from your doctor in order to be seen.”

(He then leaves, but sits in the car still in the hospital car park to phone the GP.)

GP: “Well, I can refer you, but if the pain is that bad you need to phone [non-emergency urgent care line] to get an appointment straight away.”

(He phones this number and explains all of the symptoms.)

Call Handler: “With the symptoms you’ve explained, you need to be seen straight away. We’ll send an ambulance on blue lights to you now.”

Friend: “I’m in the hospital car park; I can walk to A&E from here.”

Call Handler: “No, absolutely no walking there. We’ll send you an ambulance.”

Friend: “I’m in the hospital car park! I don’t need an ambulance!”

Call Handler: “With your symptoms, you must be transported to the hospital via an ambulance. It’s not safe for you to get yourself there.”

Friend: “I can see three ambulances from here! I can go and over and sit in one if it makes you feel better!”

(They did eventually consent to allowing him to walk the 50 feet back into the hospital himself.)

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