Wednesday, February 25, 2009

One Lousy Doctor Can Spoil a Good Day

As a comprehensive internist, I hear lots of stories from my patients about their experiences with other doctors. Some are real shockers like this one..(used with permission):

Beverly had several weeks of rectal bleeding and pain. She mentioned it at her gynecologist visit and that doctor did an exam and thought she felt hemorrhoids so she referred her to a gastrointestinal (GI) specialist for treatment and possible colonoscopy. (The patient is 50 and is due for a screening exam anyway).

Beverly saw the GI doctor who...get this...never undressed her, did no exam at all but just talked to her and told her he didn't deal with problems "below the waist". He referred her to his friend the colo-rectal surgeon. Despite no exam he gave her a prescription for nitroglycerin cream and said once her hemorrhoids were cleared up he would be happy to do a colonoscopy. She got a bill for a 99243 "consult" for $275.00. This was for no exam and him just accepting a second hand opinion that she had hemorrhoids! He didn't even weigh her but just wrote down the weight she said she was.

I saw her, did my own exam of course, and the diagnosis is a rectal fissure (a small tear), no active hemorrhoids and the treatment is different. She still needs a screening colonoscopy (per her age) but I guarantee it won't be done by the GI physician. I would block the door myself to keep her away from him.

I hate hearing these types of stories and there are 100 excellent doctors for every lousy one. This is one reason the "rate your doctor" websites are catching on!


ERP said...

That is pathetic and I agree he is an embarrassment to the field. However, these "rate your doctor" sites are just like patient sat scores - people with a illegitimate bone to pick will rake you over the coals. It often has more to do with your ability to schmoze than your real ability as a doctor.

Anonymous said...

I agree it is pathetic. I have noticed that many specialists are no longer interested in taking the time to diagnose and treat patients because they can just do procedures (like colonoscopies) and make lots of money for very little work.

Sorry to be so cynical but stories like this seal the deal.

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