Grand Theft Patient
She started coming to me because she didn't like the impersonal care at the Enormous Group Practice that dominates at the hospital, though she likes the hospital because it's close to home. All she was taking was Synthroid and aspirin.
Until I sent her to the ER with new-onset A-fib.
Two months later -- not a word from anyone in the meantime -- she comes back with a med list that includes two antiarrhythmics, warfarin, a diuretic and FSM knows what else. What happened? Is she in sinus or A-fib with a controlled rate? Who's managing her anticoagulation? What about those new skin lesions on her arm? Drug rash or something else?
It's the oldest story in the world.
When she presented to the ER, they already had her in their computer as an EGP patient. Never mind that she (and her daughter) specifically told them I was her doctor now. Nope; once you're in that computer, you're theirs for life!
That doesn't stop me from calling over there, intending to politely chew them a new one. "The cardiologist isn't here today, and his nurse has Wednesdays off." (Damn; I should become a nurse.)
I do the best I can.
I'm pretty sure the skin lesions are hives, but they're awfully localized and really round, so I do a lyme test to be sure. I do a thyroid test because even though her TSH was fine two months ago, one of her new meds doesn't play well with Synthroid. They've been managing her Coumadin, so I don't mess with that for the moment. Her pulse is 48, but she's as impressively asymptomatic as she was when it was 150.
Finally (2 days later) the cardiologist calls back. He's so sorry, but they already had her in their computer as one of their patients, so he didn't worry about it. Next time I should call and they'll be sure to keep me in the loop. (I did call the ER when I sent her over. How many more times should I call?) He was very sorry, though. By now I have her negative lyme test and have adjusted her Synthroid. Has he seen any strange drug rashes lately? No, not really. He's no help, but he's very sorry about the mixup.
My only real recourse is to "vote with my feet" by not sending patients to this hospital anymore. Unfortunately, medical care has more in common with real estate than anyone like to admit: location, location, location. When patients don't want to travel, I'm stuck. So I just have to suck it up and go calling around to get discharge information.
Ah well. Now I have to go track down what happened to the guy I sent over for a stress test who wound up in the ER.