Musings of a Dinosaur

A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Saturday, October 11, 2008

"Just One More Thing"

(Dr. Wes has had some problems of late, to which he appears to have responded by closing comments on his blog. So I'm posting this here instead of as a comment on his blog.)

The blogosphere's favorite electrophysiologist has a great post about the so-called "door-knob question," so-called because it generally comes at the end of an office visit when the doc's hand is already on the door knob, ready to leave. His example of the phenomenon is great; funny, too. Here's mine:

Seventeen-year-old girl with bronchitis:
Can bronchitis make you miss your period?
Um, no.

Dr. Wes is right, though; it added at least another thirty minutes (and a positive urine pregnancy test) to the visit.


At Sat Oct 11, 10:00:00 PM, Blogger ArkieRN said...

But taking antibiotics for bronchitis while on the pill and not using a secondary form of birth control may make you miss a period.

At Sat Oct 11, 11:17:00 PM, Blogger Dreaming again said...

Arkiern ..that's how we got Bj ..only it was strep not bronchitis .. and it was 17 years ago before this was common knowlege.

Strep in March of 1991 ...
Found out I was pregnant in mid to late April 1991 (memory fails) and first heard the antibiotic/birth control problem in June 1991.

At Sat Oct 11, 11:49:00 PM, Anonymous Anonymous said...

I dislike the list-ers more.

The ones who come in once a blue moon with a list of fifteen different health concerns, and a standard appointment time.


At Sun Oct 12, 01:11:00 AM, Blogger Amanda said...

In defense of the "doorknob question," when you barely get 5 or less minutes with your physician, and he's almost leaving the room before you totally process everything he has throw out at you in that amount of time, when else should I ask that question?
Don't get me wrong, I love our family DO. I love that all the members of our household are cared for by the same person. I love that when I am ill, and 2 or 3 or 4 of the children are ill, we can all be seen in the same office, and I don't have to waste an entire day driving between physicians and waiting. I can call the office, and most times, any of us can get an appointment same day or next day for an illness. Then we wait, on a good day, an hour to see our physician for that 5 minutes. All that being said, it does seem he is in and out in a "flash" and I am constantly trying to "catch" him in order to get questions answered. Yes, sometimes, they are related to the purpose of the appointment, sometimes not. Frankly, there are things that I'm simply not comfortable saying to the nurse or office assistant who made my appointment. I'm sure in order to make any profit with low insurance reimbursement rates, it is necessary to triple book, with 10 minute appointment slots, but it does create a bit of a back log that ends is hour+ long waits, and the "doorknob question."

At Sun Oct 12, 11:52:00 AM, Blogger Nurse K said...

That could have been the reason why she went to the doctor in the first place. A lot of people at least in the ER go through a litany of symptoms from head-to-toe and then, I guess, when I don't seem to "get" it, they throw in, "Can I get a pregnancy test?"

Then we spend 10 minutes discussing whether she is really here for just a pregnancy test or wants to be seen for any of this other stuff. Most of the time it's "just for a pregnancy test."

At Sun Oct 12, 01:14:00 PM, Blogger DrWes said...

"Dr. Wes has had some problems of late, to which he appears to have responded by closing comments on his blog."

Comments are open, but I'm moderating them now. What a pain, but it's a small price to pay to limit the riff raff that occassionally pops up on blog commentary these days.

(Like your example, BTW) Cheers.

At Sun Oct 12, 11:00:00 PM, Anonymous Anonymous said...

I am very upfront with the appointment scheduling people, and I tell them exactly why I want to see the doctor, and if there is more than 1-2 things, request they please make sure the appointment time is appropriate to complete all items.

My problem is that this has NEVER resulted in the information being conveyed to the doctor, or in an appropriate amount of time being scheduled for the appointment. I've even had a doctor say, but you were only scheduled for a 15min recheck. (That is her office's fault, not mine, since I explained my purpose for an office visit when I made the appointment, including everything I wanted looked at by the dermatologist.)

Before you complain about listers, make sure your office staff isn't the problem.

I have made an appointment for the sole purpose of getting 'vaccination A' only to arrive at the doctor's office to find they don't carry that vaccine. (It was a vaccine for upcoming trip, from a Doctor whose office specialized in travel vaccinations.)

Well, then, why am I here? Why didn't you tell me when I made the appointment that isn't a service you provide, since that is the sole purpose of my visit, and I told you that when I made the appointment? Or make arrangments to have the vaccine before my appointment, since that is why I am coming in.

No doubt some patients are not upfront about the reasons for their visit, but this problem can also be caused by the doctor's office. If you have frequent problems with insufficent appointment time for 'listers', it is time to address the scheduling done by your office staff, rather than venting about your patients.

At Mon Oct 13, 07:55:00 AM, Anonymous Anonymous said...

I'm probably a lister. However, I visit the doc so infrequently...

At Tue Oct 14, 01:52:00 AM, Blogger Unknown said...

Crankylitprof, you're probably on your doctor's list, too...


At Tue Oct 14, 07:57:00 AM, Anonymous Anonymous said...

DINO is my doctor.

I'm sure the Dino would let me know, Saurian fangs bared, if I was THAT much of a pain in the tail.


At Wed Oct 22, 05:09:00 AM, Blogger Dragonfly said...



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