Why Do I Even Bother?
So I saw this patient ten months ago.
Ten months ago. Got that? In March.
I found a lump in one of her breasts. Oh, that, she says. I'm sure that's just a cyst. I had it once before and it must have come back. That's all it is. I'm not worried. That's what she says.
Well, says I, you're probably right. But you never know for sure. I'd really like you to have a mammogram and an ultrasound, because it's been a couple of years since you've had those studies, and you can never be sure about these things just from feeling them. So it's really important that you go and have these studies done. Understand? Ok?
It's not like I just threw a mammogram requisition at her and walked out of the room. I spent a fair amount of time trying to explain to her why it was important to investigate this breast lump. She said that she understood what I was saying and that she would go ahead and schedule the studies.
I put her chart in a section of my file shelving where I store charts with pending studies. After a month, when I noted that the results hadn't come back yet, I called her. She hadn't scheduled them yet, but said that she would. The next month, I called her again. Same thing. This went on, month after month. Each time I called her, my urgings escalated. Each time I called, I documented it in her chart. Finally finally finally she got the tests. I'm sure everyone reading this is shocked -- SHOCKED -- to discover that the mass was not a cyst, but was in fact an invasive breast cancer now requiring treatment TEN MONTHS AFTER I FIRST DETECTED IT ON CLINICAL EXAM.
I'm not particularly worried about the liability issue, because of my pristine documentation, but jeez! It's times like these that I wonder why I even bother doing what I do at all.