Cut It Out

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“I’m worried that I might have diabetes, Doc.” He was here for a physical, a brand new patient that I had not met before.

“Tell me about that. What is happening?”

“I am super thirsty, peeing like crazy. I just don’t feel good. Everyone in my family has diabetes. I know all about it.”

“That certainly is suspicious.” He was overweight and admitted to a horrible diet. He was a young man with a new wife and a new baby and probably was here because he was scared and motivated to change. Kids do that to dads sometimes. That was a good sign. “We will get the labs done and if they show what we think they will show, we will get you started on meds and get you into diabetes education classes.”

“Oh, no, Doc. I don’t need classes. Like I said, I know all about diabetes.”

Sometimes you have to let patients prove they don’t really know everything, so I didn’t push it further then. We could talk some more at his follow-up once we had the official diagnosis.

Sure enough, the next day the blood work showed that he wasn’t just a little diabetic. His numbers were out of control.

I had my assistant call him and got him started on a medication, metformin, and scheduled a follow-up for two weeks.

Three days later, I received a call from his wife, whom I had never met.

She was livid.

She started off by telling me that I was a terrible physician for not making him come into the office to deliver his results face to face. I pointed out that generally speaking patients don’t like to wait until the next available office visit to get their results, particularly as it costs them time and money. Furthermore, he had told me he already knew everything about diabetes. I asked her if he was upset or if she was the one upset. She refused to answer the question.

Then, she told me that I should be sued for malpractice because I did not know how to treat diabetes and had almost killed her husband. This accusation was certainly surprising so I asked her why she felt this way. Interestingly her family was friends with a general surgeon in town. They had told him of the new diagnosis and medication to which the surgeon responded that I should have told the fellow to lose weight first because the metformin could make his blood sugar go too low and kill him.

Surely this was not the case. Metformin absolutely cannot cause hypoglycemia. Why would a physician say something like that?

Puzzled, I asked her if he had ended up having low blood sugar. Nope. “But what if he had?” she yelled. “He is going to change doctors!” The phone was slammed down on the other side. This was back when we all used real phones. Slamming certainly was gratifying. I miss that.

She was completely out of line, but I understood where she was coming from. She loved her husband. She was a new mom and did not want to be a single mom. She didn’t know me from Adam and given the opinion of a doctor she knew vs. a doctor she did not know, it was clear who she would trust. I also knew, being a woman, that people (particularly women) think they can get away with behavior with me that they would never try with a male physician.

Seething, I immediately called the surgeon’s office and was told he was in the OR. I left a message to have him call me ASAP.

Days passed. No call.

I left another message.

No call back.

I finally ran into him on the floor at the hospital as I was doing rounds before clinic. At first, I thought I would let it go and avoid the confrontation, but then the anger over how I had been treated on the phone by the patient’s wife got the better of me.

The man was sitting across from me at the nurses’ station, gray head buried in a chart, not acknowledging my presence.

He knew I was there.

“Hey. What do you know about metformin?” I asked.

He looked up. Mock surprise.

“That’s a medication for diabetes, right?” I could see from his face that he knew where I was going with the question even if he was playing dumb.

“Do you think it causes hypoglycemia?”

“Uh, I don’t know.” He looked embarrassed.

“Word on the street is that you told a patient of mine that it did.” I paused for effect. “It does NOT.” Another pause. He glanced off, uncomfortably, then looked back at me. “I got chewed out and lost a patient because of it. I would appreciate it if you would let them know you were wrong. I don’t care if they come back to see me, but I do care that they think I am an awful physician.”

“Well, I thought maybe he should try diet and exercise first.”

“Did they tell you his numbers?”

“No.”

“Diet and exercise alone were not an option.” I closed the chart I was working on and stood up. “I have sent you a lot of patients over the years. What this tells me is that you don’t trust me as a physician. I want to send patients to specialists that are not going to undermine their confidence in me. There are plenty of other surgeons in this community. I don’t have to use you.”

I never saw that patient or his wife again. I don’t know if the surgeon ever admitted his mistake to them, but he never saw another patient of mine again.

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87 thoughts on “Cut It Out

  1. Whoa. Just…whoa! I’m glad I made a whole bucket of popcorn because these stories are amazing.Yay you for seizing the moment to confront the surgeon. As an LMT I had similar things, but worse, because, ya know, I wasn’t an MD so what did I know? (In my specialty of lymphedema, quite a lot actually.) I never had the satisfaction of doing any of what you did. I got to sputter and defend and tell people to look things up for themselves. Slamming a cell phone is so not the same, is it?

    I think there are more than just a few of us sitting on the sideline, with our popcorn, reading your blog and cheering, “Go Doc!”

    Liked by 1 person

  2. What bothers me, one of the many things, is that this other doctor completely undermined the care that this man could have received from you (or any other doctor) by making a comment that someone who trusted him believed. And he did not care enough about that patient to ask questions or even take a moment to call you himself. If he cared about that man why not call and say to you, hey….is this necessary? Why not suggest diet and exercise first? Etc etc…. I hope that man is okay today. And I hope his wife heard what you were trying to explain to her.

    Liked by 1 person

  3. Wow. It seems to me that the surgeon was a bit of a coward. He not only didn’t return your call but didn’t man up face to face either. Good on you for confronting him. It shows your character and reveals his lack of. I hope that man with diabetes is okay.

    Liked by 2 people

  4. Well, I hope he went back to somebody. Love it when somebody with a little knowledge and a big opinion injects themselves in the situation. I’ve been a dialysis nurse and taken care of so many of these folks over the years.! God help him!

    Liked by 1 person

  5. Wonder what the wife thought when they went to the next doctor and got the same treatment plan? On the whole, you lucked out by losing them as patients. I can understand questioning you if they weren’t getting it but not the abuse.

    Liked by 1 person

  6. With experiences like these, it’s amazing most physicians aren’t on antihypertensives! I know my blood pressure would’ve been raised in frustration, too. Then again, I suppose it’s similar in other professions, just different situations. It’s always frustrating to be undermined by another.

    Liked by 1 person

  7. In joy vast experience as a patient, I’ve found surgeons to be the most arrogant group. good for you for standing up to him, though. I bet the loss of patients/revenue makes him think twice before making such silly statements now.

    Liked by 1 person

    • Well, I don’t know how it impacted his bottom line, truthfully. I didn’t slander him to the rest of the medical community. Most of the surgeons I know are really great people… except for neurosurgeons. Not sure if the selection process for that residency program makes them that way or if they get it beaten into them as part of the training.

      Liked by 1 person

    • It IS shocking, but I’ve read/heard enough stories similar to this, that I wonder how prevalent it is. I think the vast majority of people would be more professional than that but it doesn’t take too many to real muck things up.

      Liked by 2 people

    • I learned early on from a female cardiologist in the community about the concept of managing up. She told all of my patients what a great physician I was. It was a sneaky thing. It made me look good and made me happy. She got more referrals. The patients had greater confidence in me, for the validation of their choice of PCP, and in turn greater confidence in her from them with better compliance with treatment programs and medication adherence. It is a beautiful, powerful thing when done right.

      Liked by 1 person

  8. It is surprising/shocking to me that someone would not only talk to a doctor like that but it wasn’t even the patient! You didn’t owe the WIFE a minute of your time (not like talking to the spouse of a cancer patient, say). That you talked to her *at all* was generous.

    Liked by 1 person

  9. There are stubborn patients and there are negligent doctors, There are also the very careful ones. I have type I diabetes after multiple surgeries and total shutdown of beta cells on the pancreas. However, when I went to such education class, they hardly told anything. Some stuff was even very questionable, and they did not differentiate between types of diabetes, types of treatments (insulin, 2 insulins, pills, etc), that was an abnormally general short course in nutrition which anyway proved wrong for me. I for instance have low blood pressure, and I’m very slim, so I suppose I’m sort of more sensitive. I read with great interest your post! Superb!

    Liked by 1 person

  10. Oh my! My mother keeps telling me she “knows a doctor who…” if I tell her about a diagnosis I may have had that she doesn’t agree with. I’ve just stopped telling her about any such thing now.
    I hope that ex-patient of yours went and got yet another opinion, lest his wife will come back and accuse you of not spotting something else! Maybe she’ll just call that other doctor and chew him out too πŸ™‚

    Liked by 1 person

  11. Maybe I should hire you. I upset the “Happiness Engineers” at WP today, and in the 9 hours since then, my numbers haven’t gone up 1. It doesn’t really matter since I’m planning on switching platforms anyway, but I didn’t think they’d get this silly about it. It’s going to be a long couple months. Lol.

    Liked by 1 person

      • I told them the truth about what I thought of their new “improved” Stats page (twice), and for a change (because they just don’t seem to respond to courtesy), I didn’t mince words. They wouldn’t respond to myself, or any of the large majority who complained on the site they provided (though they answered repeatedly the same lame question from supporters of the page who couldn’t even figure out how to log off on this new easy-to-use-page), but they did finally send me an e-mail from their “happiness engineers” which tried to state that all of us who had complained had basically complained about just the same single issue (a ridiculous column that certainly was an issue, but just one of many, many issues that we had clearly stated over and over again), and they were looking into that issue because our concerns meant so much to them. It was basically just a brush-off, and if anything about this new page is going to be changed, it will almost certainly be that one nuisance column so that WP can then point at it and say, “See we listened to our clients feed-back, and made the changes that they asked for.” So many people are upset by these changes that at least one that I know of has done an entire posting about it, and at last count on just the one page that WP themselves put up so people could express their views (to which WP will only reply if you like their new page, which actually seems to mean, “if you post from your phone and only have one blog”, there were 3 or 4 people like myself planning to switch platforms. But anyway, I didn’t mean to dump this on you, or anyone else for that matter. Except for one or two of my closest friends in the Blogging world, I haven’t told anyone about my choice until now. If you choose not to publish this comment, I won’t be offended. I don’t usually rant. It’s just that this is something I’m really passionate about. I dislike it immensely when I pay for a service of this nature, and then with no consultation prior to their action, the company that has taken my money, and the money of many others, suddenly changes the whole service until it is barely even recognizable as the service everyone paid for in the first place. But like I said, please feel no obligation to publish this comment. It is far beneath what I would consider to be my normal standards. The decision is entirely yours. And should I decide to carry through and find another Blogging service to use when my current domain fees run out, please know that yours is one of the few Blogs that I will genuinely miss after I am gone, and I hope you continue to dazzle them all for many, many, more wonderful years to come.

        Liked by 1 person

      • Fortunately for me, I blog mainly from my phone so I has not affected me as much as others. The app, though, drives me nuts as it only downloads just over an hour of posts at a time, requiring me to also use the web browser. But I digress. Thank you for the kind words. You can always pop over to visit. And if you DO switch platforms, do let me know where you are going so I can keep tabs on you! πŸ™‚

        Liked by 1 person

  12. It is interesting to see what is behind that white coat, and almost like pulling back the curtain on your profession. You are so right. There are pricks everywhere ! p.s. Love the comment on the slamming down of the phone..lots of us miss that one. Hard to angrily press a button on a cell/smart phone.

    Liked by 1 person

  13. great posting. I am not a physician, although I do teach some in the medical field. I am constantly struck by the strange, off-hand comments doctors make to patients, with no context or awareness. It not only leads to confusion, it’s dangerous. I realize everyone in medicine is under a time crunch, but a little awareness goes a long ways. Of course, it goes without saying that if you are going to comment on a med, know the med! πŸ™‚

    Liked by 1 person

  14. MetformIn causing hypoglycemia wow that’s a first! If only that was possible pharm industry would be all over that. Lol I guess it’s like getting your fridge fixed instead of by an electrical engineer by a railroad engineer….

    Liked by 1 person

  15. totally understand your frustration, being in the health field myself I try not to question the reasoning of another professional (especially doctors) without having all the facts…which is never so I usually send them back to the doctor to question them πŸ™‚

    Liked by 1 person

  16. Shaking head …. And so it goes on. I’m really sorry you were treated like this, Doc. I’ve had more run ins with jerks that call themselves doctors to understand your rage. I have stories to tell too, both from the perspective as a nurse and as a patient. If doctors cannot even stand together, what hope does medicine have? None that I can see. BIG (((HUGS)))!

    Liked by 1 person

  17. Well done! He deserved to hear what you had to say. Had you not said anything to him, you would have been perpetuating the ideal (that you alluded to) that female physicians are not as good or worthy of their title as male physicians.

    Liked by 1 person

  18. Having been a medical malpractice paralegal for 14 years, this one made me laugh. (Don’t get me wrong… It also made me pissed off for YOU, but it made me laugh at HER ignorance!) I don’t know about where you live, but at least here in Florida, you not only have to have actually experienced the malpractice, not just what “could have happened”, but you also have to prove a threshold of callous disregard on the part of the physician that they knew or could have known that their actions would lead to the patient’s harm. Even leaving a sponge in during surgery here seldom nets more than a $30K verdict! And that’s only when it causes infection and the need for an additional surgery! I hate to be a cynic, but I kind of hope the hubby stopped the meds and just dieted… and then had problems… and they ended up trying to file a grievance against their surgeon friend!

    Liked by 1 person

  19. No professional should undercut another professional. What he told the wife, in the absence of any lab results, was potentially actionable malpractice. I hope he has good insurance if he is going to stick out his neck, dole out bad advice, just to undermine a woman. I think you were spot on about the wife’s motivations, too. You even managed to be compassionate and kick-ass. I quite like you.

    Liked by 1 person

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