“Her primary care doctor, Dr. X, knew that she was experiencing post menopausal bleeding for three years but only recently worked it up. She has now been diagnosed with endometrial cancer and presents today to discuss surgical intervention and the possible need for adjuvant therapy.”
The jerk did not even look at the record.
He had access to my entire record since he was on the same electronic health system. All he had to do was scroll down the screen and take a few minutes to see that I had first met her six months ago. When I heard on that first visit that she had been experiencing post-menopausal bleeding for the past three years, I referred her immediately to gynecology for biopsy.
She did not keep the appointment.
At every visit every month for the next six months as I saw her to get her uncontrolled blood pressure under control and treated her sinus infection and allergies, I begged and pleaded with her to follow up with that gynecologist, to get the biopsy done, explaining and documenting each each time that she may have cancer, that she could die if she continued to ignore this.
Finally, after I made her call the gynecologist to schedule the biopsy yet again, this time while she was still in my office and standing next to me (I dialed the number for her and passed the phone to her), she actually kept the appointment.
That was how she was then referred to this man, a gyn-oncologist.
My hands shook as I dialed his number, burning with anger. He had sent this note to the hospital, to the gynecologist, to the radiation oncologist, to everyone… saying I had dropped the ball.
I was not going to let this go. Oh, no.
His assistant answered.
“I’m sorry. He is in the OR today. Is there something I can do to help?”
I explained to the young woman what had occurred.
“Please communicate to him how upset I am.”
She was extremely apologetic and said that she would call me right back. I was not going to hold my breath. No one ever calls me back after this sort of thing.
I saw a few patients, trying to focus my brain on them. I glued a smile onto my face and worked hard to maintain my perky voice. I willed my hands to stop shaking as I moved the stethoscope around each chest… heart… lungs…
My mind kept wandering back, though, to conversations where I told this oncologist what I thought of him and his lazy ass charting skills…
In exactly 90 minutes I received another call from his assistant.
“I spoke to him and he apologized. He will amend the consult note and send the corrected note to everyone involved.”
“Thank you.” I breathed a sigh of relief.
“Doc? I really am sorry this happened,” she said.
“Me, too. Thank you for following through, I really appreciate that. I will await the amended note.”
Twenty-four hours later, there it was:
“The patient was seen by a new primary care physician and subsequently worked up for her long standing post-menopausal bleeding…”
I still hate him.