Saturday, March 22, 2008

When "Hello" sounds like "F**k you"

This past week was a little harrowing. First, our kid was sick for the first time and played the pathetic card the whole time. (When your sweet little zen boy is suddenly just whimpering it's not good) We each took a day off work so we both had piles of work waiting for us when we returned. Then, of course, I had to catch whatever amazing bug JB has, so I am now handling my 3rd cold in 6 weeks. It really reminds you where exactly your mucous membranes are in your face.

It's also been a little harrowing at work for about 8 months now for obvious reasons. So, I'm pushed to the edge not only in terms of sheer quantity but also knowledge. I have been an NP for almost 6 years now which is GREAT. But my particular patient population requires someone with about 400 years of experience. I am pushed to the brink of my understanding of any number of diagnoses nearly every day. I'm lucky to have two awesome back up docs (one internist and one endocrinologist) who help me figure out not just the safest next step but the best next step. And that's really what we're trying to do in the wake of everything: not just maintain status quo, but continue to provide precision care by utilizing lab and radiology tests only when necessary but not not using them when they might help us find the diagnosis.

So, I get 3 physician calls on Thursday. One called to ask my professional opinion about a mutual patient, we laughed, we came to a decision. One called to say hi and check in on how we're all holding up and make sure he can continue sending his trans patients to us. And one called to say "F**k you." Actually, I think she meant to call and discuss a mutual patient but it sure sounded like "F**k you." She (specialty: GYN) was questioning the use of an MRI of the head in a patient for an endocrine problem (my specialty). In the end it seemed like her problem was the cost of the test (which is ironic since I spend a good deal of time refusing to check lab tests and xrays etc when they are clearly not indicated; it makes for long days). She busted my balls for a good 10 minutes not really ever listening to my rationale, and when I suggested that she was well within her rights to suggest to the patient that she not have the test if she wanted to take on that medical liability she said, "I would never step in like THAT!"


It was tiring to say the least. It turned out, in the end, that I was right. The MRI came back showing exactly what I was afraid of. I cc'd the MD on the result.

I need to call her to follow up. I'm hoping my "F**k you" sounds like "Hello, how are you?"

1 comment:

Anonymous said...

It's lovely to see you back and posting! I hope you feel better soon honey!