Burger King medicine meme on Reddit

[Angry Birds]

No comment necessary.

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[Pudortu]

I’ve had this before and I reply with “sure” and then document in the chart why I don’t think it’s medically necessary. These people have no power over me.

 

[skougess]

Lol wtf that worked? Same as above, I’ll happily document why I didn’t perform a test.

 

[Birdstrike]

Is it "Burger King Medicine," "Patient Satisfaction Medicine," or are they the same?

Either way, there's enough truth to what that lady tweeted to make it sufficiently appalling. We did a decade of medical training to be able to give a medical order, but she can give one with none. They get the support of those who employ us. We get none. They're the customer, we're the hot dog vender. The CEO owns the stadium. We're a conduit for the exchange of a hot dog for money, from the customer to the CEO. Conduits are replaceable.

 

[bravotwozero]

Lolz.

We'll see how far she'd get at the county hospital I work at. That is, IF she survives a 20 hour waiting room wait .

I did have a patient asking me to document my refusal to refill her ativan. I did so, also adding she refused my prescription for atarax...

 

[Apollyon]

I did have a patient asking me to document my refusal to refill her ativan.

"You MUST refill it! You HAVE to!" Um, no, I don't.

 

[VA Hopeful Dr]

I’ve had this before and I reply with “sure” and then document in the chart why I don’t think it’s medically necessary. These people have no power over me.

Plus it alerts future physicians that this person is a pain in the backside.

 

[southerndoc]

I would say "sure," and then tell her she'll have access to my documentation as soon as I hit the sign button.

Wouldn't document "I refused" but would say something that patient requested a certain med, didn't feel it was clinically appropriate (and might even quote stuff if it's detrimental), and leave it at that.

The use of "provider" is annoying. Was it a physician, NP, or PA?

 

[namethatsmell]

1) This is an excellent way for a patient to erode trust implicit in any decent patient-doctor relationship...I wonder how long it takes them to burn through their "providers."

2) Uh, it's my note and for better or worse it's basically part of the practice of medicine now...patients don't get to practice without a license.

 

[The Knife & Gun Club]

No comment necessary.

“I always document what tests I chose to perform or not perform and why. I’m happy to include my specific reasoning for that exam in the chart.”

1) This is an excellent way for a patient to erode trust implicit in any decent patient-doctor relationship...I wonder how long it takes them to burn through their "providers.".

I had a guy recently tell me in his first sentence he’s a med-mal attorney who “usually only sees people like you in court!”

Bruh it’s 4 am and this is my 10th night in a row. Yesterday I told a 16 year old she had cancer and a Covid patient spit on me. I’m out of f**ks to give.

 

[Rekt]

No comment necessary.

Probably a mid level that had to google what the medicine even was before coming back.

 

[RustedFox]

1) This is an excellent way for a patient to erode trust implicit in any decent patient-doctor relationship...I wonder how long it takes them to burn through their "providers."

2) Uh, it's my note and for better or worse it's basically part of the practice of medicine now...patients don't get to practice without a license.

Nor do they get to author their own charts.

 

[Angry Birds]

Nor do they get to author their own charts.

not yet at least

 

[namethatsmell]

Nor do they get to author their own charts.

Precisely.

If there’s anything I hope the pandemic burn has fostered in physicians as a profession, it’s that extreme patient entitlement and threats, veiled or otherwise, should no longer be tolerated.

 

[RustedFox]

not yet at least

Maybe they'll get a court order.

 

[namethatsmell]

I had a guy recently tell me in his first sentence he’s a med-mal attorney who “usually only sees people like you in court!”

“Funny, I was hoping you were a Med-mal attorney! All the Med-mal attorneys I know say they do it not for the money, but to make healthcare safer and better. Well here’s a chance for you to shine: I have 5 Med students with me tonight and all want to learn how to do a proper rectal exam.”

 

[Franzd'Epinay]

In the grand scheme of demands we get from patients, "please document that you didn't do x", has to be on the more benign end.

Patients ask for stuff all time time, whether reasonable or not. If this was an unreasonable request, then the appalling thing is that someone caved in.

 

[Fox800]

Probably a noctor.

In the grand scheme of demands we get from patients, "please document that you didn't do x", has to be on the more benign end.

Patients ask for stuff all time time, whether reasonable or not. If this was an unreasonable request, then the appalling thing is that someone caved in.

 

[skougess]

Probably a noctor.

Yep. That’s the great part about being an actual physician. I am sure of my management and have no problem documenting it at the request of a passive agressive patient. I suppose if you are faking it then a patient calling you out would make you shudder.

 

[WilcoWorld]

I had a guy recently tell me in his first sentence he’s a med-mal attorney who “usually only sees people like you in court!”

At what point do we get to say, "I think you have undermined the trust necessary to have a good doctor-patient relationship, so I am going to decline your request that I be your doctor. Have a nice day, sir."

 

[Birdstrike]

At what point do we get to say, "I think you have undermined the trust necessary to have a good doctor-patient relationship, so I am going to decline your request that I be your doctor. Have a nice day, sir."

It's an interesting question, because in the outpatient world we do this all the time. In the ED it's a little tougher, because of EMTALA, but there's no law anywhere in the States that I know of, that says you have to be someone's doctor, forever. In the outpatient world, you hand them a discharge letter and then you're done (except for 'emergencies' in the next 30 days). You don't even have to have a reason. (State laws can vary on all this).

If it's a new consult referred by someone else, you can take the history, gather information and simply tell them, "I'm unable to accept you as a patient to my practice." No doctor-patient relationship is formed, and you're done. They continue care with whoever sent them to you.

What our employers think of such happenings, is another issue.

 

[dadaddadaBATMAN]

I would say "sure," and then tell her she'll have access to my documentation as soon as I hit the sign button.

Wouldn't document "I refused" but would say something that patient requested a certain med, didn't feel it was clinically appropriate (and might even quote stuff if it's detrimental), and leave it at that.

The use of "provider" is annoying. Was it a physician, NP, or PA?

In general if someone asked this I would do the same. But despite the babbling of these folks on the internet we actually have final say over what goes in our chart: patients can request modifications but we have no obligation to change them. Our hospital bylaws state we have to acknowledge the request, but we don’t have to change the chart

 

[Goro]

I had a guy recently tell me in his first sentence he’s a med-mal attorney who “usually only sees people like you in court!”

I hope that you prescribed him a really strong laxative.

 

[e30ftw]

Typical entitled patient that all of us probably see 500-1000x a year. I think they don't understand that we are very familiar with their psychology and personally if I have a patient request a non-indicated or potentially dangerous test/treatment I always clearly document why it is not indicated to hedge against a complaint. I almost always finish charts while the patient is still in the ED, so they can read my documentation on their EMR app while they are in the ER.

I am lucky to work in a system which values patient safety over satisfaction and honestly after thousands of these patients over the years it actually feels good to politely refuse to refill your xanax/percocet/suboxone/methadone/roxicodone and have you immediately elope because I know I'm doing something good for the ER and it's still like $20 in RVUs..

 

[Fox800]

"I was notified that this patient requested that the chart be modified to _____________.
In my professional opinion, the original documentation is correct and stands as-is."

 

[Angry Birds]

Let's be real though: If the patient files a written complaint, it can cause us a lot of grief... especially if you are just another pair of scrubs to admin folks.

 

[BoardingDoc]

Let's be real though: If the patient files a written complaint, it can cause us a lot of grief... especially if you are just another pair of scrubs to admin folks.

Yet another reason I'm grateful to have a chief who doesn't let me hear about any patient complaints unless A: I genuinely screwed up, or B: it's so comical he can't help but let me know so that we can both laugh about it. The latter generally makes it to our monthly meetings as well.

 

[dadaddadaBATMAN]

Let's be real though: If the patient files a written complaint, it can cause us a lot of grief... especially if you are just another pair of scrubs to admin folks.

It costs me 2-5 minutes to look up the chart if I forgot the person and 30s to write a polite sounding email. Having said that I get very few and admin likes me because of good pgs and other shiny factory worker things

 

[bravotwozero]

Let's be real though: If the patient files a written complaint, it can cause us a lot of grief... especially if you are just another pair of scrubs to admin folks.

Which is why I’ve jumped ship to a job with less toxic admin and micromanaging medical directors.

 

[southerndoc]

Which is why I’ve jumped ship to a job with less toxic admin and micromanaging medical directors.

Part of the job of a good medical director is to shield you from every complaint. Yea, if you cussed a patient out, you're gonna hear about it. If somebody is griping because of their wait, because they saw you eating at the doc station, because you didn't give them pain meds, because you didn't give them antibiotics, because you didn't smile enough, etc., then well, they get a form letter response telling them their concern has been investigated and we hope they entrust us to continue caring for them in the future.

As @BoardingDoc said, it's always good to let them know the funny ones. Some complaints are outlandish.

 

[Dred Pirate]

We had fun the other night reading the google reviews of our ED - one person mentioned how one of our intake people was rude and condesending - funny thing is that this lady is the sweetest lady anybody has ever met in their life.

 

[Apollyon]

We had fun the other night reading the google reviews of our ED - one person mentioned how one of our intake people was rude and condesending - funny thing is that this lady is the sweetest lady anybody has ever met in their life.

People exert the power they have (or don't). Think of the displacement that is put upon the kids working the Mickey D's drive though. On Google, nobody knows you're a dog.