#288 Frustration

I am a doctor. My job is to help people. Why do some of those people make it so difficult? I have one patient in particular who is driving me nuts lately. She has a potentially serious (as in BLINDING) eye condition. I diagnosed this about three years ago and she neglected to follow my advice or even follow up with me. She has recently come back in due to other problems with her health and had seemed to be more compliant. She has no insurance so I do what I can to help her out financially. I discount my fee, don’t charge for diagnostic tests and use generic medication.




In return she doesn’t show up for appointments, calls all the time and refuses to talk with my tech insisting only on speaking to me.



Yesterday she called and would not tell my tech why she was calling. By the time I was able to call her back it was after 5:00. She told me then that she thought she was having an allergic reaction to the medication that had started 3 days ago so she took herself off of the medication. That’s fine, she did the right thing. All of the medications I have to treat this particular disease are related, however, so I’m concerned about starting her on a different one without medical supervision. It was too late in the day to reach her primary care physician so I told her I’d have to address the issue the next day.



Today I spoke with her primary care physician and explained the situation to him. I arranged for her to be able to go to his office and take her first dose of medication there so that if she had a life-threatening allergic reaction she would be in good hands.



I then called the patient and explained all of this. Her first reaction was to ask me if she was going to have to pay for the visit and tell me she wasn’t going to go if that was the case.



I understand financial pressures, I really and truly do, but these things are out of my control. I am already taking a loss seeing her (my salary consists solely of a percentage of the charges I collect) and spending way more of time on her than I do on many patients. I really don’t mind the work or the time; my goal is to do the best for my patients. I mind her attitude. It’s like she thinks I am making things up and asking her to do things solely to drain her finances. I AM TRYING TO KEEP HER FROM GOING BLIND OR DYING.



I think back to last December and how amazing Eric’s doctors were and how we would have done anything, spent anything, gone anywhere to help improve his condition. I think about the re-arranging of my schedule to get my kids to doctor’s appointments and keep them home when they are sick. I don’t mind any of that. It’s just how the world works.



I’m sorry I can’t make her disease go away with a wave of my hand. I’m sorry she is not in a financial position to truly care for herself. But how is any of that my fault?



I will continue to care for her and I will do my absolute best to make all of this as easy for her as possible. But wow does she try my patience.