WhiteCoat

Posts Tagged ‘ERP’

A Classic Dr So-and-So Patient

Saturday, September 26th, 2009

ERP from ERstories.net  here again today and tomorrow… You know, WC needs a weekend off now and then…..

Why is it that certain doctors (usually primary care) attract a certain subset of patients? Our community is very heterogenous but I still find that several MD’s have tapped into certain subpopulations whether intentionally or unintentionally. Often, I find myself guessing (usually correctly) about who a patient’s doctor is before asking them. Clues like the med list, the last name, the insurance (or lack of it) they have, and PMH all give clues. I chuckle to myself when I ask them who the MD is and find I am correct. For example:

One doc seems to have about 90% of all the living Holocaust survivors in the US as his patients. (and he was not one himself) – usually on BP meds and Coumadin for Afib.

Another guy seems to have only patients with chronic pain, nebulous psychiatric diagnoses, and poorly controlled hypertension and diabetes. They often have Medicaid (which is honourable of him). However, even those with private insurance tend to be extremely challenging to deal with. Most are on Oxycontin, Wellbutrin, benzos, and Metformin.

One group sees only super rich entitled people who never have serious emergencies. However they often seem to have diagnoses of fibromyalgia and IBS way above the national prevalence. Hmmmm. Usually on Cymbalta, Xanax and something for chronic diarrhea.

One guy sees 90% patients from South America with no insurance – but they all have money and pay him cash. Often on random drugs they purchased on their last trip to Columbia.

One woman has a large non-English speaking, Russian population. They always seem to have some major issue going on. Often on no meds despite the acute MI they are having.

Another guy who is Asian seems to have all the really sick Koreans and Chinese in the area. Usually they are on dialysis and have a med list a mile long.

Another Asian doctor seems to only have the healthy ones. They tend to be on ziltch.

Of course none of this really matters since they ALL eventually become my patients! But thankfully they don’t REMAIN my patients until their next visit when I am on!

Lucky in More Ways Than he Knows

Thursday, September 24th, 2009

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Hey all, I this is ERP from ERstories doing a guest post on Whitecoat’s Blog. I want to give him and the EP Monthly staff my thanks for accepting some of my occasional ramblings.

Drunk people are often victims of their own stupidity. However, just as often they manage to avoid disaster by some miracle. For example, intoxicated persons have a tendency to end up face down in the street and often manage to avoid getting run over. Sometimes they are even luckier. Of course they never really realise this since after all, they are drunk. Hopefully when they sober up they count their blessings but often they simply can’t remember enough!

Anyway, we had a guy who was brought in by police intoxicated outside someone’s house. Apparently he was visiting the area and was staying with someone in the neighbourhood. Unfortunately, when he stumbled home from the local watering hole, he went up to the front door of the wrong house. Frustrated by the fact that his key did not work and upset that no one answered his knocking, he preceded to kick the door in. He flopped partially into the doorway and nearly passed out. This of course triggered the house alarm and the police were notified. The responding officer sped rapidly to the scene for more than one reason. The door that had been kicked in belonged to the chief of police’s house! Expecting the worst, the cops showed up with Glocks drawn. Knowing the chief’s love of firearms and the fact that he was not afraid to use them, I imagine they thought they might encounter some OK Corral- type scenario. Fortunately for the guy, the police chief was not at home at the time. Otherwise, he would have likely been brought to the morgue instead of the ER! One more of his nine lives used up I guess….

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