exactly who is responsible for your prescription snafu?

I spoke with a patient today who blamed Andrew Cuomo because she was told by her mail order pharmacy that her prescription for tramadol couldn't be filled until someone from her doctor's office called the mail order pharmacy because the directions on the prescription were different from the one before. Really? How can someone go so completely off the sanity rails and land in this train yard?

One has to wonder if the conspiracy theorists are more abundant than previously suspected.

You've only taken the med for how long?

This one isn't so much about stupid shit patients say or do, as it is about the complete retardedness of certain aspects of the insurance industry.

Worked on a med prior auth for a med a patient has literally taken for fifty years, their CSR asks me if the patient has tried any formulary alternatives. My response: the records have been destroyed, and 50 years of documented med stability render your formulary completely irrelevant. Also, were any of the formulary alternatives even in existence 50 years ago? If they deny this claim, I will appeal to the surgeon general if need be. I am absolutely for reigning in the cost of health care, but we need to be realistic. Formularies are NOT one size fits all. You shouldn't force a patient to switch meds after FIFTY plus years because there's something your company pays less $ for.

So, after the company approves and renigs the initial approval, we appeal (the patient actually started the expedited appeal, YAY!), they approve on appeal and actually renig the approval based on appeal, citing need for more information.

WHAT

THE

F#CK?!?

This is the more polite version of what I wanted to send to the insurance company, the version the Doc approved.  I whited out several UPPERCASE complaint words, and deleted the entire line about the doctor not even being alive when this patient started therapy with the medication in question.

I've redacted the name of the insurance company/their prescription benefits manager to protect the guilty and also protect myself and my office from a lawsuit, which will surely ensue if the bad PR escapes to the general public.  I love that there are active plans in place to reign in the cost of health care.  I loathe the shit insurance companies get away with & without any fear of repercussion.

For the record, the company FINALLY agreed to pay for the medication.  They still haven't contacted me personally to advise me of this.  I found out via the pharmacy.

Your what is bothering you?

From an older lady: "I had something wrong with the cartridge in my ear". I assume she meant cartilage, and not that she had a tape player inside her ear canal.

Driving habits of.....?

An 82-year old female patient was once 20 minutes late to her appointment.  Her reason: she complained she got stuck driving behind a little old lady.

magic is as magic does.

We have a wonderful young adult patient who is schizophrenic and is very faithful about taking their medication.  On their latest office visit, they had a frank discussion with our physician assistant.  It regarded the issue of magic, and those that practice the art.

Their take:  "I've done enough magic to know that I can't just (insert hand movement) poof, and expect magic to happen."

The same person has been known to frequent Uno competitions.

So is the same pyhysician assistant.

True story.

Your knowledge of anatomy definitions may be lacking.

This one is from several years back.

A grandmother brought her young granddaughter in for a sick appointment.  As it's my job, I tried to discern the reason for their visit.  Grandma's idea of helping was to say to her granddaughter "tell her how your Tweety hurts".

Huh?

Your daughter needs an appointment for what?

A mom called this afternoon wanting to know if she could make an appointment for her 7 year old daughter who, according to mom, fell through a ceiling and landed on concrete. Yesterday.

That's what she said.

Had an elderly man as a patient for some years. He had mild dementia. When he would need a blood draw or a shot, he would waggle his eyes suggestively, and would reply "that's what she said" to anything I said. In front of his wife. And his daughter. After some years he kicked it up a notch with "that's what she said, and then the bed broke!"

Some years back, under murky circumstances, his wife accidentally backed over him with their car.

Lost in translation.

Had a discussion with an older gentleman patient, he was frustrated over calling customer service for his mail order prescription plan. His complaint was the person trying to help him was black. His comment: "I don't have a problem with black people, I just don't speak their language". Which in this instance happened to be English.

inaugural post

The doctor's office I work at has a cradle to the grave population.  Our youngest patient is 16 days old.  Our oldest patient is 100ish.  The 101 year old patient passed away, and I don't know which patient now holds the honor of most senior member.  From a medical standpoint, the things our patients say are at times ironic, hilarious, profound.  The staff also say things that meet that criteria.  We started a book five years ago to document the best (and worst) of it all.  Sometimes the day is hectic and later on we can't recall just what was said.  Sometimes the things that are said are so amazing we want to remember it later.  It's not just the patients that make our book; it can be staff, it can be other providers, it can be  support staff.  This stuff really should be shared.  Many people in the medical field will chuckle, some will scoff.  Some will tell their co-workers what went down.  Lots of people that are simply a part of the human race can relate.  Here's the 1st of many things I can pass along.

We had a female patient in her  60's say when she was being seen for a sick visit that she felt like she was being dragged into a rat's hole backwards.

How does one have a frame of reference for this?