Pain in the ass patients more healthy?

[StevenXXXX]

http://www.sleepguide.com/forum/topics/ ... ealth-care

[Kairosgrammy]

Haven't seen the posting but pain in the ass patients are probably better treated if for no other reason than medical folks dislike dealing with them so give them what they want to get them off their backs. Of course, I can also see this back firing. Medical personel trying to get this patient off their back, may miss things they should have observed had they not been trying to rid themselves of a squeaky wheel. Me, I try to be sweet but very persistent.Try anyway. Usually isn't the medical folks that give me a problem though, it's insurance.

http://www.sleepguide.com/forum/topics/ ... ealth-care

[cpaptex]

The squeeky wheel always gets more grease.

[Bons]

I was a pain to my therapist at the DME until she finally admitted that she knew next to nothing about ASV's and called Phillips Respironics to get information for me. It's made her a better therapist, as she now admits.

When my husband was in the ER back in November my daughter and I became ROYAL pains in the butt, and actually listened to the doctors and nurses bitch about us out in the hallway. But since his life was at stake, you can bet we kept at it. He was in and out of A-fib, which the doctor denied because he was only looking at the monitor in the minute or two he was in the room. Daughter had just finished her grad class in EKG interpretation, and that really made him mad when she argued with him. He has a history of A-fib and intestinal problems, which usually flare together. Also, he was not getting pain meds for the (unrelated) outpatient surgery he'd had the day before, and I kept asking for meds, then went home and got the ones prescribed the day before, several hours after he was due to take them.

We were polite as possible. For example, when the nurse said she'd go get him some blankets because of his chills (fever of 103) and half an hour had gone by, I simply went to the desk and asked for some as if we'd never asked before, rather than point out her error.

And when they were still doing nothing at 3 in the morning, after he'd been there since 5 p.m. I called our family practioner who called the ER doc and ripped him a new one. ER doc then had him admitted to a general med floor, where he spent all of half an hour before the nurse said that they were unqualified to deal with the A-fib and bumped him to a cardiac floor. And there they finally ordered a CT scan and other tests.
Turns out that he had c-dif, which had triggered the A-fib, and he'd been within hours of a bowel perforation.

And then there's the time I went to the other ER in town with frank UTI bleeding and the (male) PA told me it was perimenapausal spotting and I was over-reacting - like a 53 year old woman can't figure out where the blood is coming from.......

[Kairosgrammy]

My daughter took my granddaughter to the ER running a fever etc. We figured bronchitis or sinusy stuff but the fever was high enough you didn't want to let it go. So this idiot doc prescribes some medicine that my granddaughter had had before. When my dd said that the medincine he prescribed made A. scream and cry. I will testify to the truth. I had gone to visit and we ended riding all over trying to get her to calm down. It was awful. She finally quit screaming when the medicine wore off. Idiot doc said you can either give her the medicine or not treat her. Your choice. My daughter ended up in the doc's office the next morning with a still very sick child. Guess what, she had bronchitis and needed antibiotics. Some docs need their medical licenses pulled. They should at the very least listen to their patients.

I was a pain to my therapist at the DME until she finally admitted that she knew next to nothing about ASV's and called Phillips Respironics to get information for me. It's made her a better therapist, as she now admits.

When my husband was in the ER back in November my daughter and I became ROYAL pains in the butt, and actually listened to the doctors and nurses bitch about us out in the hallway. But since his life was at stake, you can bet we kept at it. He was in and out of A-fib, which the doctor denied because he was only looking at the monitor in the minute or two he was in the room. Daughter had just finished her grad class in EKG interpretation, and that really made him mad when she argued with him. He has a history of A-fib and intestinal problems, which usually flare together. Also, he was not getting pain meds for the (unrelated) outpatient surgery he'd had the day before, and I kept asking for meds, then went home and got the ones prescribed the day before, several hours after he was due to take them.

We were polite as possible. For example, when the nurse said she'd go get him some blankets because of his chills (fever of 103) and half an hour had gone by, I simply went to the desk and asked for some as if we'd never asked before, rather than point out her error.

And when they were still doing nothing at 3 in the morning, after he'd been there since 5 p.m. I called our family practioner who called the ER doc and ripped him a new one. ER doc then had him admitted to a general med floor, where he spent all of half an hour before the nurse said that they were unqualified to deal with the A-fib and bumped him to a cardiac floor. And there they finally ordered a CT scan and other tests.
Turns out that he had c-dif, which had triggered the A-fib, and he'd been within hours of a bowel perforation.

And then there's the time I went to the other ER in town with frank UTI bleeding and the (male) PA told me it was perimenapausal spotting and I was over-reacting - like a 53 year old woman can't figure out where the blood is coming from.......

[jbn3boys]

The squeaky wheel always gets more grease.

OR the squeaky wheel gets replaced.

[thud]

My neighbor became so much of a pain in the ass squeaky wheel with his doctor that the doctor told him NOT to come back.

[Kairosgrammy]

Sounds like he needs a good report to the AMA or a good suing. Doc's make mistakes, after all they are human. There's no excuse for refusing to listen to your patient or acknowledge he might know how he feels and the doc might need to do something proactive.

My neighbor became so much of a pain in the ass squeaky wheel with his doctor that the doctor told him NOT to come back.

[Maxie]

My daughter was an ICU nurse (currently on the way to becoming a nurse anesthetist) so I've heard quite a few stories about pain in the ass patients and families. There is a difference between being a pain in the ass and wanting to be informed about your patient's or your own welfare. One of the things doctors and nurses hate is people and families who decide on the best course of action based on what they read on the internet. The best method is to treat your health care provider as you would want to be treated. Not returning with blankets may not have been an error on the nurse's part so much as a call for an emergency. I think it is almost an art to getting everything you need from a health care person and not pissing them off in the process. You have to pick your battles. Nope, pain in the ass patients are not more healthy. The squeaky wheel may get the grease but who knows about the quality of the grease!

[chunkyfrog]

Every time we've had someone in the hospital, we've had to be vigilant, and sometimes a pest for the benefit of a family member.
From the nursing staff members who weren't looking at my mother-in-law's blooming bruise at the heart catheter site (assuming she was just bellyaching)
to the gentle reminders that "Yes she speaks 13 languages, but English is the last one she learned--so please just ask her to speak English"
All in all, nurses are wonderful, and very helpful--true angels; but they are dreadfully over-worked.
As for doctors--do they have a TV in their lounge running "House" reruns so they can practice being even more arrogant?

[Kairosgrammy]

I'm sure, in many ways you are right. I trust most of the medical people I deal with because i know their reputations and they have always been reliable. My family doc will always listen to me and then tell me what he honestly thinks and we go from there. I feel as if I'm a part of my own treatment and that should be how it always is between patients and the medical people we deal with. Not that my doctor would do something that went against medical ethics but if it makes sense, he's fine. He allowed me a couple of months to get my cholesterol down through diet rather than medication. I wanted to do it that way because in the past, I had great success with that. When my cholesterol didn't go down, I did what he thought best. As I cringed, he said, "Lynn, not all cholesterol problems are caused by diet or obesity. Some folks just have troubles with their cholesterol." He's taken the time to know me, not just my conditions.

My family and I have been squeaky wheels because the situation called for it. My father, now deceased, had a series of heart attacks a year apart. My father's cardiologist did everything he could to avoid us. My father was an alcoholic unfortunately and I understand that didn't make his care any easier. The first heart attack, the doc treated him with a small dose of alcohol to prevent further damage to his heart. A year later, instead, he allows him to go through DTs. Then he gives him haldol to control the DTs. Then, while he is more unconscious than not, they try to feed him. I'm a speech path and have some experience in feeding issues. You don't try to shove food down an unconscious person's throat. If they don't choke, the danger of aspiration is extremely high!!! Fortunately, for them, it just ran down his front. Of course, let's not mention every patient's right to dignity.

When they finally let him out of ccu to the floor, he kept digging at his privates (still on fairly high doses of haldol). We asked the nurse to check him and she said his cath was filthy. FILTHY!!! From CCU where there is 1 nurse per 2 patients. FILTHY!!! That doesn't happen in a day. THe cath probably hadn't been changed since his admission much less anything done to insure cleanliness or proper hygiene.

Then of course, there was the time we came to visit him and he was naked (yes, DTs caused brain damage) including not having his monitor on. He was flat-lining at the nurses station. Did anyone rush in to find out if he was in cardiac arrest? Nope!!! In fact, he would have been quite dead by the time my daughter and I were able to dress him. It's quite possible this had happened before so they just assumed he was stripping. Make that gamble once too many times and a patient, under your care is dead. What's the excuse. You didn't want to be bothered???

When he was in CCU the second time because they let him out well before he was actually stable, the only way we could talk to the doctor, was to have some of us stand outside the nurses station and some of us outside the CCU. No, we didn't expect updates every few hours but every few days would have been nice. We ended up having to go to a patient representative to actually get the man to sit down and talk to us about what we could expect, how much healing, etc. We didn't want answers he couldn't tell us, we just wanted to know how he was doing and what, in the doctor's skilled opinion, we might expect, best and worst case scenarios. Believe me, this was just a few things that went on.

My brother-in-law has a lawyer cousin, really high up in state government, he begged for us to sue the doctor and the hospital. Said it would be a shoe in for a huge suit. Myself, the only reason I'd sue is to be sure the doctor never practiced medicine again. He wasn't incompetent, just rude and inconsiderate and still under the impreassion that he was just one step below an omnipotent God. I'm sure by that point in time, he was also aware that on this particular case, he'd screwed up and possibly wasn't too comfortable with that knowledge. Doctor's are human and they do screw up. THe truly good doctor, the one I can respect, is the one who admits this and works with patients and their families for the best outcome of the patient.

Unfortunately, not all medical care is created equal and you do have to know when to be a squeaky wheel. Sometimes, as squeaky as we were with my father's care, I sometimes think we weren't squeaky enough. I realize that he wasn't easy to deal with, no alcoholic is but he didn't deserve to be treated without dignity or concern or care for his welfare and to be honest, no one deserves to be treated the way my father was. Honestly, we shouldn't have to be squeaky wheels. Sometimes, that's the only choice we are given.

My daughter was an ICU nurse (currently on the way to becoming a nurse anesthetist) so I've heard quite a few stories about pain in the ass patients and families. There is a difference between being a pain in the ass and wanting to be informed about your patient's or your own welfare. One of the things doctors and nurses hate is people and families who decide on the best course of action based on what they read on the internet. . . . The squeaky wheel may get the grease but who knows about the quality of the grease!

[thud]

Sounds like he needs a good report to the AMA or a good suing. Doc's make mistakes, after all they are human. There's no excuse for refusing to listen to your patient or acknowledge he might know how he feels and the doc might need to do something proactive.

Honestly I don't blame the doc. He really is a pain in the bum. Not just with doctors but most everything.

[mstevens]

pain in the ass patients are probably better treated if for no other reason than medical folks dislike dealing with them so give them what they want to get them off their backs.

Getting what you want is not necessarily good treatment. Sometimes, perhaps more often than you might think, it's the worst possible treatment.

My biggest pain in the ass patients typically want one of two things: opioids or benzodiazepines they don't need and are addicted to, or my support on a disability claim that is unjustified. One step down are the patients who demand the med they saw an ad for that isn't even for their medical problem or the miracle cure that was discussed on that chat show but isn't actually available and probably never will be. A close second are the patients who demand I fix something they are actively making worse, usually by heavy drinking or drugging, and not mention that they need to change what they're doing. Just below them are the patients who simply want to argue - they disagree with my diagnosis (or with the overall concept of diagnosis in general), want me to tell them to stop the treatment that's keeping them out of the hospital, don't "believe in" medicine or my specialty (yet show up for appointments anyway), or want me to endorse their magic vitamin regimen that doesn't need my endorsement anyway. Next to them are the people who want me to argue with their insurance over costs - not prior authorization or appeal of a determination of non-coverage, but demanding that I get their copay lowered or get coverage for something that's specifically excluded in their plan (usually a non-prescription item that they want to be reimbursed for).

I encourage patients to research their conditions and come to me with questions that arise after they read up. If they're going to go on xPAP I send them here, tell them they need a machine with full data, and tell them where to get the software for it as well as offering to go over their data with them. I go over side effects that sometimes people don't want to hear about (Q: "Why tell me that?! It makes me not want to use that treatment". A:"If what I tell you might make you not want to use a treatment, then that's exactly the sort of thing I have to tell you even if it might make you decline a treatment I think you should use".) I'm willing to get into the nitty-gritty of why I'm recommending a particular treatment over another (Q: "Wouldn't Superbalon work better for me?" A: "I'm pretty sure it would. It'd cost you a thousand bucks a month out of pocket, though, until your $5,000 deductible is met, so I recommend something nearly as good for 50 bucks a month") or why I'm assigning one diagnosis instead of a different similar-seeming one. I schedule appointments that are 2 to 3 times as long as many of my colleagues because I need the time with patients to address their concerns. None of those counts as "pain the ass" to me.

If advocating for yourself in an appropriate manner with your doctor makes you a pain in the ass, you probably need a different doctor.

[jenn1270]

pain in the ass patients are probably better treated if for no other reason than medical folks dislike dealing with them so give them what they want to get them off their backs.

Getting what you want is not necessarily good treatment. Sometimes, perhaps more often than you might think, it's the worst possible treatment.

My biggest pain in the ass patients typically want one of two things: opioids or benzodiazepines they don't need and are addicted to, or my support on a disability claim that is unjustified. One step down are the patients who demand the med they saw an ad for that isn't even for their medical problem or the miracle cure that was discussed on that chat show but isn't actually available and probably never will be. A close second are the patients who demand I fix something they are actively making worse, usually by heavy drinking or drugging, and not mention that they need to change what they're doing. Just below them are the patients who simply want to argue - they disagree with my diagnosis (or with the overall concept of diagnosis in general), want me to tell them to stop the treatment that's keeping them out of the hospital, don't "believe in" medicine or my specialty (yet show up for appointments anyway), or want me to endorse their magic vitamin regimen that doesn't need my endorsement anyway. Next to them are the people who want me to argue with their insurance over costs - not prior authorization or appeal of a determination of non-coverage, but demanding that I get their copay lowered or get coverage for something that's specifically excluded in their plan (usually a non-prescription item that they want to be reimbursed for).

I encourage patients to research their conditions and come to me with questions that arise after they read up. If they're going to go on xPAP I send them here, tell them they need a machine with full data, and tell them where to get the software for it as well as offering to go over their data with them. I go over side effects that sometimes people don't want to hear about (Q: "Why tell me that?! It makes me not want to use that treatment". A:"If what I tell you might make you not want to use a treatment, then that's exactly the sort of thing I have to tell you even if it might make you decline a treatment I think you should use".) I'm willing to get into the nitty-gritty of why I'm recommending a particular treatment over another (Q: "Wouldn't Superbalon work better for me?" A: "I'm pretty sure it would. It'd cost you a thousand bucks a month out of pocket, though, until your $5,000 deductible is met, so I recommend something nearly as good for 50 bucks a month") or why I'm assigning one diagnosis instead of a different similar-seeming one. I schedule appointments that are 2 to 3 times as long as many of my colleagues because I need the time with patients to address their concerns. None of those counts as "pain the ass" to me.

If advocating for yourself in an appropriate manner with your doctor makes you a pain in the ass, you probably need a different doctor.

I have to agree with mstevens. I love my patients and try to give them the time that I want my doctor to give me. I am fortunate to be in an environment where I don't have to slog people through the system to keep my practice afloat in the medical economic environment these days. I always try to sit down and listen. It amazes how those two things make for a much more efficient visit.

Like mstevens. I also am proactive about the internet. There is some crazy s&*t out there and giving patients the useful resources helps empower them to be invested in their health care.

yes there are pain in the ass patients. just like their are pain in the ass customers and Walmart and pain in the ass sunday school teachers at church. Being kind is the best you can do and at the end of the day, if your personality and theirs don't match, they need to find someone they mesh with.

[Kairosgrammy]

I guess this may one of those cases where the patient isn't ideal. Unlike me.

Sounds like he needs a good report to the AMA or a good suing. Doc's make mistakes, after all they are human. There's no excuse for refusing to listen to your patient or acknowledge he might know how he feels and the doc might need to do something proactive.

Honestly I don't blame the doc. He really is a pain in the bum. Not just with doctors but most everything.