Re: A rant and a poll
From: Garry E. Siegel, M.D. (garrys@mindspring.com)
Sat May 20 16:34:20 2006
My 2 cents:
You did the right thing trying to contact the infected patient by any
reasonable means, and did so in a discreet fashion.
To address the bad behavior, I agree with Art--a frank and open
discussion, and if that doesn't go well, fire her on the spot. If you
can't fire her, so be it. Document what you've done.
I will occasionally treat the partner of patients with whom I have a
relationship, i.e. they don't scream at me/us, and we can get them on
the phone. In your case, I absolutely would NOT have treated anyone but
the patient, and documented that you told her to have her contacts be
evaluated/treated.
After the frank discussion (if it happens), why not send her a summary
letter of the whole enchilada by regular and certified mail?
Garry
At Sat, 20 May 2006, Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.
wrote:
>
>At Sat, 20 May 2006, Anna Meenan, MD wrote:
>>
>>Just need to blow off steam and wondering how everyone else stands on a
>>question.
>>
>>The background: Working in outreach clinic yesterday. Positive
>>chlamydia test on a patient who's been positive twice before. In fact,
>>she's 20 weeks and has never been negative yet in this pregnancy (been
>>treated appropriately and recommended to get partner(s) treated). She
>>had an appointment that day so we planned to talk to her then. She
>>no-shows (3rd time this pregnancy). My medical
>>assistant/receptionist/lab/translator, who obviously has nothing better
>>to do with her time, calls all of the phone numbers this pt. has given
>>us at various times and cannot reach her at any of them, most having
>>been disconnected. A pt. who would be an in-law of hers if any of them
>>were married, and who has come in together with her on other occasions,
>>has an appointment and does show up. Assistant asks her if there is any
>>other way to contact pt. #1. She says she will contact her and have
>>her call us, which she did. Pt#1 calls back and screams at my assistant
>>that she should not involve pt.#2 in her affairs. Assistant is very
>>diplomatic, in spite of the fact that Pt. is screaming so loud I can
>>hear every word from across the room. We arrange to get pt. treated
>>again but the question now arises as to whether we should call in an Rx
>>for her partner. Listening to her abusive tirade from across the room
>>and recalling a commercial I had seen on TV just the night before
>>(malpractice lawyer soliciting pts who had ever had Stevens-Johnson or
>>TEN and had ever taken Vioxx, Celebrex, ibuprofen, Clinoril, or
>>ZITHROMAX), I declined to phone in an Rx for FOB, who i have never met,
>>based on the attitude of pt.#1 and the knowledge that this is obviously
>>one person who will sue me at the drop of a hat if anything goes wrong.
>>There is a clinic right in town that will treat partners on a
>>sliding-scale fee basis, so access is not a problem for FOB.
>>
>>So what would y'all do in this situation?
>>
>>--
>>Anna Meenan, MD
>>
>Repeat the Chlamydia swab at the same time as group b(36 wks), even if
>prof of cure is negative, as for the other stuff I learnt A long time
>ago its beyond my controll.
>
>--
> Take care, John
>
--
Garry E. Siegel, M.D.
Private Practice
Roswell, GA
