Professional Courtesy

A couple days last week, I wasn’t feeling well.  I had a low-grade fever and shaking chills.  My body ached liked I had gotten run over by a truck.

My husband the astute diagnostician examined me and pointed out an expanding red spot on the top of my foot, “Looks like you got bit by a spider or something. Your’ symptoms are probably related to a systemic reaction to the venom.”   The red spot got bigger and bigger, my foot got hot and swollen, to the point where I was noticeably limping around.

By the 3rd day of my illness, I realized I wasn’t getting better and I finally hobbled over to one of my colleagues and sheepishly pointed to my foot, “Does this look like a bug bite to you?”   She said, “Yes, and I think you have a pretty bad cellulitis.  You should be on antibiotics for that.”

So, being the the rule-follower…instead of asking my colleague to call in antibiotics for me, or prescribing antibiotics for myself, I left a message for my primary care physician with the details.  She did not call me back.

Instead, her assistant called and said, “Dr. X said that you need to come in to be examined before she will prescribe anything for you.”   Now, I usually wouldn’t do this, but because I was really in agony, and I had a full schedule of patients myself, I said, “Can you remind Dr. X that I am also an internist?  and  I work with a group of internists?  Someone in my group has already examined me.  I was just hoping that my own physician, someone other than myself, could write the antibiotics.”   30 minutes later, the assistant called me back and said, “Dr. X said to come in at 4pm this afternoon and she will decide if you need antibiotics.”  I gritted my teeth and politely declined,  “Please tell her that I won’t be able to see her today because I have to see a patient at 4pm.  I will find someone else to prescribe the antibiotics.”

Physicians can be tough patients.

From the patient’s perspective, I always wonder when it is appropriate to identify myself as a physician when I am seeing a doctor.  In theory, it really shouldn’t matter whether or not the patient has a medical background or not.  However, from a physician’s perspective,  I know that there are certain “code words” that a medically-trained person can say that will influence my diagnostic approach, for example, the neurologist who asked me about his “supraventricular tachyarrhythmias” instead of just plain ol’ “heart racing”,  or the nurse who complained of a “firm immobile nodule” instead of a “lump on my neck”.  My own bias is that someone who is medically trained and knows what she is talking about wouldn’t tie up a colleague’s time/energy unless she felt it was really absolutely necessary. Perhaps that is why I am so peeved at my doctor for not taking me seriously, and not even having the decency to call me back to find out what was going on!

So am I just being a spoiled brat for expecting special treatment?  or is this just simple professional courtesy?


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