Posted by: notdeaddinosaur | July 9, 2010

Don’t Let the Door Hit You on the Way Out

Patients transfer out of my office all the time. Sometimes they move to California; sometimes they move to Philadelphia (which can take even longer than getting to California, especially on the Schuylkill distressway). Sometimes they find my office hours inconvenient. Being only one person, I can’t offer 12 hour days six day a week. I do evening hours once a month, and am willing to stay late just about anytime someone asks; still, it’s a trade-off that I’m willing to live with, even if it costs me some patients. Some people just want a change.

I don’t care. I’ve learned (the hard way) not to take patient transfers personally.

When you need to transfer your records, all you have to do is send me something in writing, with your signature, telling me where to send the records. I don’t need a reason, although many people include one. Still, there are times when I wish you would keep it to yourself:

I am writing to inform you of the results of my blood and 24 hour urine tests requested by Dr. X. I am sure he will give you the information on the results, but the facts are not as he thinks they are, in that I did not take the prescription meds for the duration of the two months before the test (I have the full Rx bottles to prove it). Instead I went on a very great change in my diet…mostly fresh fruits and vegetables mostly eaten raw and some chicken and cereals for breakfast resulting in 20 lb weight lose [sic] and also the good test results. After a consult with holistic practitioner and studying on my own, to find I had high acid PH for my body and using supplements and minerals, doing kidney and liver cleanse and body detox and heavy metal cleanse, I have gained great energy. No longer feel fatigued and many other side effects of the Rx meds are gone!…which I am convinced started many if not ALL my problems…I never had until the start of taking Rx drugs which caused the high acid PH in my body…this is why I have decided to go to Dr. Q as my family practitioner as he is an MD who also adds the use of holistic medicine rather than just using drugs……..I feel medicine has not taken into account the need to treat the body without the use of drugs which often work against the healing power of the body but instead need to use food and supplements and cleansing to keep the body healthy, sad to say most doctor’s [sic] are sucking on the tit of the Pharmaceutical companies and do not think of alternative ways nor research them to help and heal their patients. I feel I have to take responsibility for my own health and must do what I need to do to achieve that end result.

For chrissakes, lady! Of course you’re going to feel better if you lose 20 pounds. If I had just said, “Lose 20 pounds and you’ll feel much better,” you would have rightly accused me of being thoughtless and rude.

I couldn’t care less if you want to go to the quack down the street who started out as a family doc but who renounced any claim to legitimacy in my eyes when he started treating the flu by injecting bee pollen and giving people herbs to stuff up their noses. Congratulations on hitting it rich. You must have accumulated substantial funds to blow on supplements and cleanses instead of the $4 generic diuretic I prescribed for your hypertension.

If you really wanted to learn about your body, maybe you’d discover that your “acid” level is pretty darn close to 7.40 most of the time, unless you’re really sick; like, ICU sick. And that detoxes and cleanses, be they liver, kidneys, or eyeballs, are ludicrous and potentially dangerous.

You’re entitled to buy into the old evil pharma conspiracy. I happen to agree that a lot of their practices are indefensible.

But when you accuse me of “sucking on the tit” of anyone or anything, that’s just disgusting. I’m not sure why the imagery seemed especially nasty; perhaps because it was addressed to me personally, instead of just reading it on some moronic pseudoscientific blog. Whatever. Here are your records. Get the hell out of my practice!

You know, you may get sick someday. Really sick, that is. Something beyond the capabilities of a fucktard with a diploma and a drawer full of dried plants. You might decide you’d like to see a real doctor again. And if all you’d done was send a nice, neutral records release request, I’d gladly see you back. It’s happened plenty of times before. But not now. Find someone else!


  1. I am going to try and work “a fucktard with a diploma and a drawer full of dried plants” into a conversation this weekend – I just gotta. That was the most genuine, honest and absolutely perfect response! I don’t want to type ‘LOL’ – although I just did – but I really did laugh out loud! Thank you; I’ve only been following you for a short time, but eagerly await each new post. Enjoy your weekend, Doctor!

  2. What a freakin’ maroon. But make no mistake, if and likely when, given all that stuff she’s taking, she gets really ICU sick she’ll want all of the high tech and pharma-made meds [you can bet it’ll be our] money can buy and she’ll want it right darn quick. And you will have the satisfaction of leaving her to the tender mercies of the hospitalists and specialists. We’ve got a guy like that down the street. Somehow he still is boarded by the AAFP (proving once again THAT organization’s cluelessness/uselessness) and a state license (which says more about the state board than I really want to know).

  3. Love it! I am living vicariously through you. Wouldn’t it be a gas to actually say those things to the patient who acts this way? Of course we physicians would be accused of being unprofessional.

  4. I think you need a kidney cleanse.

  5. High acid pH? Might need some more of that studying they mentioned..

  6. Anon: That letter gave me a kidney cleanse: it really pissed me off.

  7. Wassamatter, didn’t you diagnose the obsessive-compulsiveness in this customer?

    I knew a guy who was this wacko and more. Instead of taking the lithium that a doctor would have prescribed for his bipolar disorder, he self-dosed on “liquid lithium” that he got some place online (no prescription needed), with no monitoring and only his impaired judgment to tell him what to do. He was into the pH testing, too.

  8. I think your response also gave you a refreshing spleen cleanse, Dino.

  9. I sooo have been planning to reinvent the “get off your fat ass and do some exercise and stop eating McDonald’s” treatment that we’d all agree is sound advice, but couch it in some kind of alternative holistic terms.

    This is my cure for metabolic syndrome. I am going to charge a million dollars for a consult that will explain to each one exactly how to cure their diabetes.

    I’m going to demand that people do their power walking in alignment with the meridians of the earth at a particular hour every (making up some bullshit about how the magnetic field and the sun at that particular time will realign their cells – but better sounding than that). Their exercise must not ever be less than 37 minutes (prime numbers, both) but never more than 73 at a time. This must be done at least five days out of seven (a number considered to have special mystical power over the blood by the Wackkooo people of somewhere or other). If I charge extra, I’ll somehow use their birth date to calculate their exact times for ideal exercise.

    You must eat only whole grains. Your brown rice may only come from fields in (pick some area of the world that sounds exotic) and may only be combined with legumes and vegetables. (I’ll make a similar list for every staple.)

    Any slip up – eating some kind of sheet cake from the grocery store – must be immediately reported to me so we can make a plan on how to correct the imbalance you caused. I will then give them a plan that sounds ridiculously plausible – such as they can only use cumin and tumeric as spices in their grains and legumes for a week.

    I’ll use some random number to convert pounds or kilograms into some mystical unit, and I’ll set their weight loss goals by that number, not BMI.
    (“I want you to lose, as a first step, until you weigh 100 moon-os, an ancient unit of weight, with the power of the round and complete number of 100.)

    How much you wanna bet that I get more people to lose weight and cure their diabetes like that than through reason?

    I am so not joking about this. When I get into my own practice I am going to do this. I think we’ve forgotten the power of mystique – this is my 2010 white coat.

  10. It occurred to me tonight that I hadn’t seen a post from you in my RSS feeds for several months. So I checked your old blog and discovered why.

    And now I realize again what I was missing. That was masterful, Dino. 😉

  11. Don´t freak out about such things.

    If they blow their money on cleansing stuff than what do you have to care as long as they do not take something toxic?

    Sure they could have taken the precribtion and also could have kept all the extra weight and eaten unhealthy stuff.

    But imagine what that would have cost later…too much weight, unhealthy food and all the diseases that follow with that.

    Now they are more healthy than before..sure they have spent extra money but they do not have to take medicine and also have a higher chance of not getting diet based illnesses.
    It is not as if it was your money they spent, or?
    Isn´t that a reason to be happy and giggle in secret about everything?

    They could have it cheaper by just changing the diet and loosing weight…but you know how it goes…

    If you don´t have to pay good money for it, it is not good/will not help.

    No matter how good the advice, if it is free, it is also worth nothing in the eyes of the people.

    So if people pay money, it feels more precious.

    No matter if medicine, diets or pets.

  12. Typical arrogant condescending doctor. You didn’t do your job, so the patient found a way to help herself. No one cares if your fragile ego was hurt. Don’t think that just because you have a diploma hanging on your wall doesn’t make you just as much of a “quack” as a holistic practitioner.

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