Posted by: notdeaddinosaur | September 30, 2014

Timing; Following Up

Many thanks to all who responded to my conundrum about conveying bad news on a Friday. Lots of different answers confirmed my initial impression: there really wasn’t any “right” answer. I just did my best based on what I know about my patients. Just thought I’d let y’all know how it played out.

Monday came.

I picked up the phone the moment I got into the office (pretty FSM-damned early) and caught the patient before leaving for work. Conveyed the fact that I had news and that it wasn’t good. Arranged for patient (and spouse) to come for an appointment within the hour.

They reacted about as expected. It actually hit the spouse significantly harder than the patient. Tissues were proffered and accepted. They had spent the weekend reading up on some of the various diagnoses we’d discussed earlier, though not the one that it turned out to be.

But it was a good weekend for them. Mission accomplished.

Phone numbers were provided to the required specialists. More hugs offered and again accepted. After they left, I picked up the phone again and spoke with the surgeon myself, giving him the specifics and to expect the call. He reassured me that the patient would be taken care of promptly. In my experience with this practice, it usually means surgery will ensue within the week.

And yet…

It’s now more than a week later, and I haven’t heard anything from either patient or specialist. Chances are that surgery has already occurred, a definitive diagnosis has been obtained, and further treatment is being planned.

But I know nothing. Out of the loop. Radio silence.

I’m confident that my patient is being well cared-for. But what about me? I’m still worried.

I know how whiny that sounds. I know I’m not the one facing major surgery and potential further treatment for a life-threatening illness. But still; I care. I don’t want to bother the busy surgeon by calling and bugging him. I’ll probably get a letter from him eventually. And I certainly don’t want to bother my patient or the spouse. It’s not their responsibility to keep me informed.

But still; not knowing is difficult. Karma for having waited until Monday? Perhaps.

Oh well.

 

 

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Responses

  1. Not karma. You were totally informed when I was in the hospital because I have you on speed dial.😁 They also serve….

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  2. Wow, that has to be frustrating. I have never thought about it before. I guess I always presumed that my primary gets reports from the specialists that he sends me to. In all likelihood your patient is being swept up in a whirlwind of medicine. Thank you for pointing this out to me.

    Also thank you for calling the patient into your office to receive that news. I have heard all too often of people getting dire diagnoses over the phone, and often when they are at work.

    I hope your patient does well and that you hear from them soon. Would it be inappropriate for you to call them to check up on them?

  3. Why not give the patient a call? It meant a great deal to me when my internist stopped by my hospital room the day after my cancer surgery and called me the morning of my first chemo appointment. She works for an outpatient practice in the same hospital where I was treated so these things were super easy for her to do, but just knowing that she cared enough to ask how I was faring & to wish me well meant the world to me.

  4. I feel like it would be okay to call the spouse to check in and follow up. You are naturally supportive; maybe there is some way you can be of assistance. If nothing else, you can let them know you’re thinking of them, which has to be worth something.

  5. Busy surgeon my foot. Seems like the Great Man could at least send you an op note. These people need to be reminded who it is that feeds them. If he hasn’t got time to talk to you maybe he doesn’t need your referrals. Pick up the phone and call him already.


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