March 9, 2014

chief complaint

     Whenever one makes an appointment with a doctor, they ask for a reason for the appointment.  Everybody's done it.  The person then booking appointment, enters into the electronic medical record what the patient is being seen for.  This is supposed to help us.  Before we go into the room, we like to know what we're walking into, at least I do.  But on my last rotation - pediatrics - the chief complaints were written as if the person entering them had no medical training whatsoever.  Rather than get irritated, I started keeping a running tally of them so I could laugh at them.  But really it is a sign of driving down the cost of healthcare with foreseeable consequences.  Less trained people are replacing those with more training.  PAs are replacing doctors.  LVNs are replacing RNs.  Psychologists are replacing psychiatrists.  But I'm not going to get into that right now.  I'm just going to use my list to laugh.

  1. Thrash in mouth - I think you meant thrush in mouth.  Thrashing in the mouth would be quite a terribly different thing.  And I wouldn't know how to treat it either.
  2. Swollen right tisticle - Seriously?  We can't get testicle spelled correctly either?  And it was the left tisticle, by the way, but I figured it out.
  3. Lump near head - Do you mean the neck?  That thing that the head is connected to?
  4. Rash on bottom - Bottom of what?  Bottom of the hands, feet, etc?  It is appropriate to use buttocks in the medical field.
  5. Rash in private area -  Oh, good grief.  Can't you use at least the diaper area?  Or, groin?  Or, God forbid, the anatomically correct term of perianal area?
  6. Pain - Help me out here.  Pain where?????  Believe it or not, it makes a BIG difference where the pain is.
  7. Fever - Again, help me out here.  Fever in and of itself is not a reason to bring someone in (unless it's a newborn).  Fever and what?  Cough?  Abdominal pain?  Those are very different things.
So if ever your doctor walks in and has no clue why you're there or they are running late, it may not be their fault.  They may have quick tried to see a patient with a run-of-the-mill headache and it turned out that the kid could hardly breathe for the wheezing and obvious new diagnosis of asthma.  We can't exactly just let that go.  We've got to try to get the kid stabilized and then decide whether they need to go to the ER.  So the next time you're making an appointment, do everyone a favor and be as specific as possible.  If you have three separate problems, tell them that.  Don't do the infamous, "oh by the way..." as we're trying to walk out the door having solved one problem.

No comments: