Practice Management
I would rather have a patient with a stab wound to the chest than a patient with a serious underlying problem who just wants antibiotics and a quick evaluation. Is there a way to tease out benign- appearing patients who are “pre-crump?” This month’s case is that very patient—a raindrop in a torrent of mucus and purulent drainage.
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What happens when our patient so badly wants to be well that they talk us out of the correct diagnosis? “I think it is my anxiety” was the mantra accepted by the physician in this case. Though diagnoses are not always clear after the initial encounter, they are not up for negotiation. Patients have a vested interest, due to denial or human nature, in believing that nothing is seriously wrong with them. It can be …
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Headaches are both common and challenging, accounting for 4% of ED visits and comprising the eighth most-common complaint seen by primary care physicians. This frequency can create a false sense of security, as there are numerous life-threatening etiologies hiding in the “haystack.” In this month’s case, our patient was a bounceback on her first visit, having previously seen her PCP and an urgent care doctor. In addition to a brief discussion of headaches and their …
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Jonathan is a young man who changed the course of musical theater and would still be making history today if things had turned out differently. Jonathan was born in Mount Vernon, NY in 1960. When he was 22, he moved to New York City to pursue his dream of writing a musical. Like most struggling artists, life wasn’t easy. He spent weekends waiting tables at the Moondance Diner in Soho. He spent weekdays at his …
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In our last Bouncebacks article, we explored the difficulties that arise when the patient and doctor disagree on treatment through the case of a 28-year old pregnant patient who left against medical advice (JUCM, February 2009). In the second part of this series, we present a case which explores differences in expectations between a patient and the physicians.
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