I agree. Yesterday, I called our GI specialist about a patient. While on the phone I asked him about a patient that he MUST have seen a few days ago. Had to, because I read his consult note three hours earlier. So, I was describing the patient to him when he said, "Oh, that patient, I saw him this morning!" Now, that is incredible. Appointment at 10 am, consult note by noon.
And, this surgical clearance. I suppose it is more important in the FP world, but I get 10 year olds all the time for physicals for a tonsillectomy. I would think taking a bleeding history would be all that is necessary. It's all CYA. But, I sign the form and talk to the patient about Lebron, listen to the heart and lungs and charge for the visit.
The one that takes the cake is the one where the patient was having fairly significant surgery. So, I did a complete history and physical and wrote on my note, "Past physical, OK for operation."
We received a phone call back stating that wasn't sufficient and that I needed to send a letter stating, "Cleared for all procedures." Well, being the passive aggressive person that I am, I refused. (Of course, I would always acquiesce for the good of the patient, but please). So, they called again. I refused again.
I finally called the surgeon who happened to be in his office surrounded by all of his staff who couldn't come close to seeing the forest for the trees. I told him I didn't see why my H & P with the statement, "Normal H & P, OK for operation," was not sufficient. He agreed and asked what the problem was, and I told him about the request for the exact quote. I was so elated when he told his staff in a voice that was not normal, yet not shouting, but somewhere in between, "What the hell is wrong with what he wrote? It is perfectly sufficient. Can we focus on other more important things?" He then apologized.
I told the story to the mother, and I guess her take on the whole thing without stating it was you were so focused on your passive aggressive attitude, that you would put my daughter's surgery in jeopardy. I never got the chance to tell her I would have given in. The surgery was two weeks away. She left the practice. I should let it be known that this is a very prominent Boston surgeon, and we jumped through multiple hoops to get the appointment in a week and not six months. What I learned:
1. Always write "Cleared for procedure." (The word 'cleared' seems to be the buzz word)
2. You can be passive aggressive. Just share it with your staff and not the parent.
3. Just send the damn letter stating what they wanted.
