Home Forums Discussions General Discussion Have you ever had a patient who wasn't born yet?

Maybe I haven't noticed, but I am finding patients who were seen before the DOB:

3 year old girl last seen 4 years ago (08/13/07) DOB: 6/11/2007

2 year old girl last seen 3 years ago (12/02/08) DOB: 6/27/2008

There are more. Don't know how many? Is it just rounding up to the next year?

Look at dates again. Not contradictory.

OK, four years ago from today would be 3/28/07. She was born on 6/11/2007. So it would appear that she was seen for a visit before 6/11/2007 which is her birthday. I don't see how that is possible.

She was also seen on 3/28/2007, not on 8/13/07. If it were 8/13/07, why not say, "3 yo girl, last seen 3 years, 7 months, 16 days?"

The two year old's last visit was 2 years, 3 months, 27 days; not
three years. The child cannot be over 36 months old, yet three years is likely over 36 months.

Am I missing something here?

I believe it is rounding years up but giving correct date of last visit. I see what you mean now. A patient is 'new' if they have not been seen in over three years, so this could cause billing problems if we don't get out the calendar.

It's interesting. If I see a patient 11 days ago, it will say that. This may be the same problem my programmer ran into with VIPER. Trying to put down how long since they had a vaccine. He says it can be very difficult.

Maybe once they get to a certain point, it should just say, "Patient seen a long time ago." I think you have to choose certain increments such as day, weeks, months, etc. I would say, patient seen just over 36 months ago, then patient seen over three years ago, over four years ago, etc. where the time seen is always less than the actual time.

Maybe it should just list the number of days. 'Course, if they were seen 925 days ago, you're still going to wonder exactly how long that is, though it is a couple of years.

And then throw in the leap year.

I think number of years plus days. But, it can't be longer than he was seen.

The only patients I have ever taken care of before they were born were the ones in their Mother's tummy.

I am cheerful to say that I don't get up in the middle of the night to do that anymore!

LOL. And good for you. And, the day I gave up my hospital privileges was the happiest day of my life. Even gave up seeing the babies that you delivered.

Now, I can work 9 to 5. Well, 9 to 7. Well, actually, 9 to 10.

I would have retired some years ago, had we not gotten a team of hospitalists to do the inpatient work. They, like me. started their careers doing everything. Periodically I feel guilty, like I am not a "real" doctor anymore because I am not doing ICU and inpatient stuff, but when I talk to my hospitalist buddies, they admit that they, too, wonder if they are "real" doctors because they don't follow patients over time.

I wonder, Bert... do you ever get that channel also?

Definitely. And, on the logistical side, it makes it rather difficult to do elective admissions say for an infant who has had bilateral ear infections for over a month and needs IV antibiotics. Try selling that to a hospitalist.

But, yeah, I am right with you. But, I wouldn't go back.

Selling an admission to the hospitalist is clearly a downside of the new paradigm. Often, we have to send a patient through the ER, which then triples the cost of the admission workup. I wish that part could be cleared up.

It is still very much like it was before. You could do a direct admit from the office as you had just seen the patient and could vouch for the likelihood they wouldn't crash.

I recall as a resident when an attending called with an admission, you could either moan and complain or act like he/she just made your day. Figured may as well do the latter, you were getting the admit anyway.

Our hospitalists generally do the latter, but the other day one told me to try give small amounts of Pedialyte and maybe the baby wouldn't throw up. Duh! I never thought of that.

I wish our crew would accept that. Some act like our IQ dropped 30 points when we stopped our inpatient duties.