You’re Getting On My Nerve

Let’s take my two situations separately and you can judge for yourself if my anger is justified. The first one surrounds a referral to a neurosurgeon for a patient of mine that has sural neuritis. After trying to surgically decompress the nerve, my patient continues to have symptoms. Not being successful with my patient, I discussed with him the option of this referral, and he actually found this physician himself. To make things more complicated, the patient might have a mixed connective tissue disorder, which appears to have increased his scarring. I referred him to one of my colleagues, a rheumatologist, who was a challenge to speak with directly (rheumatologists are very hard to come by in my area due to a significant shortage). But that was the easy part.

My medical assistant proceeded to contact the neurosurgeon’s office and received the runaround from his staff. After multiple attempts at communication, in which they kept asking my MA various idiotic questions, she’d finally had enough. Now, for perspective, my medical assistant is an incredibly patient person (she must be to work with me!) and has been in the medical field for a long time, working for various physicians, so she understands the system well. After three separate phone calls in which I offered to speak with the physician, they finally – just this morning as of writing this editorial – asked the absolutely most idiotic question that brought my assistant to the end of her rope.

Oh…you want to know the question, huh? Patience, my friends. I was getting there!

Here’s the question: “We don’t understand what you want. Our doctor doesn’t do work on the legs. What do you want him to do?”

Really? Oh, I don’t know, neurosurgeon. Maybe I want you to do some actual neurosurgery? How about releasing the nerve. That’s called an external neurolysis, doctor. Ugh. My thinking here was that the neurosurgeon could do the neurolysis using a microscope with a small incision approach and then bury the nerve in muscle if the release didn’t work. Why did I need to spell this out to him?

My assistant actually said to me, “It seems like they don’t want our business,” and she’s right. If someone tells me they have a patient with a foot problem, I don’t ask for a giant explanation. I say, “Thank you for the consult, and I’m happy to see them.”

Foot problem – foot doctor. Nerve problem – nerve doctor. Right? Maybe I missed something in medical school.

The Wrist of the Story

The second situation was my lesson to stop being a good Samaritan. Another patient of mine is a super nice guy who’s had lots of problems with his entire body as a result of more than 30 years at an incredibly physical job. I did surgery on one of his feet, which turned out well, and this past week he came to me with a ruptured tibialis anterior tendon on the opposite foot. He wants to have a surgical repair, which makes perfect sense, given his dropfoot and worsening flatfoot.

What’s the problem, you ask? Well…he’s having reconstructive wrist surgery this week. He wants to have his ankle surgery shortly after the wrist (within two weeks he says) but will need to be absolutely non-weight-bearing post-op.

So, I need to find out what limitations my patient will have after his wrist surgery so he doesn’t accidentally do anything to screw up his wrist. Communication…right?

Wrong.

Again, my MA tried to call the orthopedist’s office, and the staff refused to connect us with the surgeon. Finally, after two more tries my assistant, flabbergasted, tells me the other doctor’s staff refuses to put him on and he wants to know what we want. That’s when I got on the phone and very grumpily explained that I was trying to prevent the surgeon’s work from getting screwed up by my patient crutching around on his surgical hand.

What does a guy have to do to speak with a doctor? What happened to communication anyway? I have yet to speak to either of these doctors.

Moral of my tale of woe? Don’t be like these doctors. Communicate with your colleagues. When someone calls you, there’s a reason. Simplify your professional life and call people back quickly before you become an annoyance. Maybe I’ll try smoke signals with these doctors next.

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