Some Patients Still Make it Worthwhile

November 24, 2014
Melissa Young, MD

This is a short list of the little things that eat away at my energy and goodwill. Thank goodness there are still patients who make it worthwhile.

Random thoughts brought on by frustration…

Why do I need to get prior authorization for certain diabetes medications but not narcotics?

Why can a physician order a thyroid ultrasound without a reasonable diagnosis but I can’t have my hyperthyroid patient get a I123 uptake and scan without getting a pre-certification?

Do patients really think that I sit around all day with nothing else to do but call them at the drop of a hat to tell them what their lab results are?

Do they really think that I would intentionally not call in or send in their prescriptions if their pharmacy informed me that they needed something?

Do they think that yelling at me or my staff will get them what they want?

Why can’t primary care physicians manage primary hypothyroidism?

When formularies change, how can I get the prior auth when the patient hasn’t failed the formulary alternative because he has been on the same drug (which used to be on the formulary) for 15 years?

How do I get the prior auth for a triglyceride-lowering drug when I don’t have the baseline triglyceride level because the patient has been on the drug since I’ve known her?

Why do radiologists make clinical diagnoses based on pictures? You cannot say someone is hyperthyroid based solely on an uptake (which was unfortunately ordered on a euthyroid patient by a PCP).

Why do hospital nurses feel they can hold insulin without an order but would never hold any other med?

Who coined the term “hormonal imbalance”?

Why is the thyroid everybody’s scapegoat?

Why do they still make Armour?

These are some of the questions I ask myself on a regular basis. I don’t mean to seem whiny although I am well aware that I am right now. I used to wonder why some of my senior colleagues seemed cranky all the time. I get it now. It wears on you. The little things that eat away at your energy and goodwill. Thank goodness there are still patients who make it worthwhile.