Those to Whom the Rules Do Not Apply (In Their Opinion)

There’s a patient I don’t like very much. I’ll call her Mrs. X. Mrs. X has definite medical problems, though she doesn’t seem to think so. Her lipids and blood pressure really are much higher than they should be. She could stand to lose a couple of pounds, and she really should be more active. She does not concur. Every time she makes an appointment, she calls and changes it three, four, five times. After all that, she often doesn’t show up. The first time I saw her, I identified several health issues. I told her that her blood pressure was too high, as was her cholesterol. Her response: “I disagree.” Say what? “I don’t really think I have much of a problem. I’ll see if I can do something about the way I eat, but I’m not really worried.” That made one of us. The BP was 190/114, with fasting triglycerides over 700. Her liver function tests were also abnormal (no surprise with TGs that high), so I asked her to get an ultrasound of her liver. “I don’t think that’s necessary.” Okay then. She agreed to begin a medication, for which I asked her to return in three months for a blood test. She took the prescription, and vanished for a year and a half. After a while, I got a notice from the pharmacy that she was requesting a refill. I refused, telling them to ask her to call for an appointment. Six months later, she did. Then she re-scheduled it three times, no-showed once, cal...
Source: Musings of a Dinosaur - Category: Primary Care Authors: Tags: Medical Source Type: blogs