*SW = something wrong
Me: Morning! How can i help you, ma’am?
Auntie SW: The rain was really heavy out there.
Me: Yup, it’s been raining season lately. How can i help you?
Auntie SW: You see, i have this condition A that requires me to take warfarin, i have been taking it for ......
(rambling on and on about her disease for the last 10 years for 5 minutes while i was busy accessing my terminal for her old records in the hospital)
Me: Yes, i see that you have this condition for the last 10 years, and your last INR test done yesterday was great! But can you tell me what brings you here today?
Auntie SW: Oh ok.
She flipped out a referral letter from her private cardiologist that she saw this morning. It was directed to the cardiology team taking care of her in my hospital, with a recommendation to lower her dose of warfarin.
Me: Hmm. You just saw your cardiologist this morning, and this letter is directed to the National Heart Centre. Where do i fit in this picture?
Auntie SW: Oh i am going for a cataract operation in 2 weeks time in your hospital.
Auntie SW: Can you please help me update my new warfarin dose in your computer system?
Me: Auntie, do you realise this visit costs you 90 dollar?
Auntie SW: Yes i do.
Me: You could have just waited for the day you come for the operation and let them know of your new warfarin dose you know? The nurses then will serve you warfarin at your new dose.
Auntie SW: But... what if they serve me the wrong dose? I can die from that!!
Me: Auntie...... No one dies from bleeding from a cataract op, even if you have warfarin on board. And you could have saved this 90 dollar by showing them the letter on day of admission.
Auntie SW: Nevermind, i can pay the 90 dollar. Just update my new dosage on your computer for me.
Me: Auntie i can’t do that. My emergency room’s record do now show on their electronic prescription database.
Auntie SW: Can you just try?
Me: It can’t be done. (My heart rate presently 140/minutes)
Auntie SW: Really?
Me: Yes.... Auntie, why don’t i just cancel your visit and save you the 90 dollar? You just show your letter on admission as i have told you just now.
Auntie SW: Hmm... Can you do an INR test for me today? I am willing to pay 90 dollar for that.
Me: YOU HAD JUST DONE AN INR TEST YESTERDAY! WHAT’S THE POINT? AND PAYING 90 DOLLAR JUST FOR A TEST ARE YOU OUT OF YOUR MIND?!!!
(i mildly raised my voice. just mildly, believe me. really. )
Auntie SW: (sheepishly) Ok then. I go home then. You really cancelling my visit for real?
Auntie SW: Ok then. Bye. (walking out, then turning back) I really don’t need an INR test today?
Me: YESSSSSSSSSSSSSSSS. Bye.
Went through the trouble of erasing my entries and instructed the nurses to cancel the visit. So much trouble for saving 90 dollars. She might be dirty rich, despite the haggard clothing.
Was half way through my another consult when i heard a door knock, and the door was opened without me acknowledging first.
Auntie SW: (popping her head in) Why don’t you uncancel my visit and do an INR test for me?
Me: (Heart rate 180/minute, face flushed with anger) I AM NOT GOING TO DO AN INR TEST FOR YOU AND YOU STOP WASTING MY TIME! GRRRRRRRRRRR
Auntie SW: Ok ok... sorry.... (sheepishly went out again)
Being a doctor is a real health hazard. My cardiovascular risk must have gone through the roof that day.