Me: "So Max can get pretty stressed and anxious sometimes?"
Mrs Feely: "Oh yeah, he starts shaking and shivering, especially when people touch me. Here, I'll show you. Touch me."
Monday, November 15, 2010
Saturday, October 30, 2010
Mrs. Argumentative, part 2
I try to go out of my way for many of my good clients. Nothing unreasonable of course, I won't step out of a surgery just to talk about yesterday's football game. But occasionally I'll let my staff interrupt me in an appointment, or I'll squeeze one of them in over my lunch hour even when it's not an emergency. The good clients are given that status for many different reasons as you can probably expect, one of them being that they know when they are putting me out, but are noticeably appreciative and they don't abuse my generosity.
As you can probably guess, Mrs. Argumentative is NOT one of my "good" clients. Even if I was somehow able to put aside her hatefulness, impatience, noncompliance, and overall annoyance to all other things living, her phone call yesterday immediately rejected her from ever achieving that status.
She called while I was in the middle of a very sick appointment and demanded to talk to me. She refused to hang up the phone and was ok with sitting on hold as long as it took. Her reason was simple, she didn't have time to call me later, and she didn't want to sit around waiting for me to return my messages. She explicitly said, "I'm just as busy as he is!".
Her question? She couldn't remember whether she was supposed to come in for her recheck appointment before or after finishing the medications. And she had to hear the answer from me, not my staff.
Huh?
It didn't take me long to decide which I'd rather do, talk to Mrs. Argumentative or finish with the vomiting patient in my exam room. After all, she made the choice herself. She DID say she'd sit on hold as long as it took.
I think she hung up after 20 minutes.
As you can probably guess, Mrs. Argumentative is NOT one of my "good" clients. Even if I was somehow able to put aside her hatefulness, impatience, noncompliance, and overall annoyance to all other things living, her phone call yesterday immediately rejected her from ever achieving that status.
She called while I was in the middle of a very sick appointment and demanded to talk to me. She refused to hang up the phone and was ok with sitting on hold as long as it took. Her reason was simple, she didn't have time to call me later, and she didn't want to sit around waiting for me to return my messages. She explicitly said, "I'm just as busy as he is!".
Her question? She couldn't remember whether she was supposed to come in for her recheck appointment before or after finishing the medications. And she had to hear the answer from me, not my staff.
Huh?
It didn't take me long to decide which I'd rather do, talk to Mrs. Argumentative or finish with the vomiting patient in my exam room. After all, she made the choice herself. She DID say she'd sit on hold as long as it took.
I think she hung up after 20 minutes.
Thursday, October 21, 2010
Mrs. Argumentative
So I admit it, I have some clients that I absolutely do not like (surprise!). I cringe when I see them on the appointment book, and my staff has even started putting one or two of them on the schedule occasionally as a really cruel and heartless joke. Sometimes I really don't like my staff either.
But there's only one client that I can honestly say that I HATE. Yes, I said it. I HATE her. I rarely use that word, and it bothers me that I feel that way about her. But I do and it feels so good to actually say it. She's always so damn angry at the world and she sits in the corner of the lobby and then the exam room sulking and brooding. Even when I ask her questions or make small talk, she responds with very suspicious tones and the occasional "Why?". "Because I was curious how your day has been, that's all....". I've known her in this capacity for 3 years and never once have I seen even a hint of a smile. She yells at the staff and has made one or two in the past cry. She's all but flat out said that I was a quack and didn't know what I was talking about. And she doesn't take any of my advice.
It should come as no surprise then to learn that I've requested to have her fired as a client of the hospital multiple times. Unfortunately for me, the owner has this demented belief that this particular client will somehow convince the rest of our 2000+ clients to also leave. Come on!! What's she going to do, drop fliers from a hot air balloon? Take out a commercial during Dancing with the Stars?? Run out onto the field during the World Series with "Don't use XYZ Hospital, they're really bad" painted on her naked back???
It would make a great YouTube video, but it ain't happening. Believe me.
So why am I telling you this? Well, she has three Shelties and brings each of them into the hospital for an exam with Yours Truly approx 3-4 times per year. That means approx once a month I'm graced with her presence. And tonight was the night. Grumble.
Luckily for me though, there was only one point of contention this evening. The appointment with Short Straw 1 was actually going fairly smoothly, that is until I made the mistake of asking how Short Straw 2 was doing. You see, a few months back her and her breeder friends refused to believe that the cause of that dog's pruritus (itch) wasn't caused by hypothyroidism. And since she never believes me anyway, I finally referred (unloaded) her to a local dermatologist (with apologies ahead of time of course). Finally, after repeating many of the same tests I had, including skin scrapings, fungal cultures, a thyroid panel, and even a trial treatment for Sarcoptic mange, he came to the same conclusion as me, that Short Straw 2 is most likely atopic (allergic). Definitely not hypothyroid.
Me: 1, Mrs. Argumentative: 0
Well, during this particular appointment, she reported that she also came to a conclusion: (verbatim) "Dr. Dermatologist is a quack and my breeder friends know more than he does, [Apparently Shelties are always hypothyroid when their T4 is below 1.2 regardless of what the reference range or the dog's clinical signs say] and I've spent hundreds upon hundreds of dollars to finally figure this out. When Short Straw 2 runs out of the drugs that he's prescribed, the itch always comes back. He's miserable! He's obviously hypothyroid, and I just can't figure out why you guys won't prescribe him the medicine for it"
My response: "Hypothyroidism doesn't cause itch."
Mrs Argumentative: "Yes it does, everyone knows that!"
Me: "Hypothyroidism can cause infections that in turn cause itch, but the disease itself doesn't cause itch."
Her: "Well, Short Straw 2 doesn't have any infections."
Me: "Exactly."
Me: 2, Mrs. Argumentative: 0
Her: "But I've read the internet, and everyone says...."
Me: "I read medical textbooks and journals written by other doctors, not some old Joe Schmoe."
Her: "What I've read wasn't written by Joe Schmoe!"
Me: "Who wrote it?"
Her: "Well, I don't know."
Me: "Exactly."
Her: "Whatever, I don't want to talk about it. Let's get back to Short Straw 1."
Me: 3, Mrs. Argumentative: 0
Could someone please tell me WHY she uses us when there are dozens of hospitals in a 5 mile radius? I hate her and she doesn't like me or my staff. The feelings are pretty mutual in my opinion, yet she has a recheck appointment with me for next week.
yay me.
But there's only one client that I can honestly say that I HATE. Yes, I said it. I HATE her. I rarely use that word, and it bothers me that I feel that way about her. But I do and it feels so good to actually say it. She's always so damn angry at the world and she sits in the corner of the lobby and then the exam room sulking and brooding. Even when I ask her questions or make small talk, she responds with very suspicious tones and the occasional "Why?". "Because I was curious how your day has been, that's all....". I've known her in this capacity for 3 years and never once have I seen even a hint of a smile. She yells at the staff and has made one or two in the past cry. She's all but flat out said that I was a quack and didn't know what I was talking about. And she doesn't take any of my advice.
It should come as no surprise then to learn that I've requested to have her fired as a client of the hospital multiple times. Unfortunately for me, the owner has this demented belief that this particular client will somehow convince the rest of our 2000+ clients to also leave. Come on!! What's she going to do, drop fliers from a hot air balloon? Take out a commercial during Dancing with the Stars?? Run out onto the field during the World Series with "Don't use XYZ Hospital, they're really bad" painted on her naked back???
It would make a great YouTube video, but it ain't happening. Believe me.
So why am I telling you this? Well, she has three Shelties and brings each of them into the hospital for an exam with Yours Truly approx 3-4 times per year. That means approx once a month I'm graced with her presence. And tonight was the night. Grumble.
Luckily for me though, there was only one point of contention this evening. The appointment with Short Straw 1 was actually going fairly smoothly, that is until I made the mistake of asking how Short Straw 2 was doing. You see, a few months back her and her breeder friends refused to believe that the cause of that dog's pruritus (itch) wasn't caused by hypothyroidism. And since she never believes me anyway, I finally referred (unloaded) her to a local dermatologist (with apologies ahead of time of course). Finally, after repeating many of the same tests I had, including skin scrapings, fungal cultures, a thyroid panel, and even a trial treatment for Sarcoptic mange, he came to the same conclusion as me, that Short Straw 2 is most likely atopic (allergic). Definitely not hypothyroid.
Me: 1, Mrs. Argumentative: 0
Well, during this particular appointment, she reported that she also came to a conclusion: (verbatim) "Dr. Dermatologist is a quack and my breeder friends know more than he does, [Apparently Shelties are always hypothyroid when their T4 is below 1.2 regardless of what the reference range or the dog's clinical signs say] and I've spent hundreds upon hundreds of dollars to finally figure this out. When Short Straw 2 runs out of the drugs that he's prescribed, the itch always comes back. He's miserable! He's obviously hypothyroid, and I just can't figure out why you guys won't prescribe him the medicine for it"
My response: "Hypothyroidism doesn't cause itch."
Mrs Argumentative: "Yes it does, everyone knows that!"
Me: "Hypothyroidism can cause infections that in turn cause itch, but the disease itself doesn't cause itch."
Her: "Well, Short Straw 2 doesn't have any infections."
Me: "Exactly."
Me: 2, Mrs. Argumentative: 0
Her: "But I've read the internet, and everyone says...."
Me: "I read medical textbooks and journals written by other doctors, not some old Joe Schmoe."
Her: "What I've read wasn't written by Joe Schmoe!"
Me: "Who wrote it?"
Her: "Well, I don't know."
Me: "Exactly."
Her: "Whatever, I don't want to talk about it. Let's get back to Short Straw 1."
Me: 3, Mrs. Argumentative: 0
Could someone please tell me WHY she uses us when there are dozens of hospitals in a 5 mile radius? I hate her and she doesn't like me or my staff. The feelings are pretty mutual in my opinion, yet she has a recheck appointment with me for next week.
yay me.
Friday, September 17, 2010
Hand-me-down Frontline
What would you do if you accidentally applied two doses of Frontline Plus (a popular flea and tick killer) onto the same dog? You could do nothing and forget about it, after all it's much much less toxic (if at all) compared to other pesticides. You could wash the dog and try to remove it. But would you then apply another dose for this month (is there any residual that you didn't completely wash off)?
Well, the client that just called had a great idea. She was wondering if she could rub both of her dogs together, essentially sharing the extra Frontline between the two.
Makes you think, huh? Seriously, that stuff is expensive!
Of course we said no. But hey, at least she called us before doing it, which is more than I can say about most of our clients.
Well, the client that just called had a great idea. She was wondering if she could rub both of her dogs together, essentially sharing the extra Frontline between the two.
Makes you think, huh? Seriously, that stuff is expensive!
Of course we said no. But hey, at least she called us before doing it, which is more than I can say about most of our clients.
Thursday, September 16, 2010
Respect my authority!
My associate just saw a client that brought her dog in to discuss some behavior issues. She was upset because instead of chewing HER underwear up, her dog preferred to chew up her 21yr old daughter's underwear. The owner firmly believes that this is a sign that her dog doesn't respect her as much as her daughter.
I'm seriously NOT making this up.
I'm seriously NOT making this up.
Monday, September 13, 2010
Stupid clients
We all have 'em, right? This isn't a funny story or anecdote, just a vexation about a client I saw this afternoon.
I'll never understand how some people ignore their pets' illnesses. Never. You know the usual "he's been vomiting for 2 weeks.", or even the "no doc, I hadn't noticed the 2 pound mass on his leg.". I really want to start making a list of the symptoms these pets have, and the length of time their idiot owners have ignored them before rushing in to the clinic on a Friday night just hours before their flight to Cancun.
This poor dog this afternoon had been chasing a ball yesterday when he acutely came up lame on his left front leg. Sucks, but happens unfortunately. The owner only brought Fluffy in because his leg must've been broken or dislocated because it was "hanging" off to the side at a weird angle. It seemed "back in the normal position" this morning. What annoys the hell out of me is that in MY corner of the world, there are four 24 hour emergency clinics within 25 minutes. But instead of taking his very painful dog with a leg "hanging off to the side" to one of them, he waited almost 24 hours to bring Fluffy in here. Thankfully although the elbow was severely swollen and painful, other than a small amount of DJD I didn't notice anything severe. I do think that it luxated and tore the joint capsule, but it must have self-reduced sometime overnight (I'm guessing here).
By the way, did I mention that this dog was diagnosed with immune-mediated thrombocytopenia one month ago by one of my associates, and the owner hasn't been back for rechecks since the initial diagnosis and hasn't picked up his meds? At the time, the platelet count was 24,000. I guess I wasn't surprised that he had multiple petechiae on his gums. I told the dumb ass that he's lucky his dog hasn't died, and that maybe it was a good thing that Fluffy hurt his leg, otherwise we might not have seen him back until it was too late. (Add: I have to wonder if some of the swelling in the elbow is actually hemarthrosis which the owner won't let me treat).
The owner did show one shred of concern though (and I'm completely serious): Despite the painful, swollen elbow and the IMTP, before I took the dog downstairs to do the x-rays and bloodwork the owner really wanted me to look at a small lump on Fluff's neck (sebaceous adenoma), because it was really ugly.
I'll never understand how some people ignore their pets' illnesses. Never. You know the usual "he's been vomiting for 2 weeks.", or even the "no doc, I hadn't noticed the 2 pound mass on his leg.". I really want to start making a list of the symptoms these pets have, and the length of time their idiot owners have ignored them before rushing in to the clinic on a Friday night just hours before their flight to Cancun.
This poor dog this afternoon had been chasing a ball yesterday when he acutely came up lame on his left front leg. Sucks, but happens unfortunately. The owner only brought Fluffy in because his leg must've been broken or dislocated because it was "hanging" off to the side at a weird angle. It seemed "back in the normal position" this morning. What annoys the hell out of me is that in MY corner of the world, there are four 24 hour emergency clinics within 25 minutes. But instead of taking his very painful dog with a leg "hanging off to the side" to one of them, he waited almost 24 hours to bring Fluffy in here. Thankfully although the elbow was severely swollen and painful, other than a small amount of DJD I didn't notice anything severe. I do think that it luxated and tore the joint capsule, but it must have self-reduced sometime overnight (I'm guessing here).
By the way, did I mention that this dog was diagnosed with immune-mediated thrombocytopenia one month ago by one of my associates, and the owner hasn't been back for rechecks since the initial diagnosis and hasn't picked up his meds? At the time, the platelet count was 24,000. I guess I wasn't surprised that he had multiple petechiae on his gums. I told the dumb ass that he's lucky his dog hasn't died, and that maybe it was a good thing that Fluffy hurt his leg, otherwise we might not have seen him back until it was too late. (Add: I have to wonder if some of the swelling in the elbow is actually hemarthrosis which the owner won't let me treat).
The owner did show one shred of concern though (and I'm completely serious): Despite the painful, swollen elbow and the IMTP, before I took the dog downstairs to do the x-rays and bloodwork the owner really wanted me to look at a small lump on Fluff's neck (sebaceous adenoma), because it was really ugly.
hurry doc, I need this fixed real quick like.
At least that's what I usually hear. Not the couple that came in with their 5 year old daughter and two 1 year old cats. Their idea of a quick fix is measured on the scale of ice ages. During their annual exams, I noticed fleas.
me: "So your cats have started to go outside? How long have they had the fleas?" (leading into a conversation about life expectancy of indoor vs outdoor cats, fleas, parasites, vaccines, etc).
mrs. tortoise: "Yeah, we can't seem to keep them in. They've had the fleas about 3 months. Oh, and do you know why she's been urinating outside the litter box?"
me: "Um, no I didn't realize she was doing that. How long has that been going on?"
mr. tortoise: "Every other day or so for about 6 months. We figured it might be a bladder infection and she'd need some antibiotics."
When I told them that it could take months to get the urinalysis back (joking of course), I guess I wasn't surprised that neither of them seemed the least bit shocked. Their recheck appointment is scheduled in.....well, we'll probably do it during their next annual exam in 2015.
me: "So your cats have started to go outside? How long have they had the fleas?" (leading into a conversation about life expectancy of indoor vs outdoor cats, fleas, parasites, vaccines, etc).
mrs. tortoise: "Yeah, we can't seem to keep them in. They've had the fleas about 3 months. Oh, and do you know why she's been urinating outside the litter box?"
me: "Um, no I didn't realize she was doing that. How long has that been going on?"
mr. tortoise: "Every other day or so for about 6 months. We figured it might be a bladder infection and she'd need some antibiotics."
When I told them that it could take months to get the urinalysis back (joking of course), I guess I wasn't surprised that neither of them seemed the least bit shocked. Their recheck appointment is scheduled in.....well, we'll probably do it during their next annual exam in 2015.
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