Annoying Things

I think I've been more than a tad touchy these last few weeks, as I contemplate major upheaval in my career and family life, so maybe I am noticing things that bother me more often. Never the less, I am going to post annoying things that people say and do that really piss me off, since it wouldn't be *professional* to say it to their collective faces.

~ Any referring physician (ER, family medicine, pediatrician, all are offenders) that tells their patient with unexplained lower abdominal or pelvic discomfort and a normal exam and ultrasound that 1) "You must have had a cyst that ruptured." or 2) "You probably have endometriosis."

First of all, sometimes, you can just have pain in a certain area with no pathologic explanation. Some people have pain when they ovulate, or right before their period, or when they move the wrong way, or have sex 3 times a day, every day (yes, one patient referred to me for vaginal irritation and pain admitted to this...hmm, wonder why you are so sore???) Second of all, there are a whole bunch of different things that reside in the lower pelvis, including bowel and bladder, both of which can be causes for significant pain in their own right. Why every woman with low abdominal pain must have a "female issue" is totally beyond me.

It isn't that women with pelvic pain shouldn't be referred, they absolutely should be seen and worked up by a specialist. However, I have found that these two phrases mentioned above are physician code for "I have no idea what is causing your pain, but instead of saying that, I'll scare you into thinking you have ovarian cancer or a chronic disease." Because that, my friends, is what the patient hears, and is scared to death until they come see the GYN, so much the better for all involved.

~GYN consultation in the hospital "for pelvic exam." I kid you not. Apparently I have been doing it all wrong, doing my own cardiac exams and lung exams on my patients when I should have been consulting cardiology and pulmonology. How silly of me! What, the patient hasn't had a pap in 4 years, has a broken femur, can't move her hip, and is on her period? Why *don't* we "just do it while she is in the hospital?" Freaking fabulous idea. Thanks, alot.

~"Annual Exams" that really aren't annual exams. By that I mean, I made an appointment for a routine health screen, but what I really meant was that I just had my pap and breast exam at the health department last month, *however* I think my boyfriend is cheating on me, and I need tested for all STDs, and it has made me really depressed (I think it is my hormones), and by the way, I have no libido....can you please fix me in 15 minutes??

~Referrals for a "dropped bladder" (gotta love that technical term) on patients that weigh 350+. There isn't a surgical procedure in the world that can combat the overall gravitational forces working on those bladders. Never mind that most of these patients also have multiple medical problems, making surgery a veritable nightmare to begin with, and if you mention losing weight to help with their incontinence they wonder aloud why you "can't just fix it?" Oy.

~When men come into the exam room with their wives/girlfriends, etc., proceed to speak for them the entire visit, ask to "look in there" when you are doing the pelvic, and then finally, when you have your hand on the door, reveal that the "real" reason they came was because he thought there was something "wrong with her" because she doesn't want sex as much as (the guy) does. Gee, I just can't imagine why she isn't all over you, buddy. Nice.

~People who tell patients (pardon the poor grammar, but this is verbatim) "Just call your doctor if you have a question, that's what they are there for." (or the variation, "that's what you are paying them for."). Actually, your physician is "there" to provide health care and ensure that you (and, if pregnant, your baby) are well.

They are not "there" so you can page them at 1:40 in the morning (this is an actual call here) when you notice that your right breast is just slightly larger than your left, and you wanted to be certain that was "normal." Also, "you" are very often *not* paying your physician to answer after hours phone calls, and neither is your insurance company. They are answering your questions *for free* on their own, scarce, precious home and family time. (Oh, what, you think that answering ridiculous phone calls are just "part of the job?" Then why do lawyers get to bill by the hour, phone call, and email? Why is a physician's time and expertise any less important?)

So quit thinking that doctors are automatons with no lives, that never sleep, who "deserve" to work for free, and live only for the next breathtakingly inane page about your deep ruminations about your inner workings, You're wrong. And amazingly inconsiderate. If you aren't bleeding, losing appendages, or dying, save your calls for office hours, please.

~Finally, the most annoying thing of all...being on call for the whole. long. holiday weekend. There's nothing quite like having someone wish you a great "weekend off" when you know you'll be living at the hospital and fielding midnight phone calls while every other American in the free world is getting their drink on, living it up with parties, picnics, festivals, and sleeping in. Bitter, bitter, bitter am I.

Luckily for me, (and you, I imagine) a change will soon be coming. And not a moment too soon. Thanks for letting me get it off my chest...oh, and have a great Labor Day weekend. Heh. :)