Tuesday, October 20, 2009
Allow me to start by saying I love my dentist. He is one of the most intelligent men I have had the privilege of speaking too. He has far more general medical knowledge than I. The only problem I have with him is that he always starts conversations that are dependent on me answering 100 questions while I have my mouth open wide and full of instruments. Anyway, the dental residents here at our hospital, I don't love quite so much. Today, they sent over a lady from the dental clinic because of bleeding gums. I mean minor bleeding gums. They requested that she be evaluated for a bleeding disorder. I did a CBC to check platelets and Hgb, and informed the pt that any further workup would need to be coordinated by her family doctor, because these are not the kind of things we do in the ER. She was unhappy and took it upon herself to page the dental resident from her room phone. The resident came down and chewed me out for 5 minutes. She wanted something done, and done know. She had intended for me to diagnose the problem, and send the pt back to complete her dental work, before the dental office closed at five. She wanted to know why her critical patient had set in the waiting room six hours before even being evaluated. This changed nothing that I planned to do, and it made it obvious how little she understood about medicine in general. I stayed calm, and attacked her instead with the use of big words like Idiopathic Thrombocytopenic purpura and diathesis. We parted on fairly good terms, and hopefully she has the point that we don't need her bogus referrals, particularly in the midst of the swine flu crises.