Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Why a neurologist turned down an interesting hospital case

Doctor Grumpy, MD
Physician
August 8, 2011
Share
Tweet
Share

Dr. Grumpy has lost his neurology mojo over time. Actually, I shouldn’t say I’ve lost it, as much as it’s been worn down by red tape.

Yesterday I turned away a good hospital case, and told them to find someone else. The patient was insured. The patient was interesting. Not some run of the mill chronic back pain case.

28-year old guy admitted for abdominal pain and weight loss. Large mass found (possibly lymphoma). Within 2 days of admission he developed 2 separate cranial nerve palsies, on opposite sides.

Now, I know you residents and medical students are out there, holding up your hands and yelling, “Oooh! Oooh! Mr. Kotter! He could have meningeal lymphomatosis with cranial nerve palsies! He needs an MRI and spinal tap.”

You think I didn’t know that? Like I said, these are the interesting cases that make the job fun.

So why did I tell them to find another neurologist?

Here’s why.

The patient had seen another neurologist (who didn’t come to my hospital) about a week before. He’d had an MRI done as an outpatient. He’d had a spinal tap done as an outpatient.

And yet, no one, including the patient and his family, had any idea about which neurologist he saw (beyond “his office was on the west side”), or where the MRI was done, or where the spinal fluid had been sent for tests.

I don’t care that someone else had already done the key parts of the workup. I’m not looking to stand up as the great Grumpy, solver of the unsolvable. Any competent neurologist would know what to do.

And getting results is reasonably easy if you know where to fax a release.

But in order to get the answer here I’d have had to try to track down a neurologist, an MRI facility, and a laboratory. And there are no shortage of any in Grumpyville.

And from personal experience (particularly involving tracking down labs) I knew it could easily take an hour or more of phone time to do this. I’ve found that when you want something specific, delegating it to an order in a chart (“please get outside labs from Planet Phlebotomy”) will often get you nowhere, or some results you didn’t want. So I’d likely be doing the calling, and getting transferred between departments, and then cut off, and having to call back … you get the idea.

When you have a full-time office practice, and a family of 5, adding an extra hour or two to the day isn’t something you want to do. Especially when you’re going to get paid the same amount for the consult no matter how much work you put into trying to track the results down.

ADVERTISEMENT

And so I quietly told them to call another neurologist.

I still like what I do. But the realities of time, money, and frustration can dull the scientific curiosity of anyone. Even me.

“Doctor Grumpy” is a neurologist who blogs at Doctor Grumpy in the House.

Submit a guest post and be heard on social media’s leading physician voice.

Prev

Your medical information is not private, and it's sold routinely

August 8, 2011 Kevin 16
…
Next

My primary care frustration is outweighed by my relationships with patients

August 8, 2011 Kevin 3
…

Tagged as: Hospital-Based Medicine, Specialist

Post navigation

< Previous Post
Your medical information is not private, and it's sold routinely
Next Post >
My primary care frustration is outweighed by my relationships with patients

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Doctor Grumpy, MD

  • Medicine can suck the compassion out of you. But I still give it my best shot.

    Doctor Grumpy, MD
  • Charging $5 per visit is easy if you’re independently wealthy

    Doctor Grumpy, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Would you refuse drugs from an Israeli drug company?

    Doctor Grumpy, MD

More in Physician

  • Ethical dilemmas in using unclaimed bodies for medical research

    M. Bennet Broner, PhD
  • The Nova Oath: a physician’s pledge to courageous and ethical care

    Kenneth Ro, MD
  • True stories of doctors reclaiming their humanity in a system that challenges it

    Alae Kawam, DO & Kim Downey, PT & Nicole Solomos, DO
  • Why wanting more from your medical career is a sign of strength

    Maureen Gibbons, MD
  • How a rainy walk helped an oncologist rediscover joy and bravery

    Dr. Damane Zehra
  • How inspiration and family stories shape our most meaningful moments

    Arthur Lazarus, MD, MBA
  • Most Popular

  • Past Week

    • When did we start treating our lives like trauma?

      Maureen Gibbons, MD | Physician
    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
    • How to speak the language of leadership to improve doctor wellness [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why some doctors age gracefully—and others grow bitter

      Patrick Hudson, MD | Physician
    • How to survive a broken health care system without losing yourself [PODCAST]

      The Podcast by KevinMD | Podcast
    • How the shingles vaccine could help prevent dementia

      Marc Arginteanu, MD | Conditions
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Addressing the physician shortage: How AI can help, not replace

      Amelia Mercado | Tech
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
    • Physician patriots: the forgotten founders who lit the torch of liberty

      Muhamad Aly Rifai, MD | Physician
  • Recent Posts

    • How to speak the language of leadership to improve doctor wellness [PODCAST]

      The Podcast by KevinMD | Podcast
    • Ethical dilemmas in using unclaimed bodies for medical research

      M. Bennet Broner, PhD | Physician
    • The Nova Oath: a physician’s pledge to courageous and ethical care

      Kenneth Ro, MD | Physician
    • AI is not a threat to radiologists. It’s a distraction from what truly matters in medicine.

      Fardad Behzadi, MD | Tech
    • How deep transcranial magnetic stimulation is transforming mental health care

      Muhamad Aly Rifai, MD | Conditions
    • True stories of doctors reclaiming their humanity in a system that challenges it

      Alae Kawam, DO & Kim Downey, PT & Nicole Solomos, DO | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 5 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • When did we start treating our lives like trauma?

      Maureen Gibbons, MD | Physician
    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
    • How to speak the language of leadership to improve doctor wellness [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why some doctors age gracefully—and others grow bitter

      Patrick Hudson, MD | Physician
    • How to survive a broken health care system without losing yourself [PODCAST]

      The Podcast by KevinMD | Podcast
    • How the shingles vaccine could help prevent dementia

      Marc Arginteanu, MD | Conditions
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Addressing the physician shortage: How AI can help, not replace

      Amelia Mercado | Tech
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
    • Physician patriots: the forgotten founders who lit the torch of liberty

      Muhamad Aly Rifai, MD | Physician
  • Recent Posts

    • How to speak the language of leadership to improve doctor wellness [PODCAST]

      The Podcast by KevinMD | Podcast
    • Ethical dilemmas in using unclaimed bodies for medical research

      M. Bennet Broner, PhD | Physician
    • The Nova Oath: a physician’s pledge to courageous and ethical care

      Kenneth Ro, MD | Physician
    • AI is not a threat to radiologists. It’s a distraction from what truly matters in medicine.

      Fardad Behzadi, MD | Tech
    • How deep transcranial magnetic stimulation is transforming mental health care

      Muhamad Aly Rifai, MD | Conditions
    • True stories of doctors reclaiming their humanity in a system that challenges it

      Alae Kawam, DO & Kim Downey, PT & Nicole Solomos, DO | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Why a neurologist turned down an interesting hospital case
5 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...