Indexing Title:

     MJCABAHUG’s Medical Anecdotal Report [05-01]

     MAR Title:

            IRATE CUSTOMER

     Date of Medical Observation:

            February 6, 2005

    Narration:

              On a busy Monday morning at the Emergency Room, our Thyroid Fellow- surgeon told me that a certain patient of a hospital employee will be coming over for admission due to a right upper quadrant abdominal pain.

            He saw the patient a week before but was sent home for elective operation scheduling. An hour later, the patient came in and was showed to his bed. The patient was interviewed by a clerk and was referred to me.  Though I already know the case of the patient, I still approached him to make my history and physical examination.

            As I was approaching the patient, I noticed that he was sitting on a wheel-chair, so I instructed him to lie down on the bed.  I saw in the patient’s face that he was in pain. He even had the headrest inclined because he could not lie down due to the pain. I was then starting to ask questions about the history of the patient while trying to adjust the bed to make it flat.  I asked the patient if he has yellow discoloration of his skin, and in an antagonistic manner answered me back, “you should be the one to notice it because it is you who is examining me and that I could not see myself because I don’t have a mirror in hand”.

            I was then taken a back, and humbly told the patient that it is important for me to know his history for his treatment He started raising his voice, and before losing my temper, I courteously told the patient that I better ask another resident to examine him and walked away.

Insights (Physical, Psychosocial, Ethical) (Discovery, Stimulus, Reinforcements):

             Looking back at this rare incident, I think that my decision of walking away from the patient rather than confronting him was right . 

            As physicians, we have the right to refuse patients. 

            But since we are in this institution where we cannot choose our patients, maintaining our composure in front of an annoying patient and avoiding confrontations are the most appropriate ways to show our professionalism to avoid complaints and lawsuits which are rampant these days.