Any nurses working in doctor's offices?... is this the norm?

Nurses General Nursing

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Sorry guys, I have to vent so this may be a little lenghty... Approx. week and a half ago went to see my PCP for painful joints (since X-mas), hair falling out, intolerance to cold, irritable and weird rash on my face (not the butterfly rash that goes along with Lupas) and extreme fatigue. Right away doc orders two blood tests(ANA and sed rate) and says there is possibility i may have Lupas. I anxiously wait over four days for the results and I"M the one who had to call the office for the results!!:angryfire Anyway, the medical assistant tells me that ANA came back positive but sed rate was negative. Then tells me the Doc wants me to have another ANA, c-reactive protein and a anti-DNA antibody test. Had those done very next day and waited 6DAYS for those results and I'm the one who had to call for them AGAIN!!!:angryfire I ask her(the MA) why did no one call me before this with the results, that I have been on edge all these days waiting. She says that they had the results days ago but that Doc wrote on the lab OK, so this MA said she didn't think she had to call me. Appareantly, they only call if the doc tells them to. I kinda went off on her and said that regardless of whether or not my tests were ok that I felt it was common courtesy to call me and let me know what was going on especially since she seen me in the office a short time ago and knew how worked up I was at the possibility of having Lu[pas. Ok here comes the part where I wanted to reach through the phone and ring her neck... The MA rudely informs me that she doesn't have time to call everyone with normal lab results, however the klincher was my second ANA was still positive, but everything else came back negative. I question her as to why my ANA is still positve and she says she has no idea but that if I am that worried, she will leave note for Doc to call me in the am.

Can anyone please let me know if I am overreacting to this??? If I would have never called them, I wouldn't even know that my ANA is still positive!!! And does anyone know what could possibly be causing me to be positive??

Thanks so much in advance, and again I apologize for the length.

I recenty started working in a doctors office after three years of SNF. Unfortunately for patients, the MD office's tend to hire MA's (they get paid alot less) and then proceed to allow them to perform tasks that nurses really should be doing. I work for a couple of good docs and if labs are normal we still call. The only time we don't is with normal Pap's which we send a postcard for that. Usually our results are back in 1-2 days and the patient knows around the same time. Exception would be a C+S. So sorry for your ordeal. I would definately speak with either the doc or the office manager. If they don't semed concerned find a new doctor quick. Good luck. :nurse:

Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

I've had the same doctor since he was a resident. I checked him out thoroughly with his attendings and his peers. He's board certified and a really nice man. He has a long time office manager that is very professional and will bend over backwards to help. He has a receptionist who is the most efficient I have ever seen. Then his long time LPN-Nurse from Paradise!! Worked like 10 women....moved on for more money and a larger group.

Now as for your problem Labs. The new MA has set up a system for you to call in and enter your secret number. It should be ready in less than 2 days. I have called as many as daily for a week. Eventually getting through, you get her voice report about your labs. It goes like....welll...hmmmmm your CBC is OK, your others are OK (chews bubble gum) and Dr. wants you to call him about it. Numbers! I want numbers and I want a copy. No way according to her.

She's a pleasant enough person, but I don't see how he can afford to have someone with so few technical and people skills.

Secondly this doc has hired a NP. Without rhyme or reason sometimes I see her and sometimes I see the doctor. I'm sure she is a good NP. But she diagnosed 2 ailments wrong and I was subjected to the wrong medication for nearly a month.

I don't like her. I want to see the doc that I trust. I pay on time, I don't complain, I only go when I am sick. Is it ageism? Do Medicare folks not get to see the doctor?

As I see it the physician is employed by us. Then why do we feel we have to do things HIS way....not health matters....just the way we are treated.

Grrrrr.

So true. Unfortunately, the squeaky wheel gets the grease. My Mom kept going to different Doctors at Kaiser Hospital, complaining of abdominal pain and constipation. They reccomended fiber and excercise, and did no tests for 6 months. When they finally did a colonoscopy, it was too late, and she was diagnosed with colon CA at the age of 42. She died at the age of 45.

Thats heartbreaking. Im so sorry.

Just curious, is this a ,malpractice type case, failure to dx?

Specializes in ICU, Research, Corrections.

Hi all,

Whenever I get labs I have the Dr write on the order "fax results to patient" or "patient allowed to call lab for results". In that way you can effectively eliminate the middle man and interpret your own results. I just do not trust anyone else to interpret my labwork......even busy doctors. This also goes for invasive tests or procedures and pathology reports. I have found, (the hard way), you have to be pretty aggressive to ensure quality health care.

Cheers,

Lu Ann

(now officially an RN!) :coollook:

Specializes in LDRP.

I just recently went to the doctor (ok, 2 months ago) and had some labwork done, a CBC and TSH.

They mailed me a copy of the results, complete with number results, reference range, and, the last recorded results from the same test, so i could see how that result has changed since last time i had the test.

AND, i recieved it in less than a week.

I would recommend changing doctors. I had the same problem with my first urologist. (Ordering tons of tests and never giving me the results even after I called and throw a fit) I thought that it was a one time thing, but I was VERY wrong. Since I have changed urologist I haven't had the same problem.

Thank God that I didn't have something more going on (I have a history of passing kidney stones, UTI, and kidney infections), but he needed to tell me that. My new urologist always has his nurse call me if my tests are negative, and if they are positive they always make an appt so the doctor can tell me what is going on.

i think you have every right to be mad the doctor should of called you days ago to tel you your test results you should write a letter to him explaining your anger and shen one to the medical bord of your state . i hope you feel better.

Okay, I see MA bashing again. Believe it or not the MA's are not taking the lab results and just randomly stamping "WNL" on them. What a ridiculous statement to make! Honestly, I'm tired of reading on here what idiots you all think MA's are! We are here, we're not going anywhere and we do perform a service. Come on guys, the bottom line is that we are all here to help people. Believe it or not, some of us actually have some education!

Now, about what happens with your lab results in the doctors office... when they are received they are put with the chart in a stack for the MD to review. He/She will do this either during the day between pts or at the end of the day after clinic. If I see something grossly abnormal I will bring it to his attention so sometimes the normal results do go to the bottom of the stack. I always tell pts to give us a few days and if they don't hear from us they should call the office. Doctors are famous for taking days off and results will sit in stacks for quite a while. I have pts get angry about this all the time and my response is that they should schedule an appt to come in and discuss their results when the doctor returns. We also have a PA who will discuss their results with them.

Another thing that happens is that we never receive the results and we don't realize it until the pt calls. Someone may have had an xray and our office never received the result because mistakes do happen and we are a large clinic, so when the pt calls for his result is when I realize I never got it. So, I call radiology and request the report. Same thing with labs.

Anyway, I know that when it comes to someones health they are anxious and impatient so I do my best to explain that it may take a few days to get the results. Of course, in the clinic most tests are not stat.

So please, can we agree that it is not the MA's fault?? Nobody is "stamping WNL" on your results. MA's do not call the pt with results until the MD reviews them. period.

I work in a clinic, and I agree with some of the posters here that there is a time frame to go by. The patient is told if they do not hear from us in 3 days of results, to call us.

As far as your +ANA, we generally refer those to rheumatologists for followup.

As for all of the symptoms you went to the PCP with, did he not check a TSH? Alot of your symptoms sound common to hypothyroidism.

I don't know about the rest of nurses, but I for one look out for myself. As in, if I'm sick I make sure the MD checks out what I think I have wrong with me (makes them not so happy that we self-diagnose, but its our life). I had an abnormal iron level, and I had to push and push them to do DNA testing to determine if I had hemochromatosis....guess what, I was right. So that's just a little incident to let everyone know that you have to look after yourself when something isn't right.

To the OP, hope you get the care you need and get better.

Specializes in PICU, Nurse Educator, Clinical Research.

I always worry about things happening like these terrible missed diagnoses so many people have posted in this thread. I've had 3 surgeries in the last 18 months for 2 different problems, and I was amazed at how many times I had to call the various offices for test results. My endometriosis was incorrectly diagnosed for an entire year before I finally found a specialist (after my own extensive research) who figured out what was probably going on. He did my second surgery (I'd had extensive endometrial implants on my abdominal organs that had caused the formation of adhesions that pulled on my organs and bled frequently, and hormal imbalances caused by the endo were causing me a ton of other problems), and now I'm 98% symptom-free from the endo.

I recently had arthroscopic hip surgery for treatment of seven months of hip problems, and I took a few lessons learned from my endo saga into account when dealing with this problem. These actions have helped tremendously:

1- Whenever I see any doctor, I take note of who assists him or her- MA, LPN, RN, and try to get a feel for how helpful and knowledgable they are. Title often has nothing to do with how thorough the person is- a certain medical assistant was incredibly attentive and helpful in resolving my problems at one clinic, while an RN at another simply refused to pass along my information to the MD. I learn names, and ask to speak to the specific people I've had good results with.

2- I *always* get copies of my records- MRI's, clinic notes, surgical reports, labs- everything. I try to get all radiographic studies on CD (which is a lot easier than i thought it would be), and I scan all hard copies of notes into my computer as PDF files, and burn everything onto a single CD. Then I make a summary sheet with contact information for all the other specialists I've seen, the diagnoses, and pertinent lab and test results, along with a brief timeline. I give this information to any new doctor I see. I get some strange looks sometimes, but who cares- in this day of 'managed care', we each have to take personal responsibility for our own medical care.

3- Don't flame me for this- i'm aware it's not the case everythwere, but it's been my experience...i tend to get better results when i see clinics within research hospitals, instead of going to GP's for specific problems. i'm fortunate that my insurance doesn't require a referral to specialists.

4- I always look for second opinions if i don't feel i'm being taken seriously. I've been called a hypochondriac and overreactive by some physicians, only to seek second opinions and discover that yes, I *did* have problems that were not recognized by previous doctors.

Sorry- I've taken a tangent from the OP's question! I just feel like we're indoctrinated wtih this belief that 'doctor knows best' in this country, and it takes being that proverbial squeaky wheel to really get things done sometimes.

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