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

grimmy, RN · Mar 30, 2005

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 don't think you're over-reacting at all. i think your pcp's behavior is appalling, if not unprofessional. i think you need to speak to your pcp directly and request all lab results reported to you, in writing. this is your right as a patient. if my pcp did this to me, he'd be fired. and i wouldn't leave him any question as to why. frankly, having a medical assistant give me my lab results over the phone is unconscionable. do they do that for all lab results? what if you had a positive pap or hiv? you'd need some counseling, damnit, and an ma is absolutely the wrong person to be doing that. worse case scenario, fire the pcp, find another, and write ex-pcp a scathing letter stating exactly why you left. carbon-copy the letter to your insurance company and the state licensing board. :angryfire

mysticalwaters1 · Mar 30, 2005

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.

Nope not overeacting and i guess this is happening with some pcp. My father had 2 sicknesses that needed treatment and luckily he got in the next day but both times had to see the physician assistant and those times when he went back for reg checkup his pcp didn't realize he even came in! What's going on and one time he had an us of his abd for pain then realized he was constipated had pain in his back too but he's a diabetic and wasn't sure so got the tests ordered by the pa and got bunch of prune juice had bm and felt lot better. Anyway i really though SOMEONE would call and say oh your tests are ok even if it was constipation. What if something else was on it? Its' just corteousy to let people know what the heck is going on. I work at a local hospital and i am seeing how my dad and my own medical group handle pts at home and in the hospital and i'm really thinking of switching medical groups. The group is so large do not report to their partners so you're basically screwed if an issues is going on with a pt and you have to call the oncall dr has no idea about the pt. Anyway yes that's horrible even though my dad found out it was constipation they should have called even if it was normal. And what if they made a mistake and it was positive that freaks me out too!

hhrhrn41, RN · Mar 30, 2005

Nope not overeacting and i guess this is happening with some pcp. My father had 2 sicknesses that needed treatment and luckily he got in the next day but both times had to see the physician assistant and those times when he went back for reg checkup his pcp didn't realize he even came in! What's going on and one time he had an us of his abd for pain then realized he was constipated had pain in his back too but he's a diabetic and wasn't sure so got the tests ordered by the pa and got bunch of prune juice had bm and felt lot better. Anyway i really though SOMEONE would call and say oh your tests are ok even if it was constipation. What if something else was on it? Its' just corteousy to let people know what the heck is going on. I work at a local hospital and i am seeing how my dad and my own medical group handle pts at home and in the hospital and i'm really thinking of switching medical groups. The group is so large do not report to their partners so you're basically screwed if an issues is going on with a pt and you have to call the oncall dr has no idea about the pt. Anyway yes that's horrible even though my dad found out it was constipation they should have called even if it was normal. And what if they made a mistake and it was positive that freaks me out too!

Thanks so much for your input.:) I guess i'm not the only one who's had to deal with this unprof. behavior. Healthcare is so sad nowadays.... It's just a freakin business to most docs!!!:angryfire BTW, where in do u live? b/c the scenario you've described goes on at our hospitol with the doctor groups that come to us from outside our hosp.

CrunchRN, ADN, RN · Mar 30, 2005

When I was an office nurse I would always tell people I would mail normal results, and call if anything abnormal. I told them to call us if they did not get results and gave them a time frame. For less common tests (like yours versus routine cholesterol, etc...) I would call and discuss the implications with the patient. For any anxious/concerned patient I would tell tham I would call them with the results no matter what, and if they felt it was taking to long that they should call me. That was in case we did not get results or the MD hadn't prioritized them and I needed to shove them under his nose:chuckle . Luckily I worked for MD's who were willing to pay for an RN because they felt it was worth it. Our patients benefited from that. I am sorry about the way your office handled things, but from what I have seen that is the way the majority operate. I would definitely insist on speaking with the physician directly about your results. I always made sure that patients who wanted to do this were able to in as timely a manner as possible.

mariedoreen · Mar 30, 2005

My dad had an MD who refused to hear more than one symptom at a time... If you had been seeing this doc OP you would have had to make 6 visits, one for each symptom you listed above... My dad made an appt for his night sweats (Oh you're using too many blankets) on the way out he made his next appt where he then wanted to talk about his SOB (oh it's your asthma) then another appt to discuss his growing fatigue (not so much time at the gym Bob...) then the next for...

After several of these appts the doctor's nurse made a comment to him "Bob, I think you're a hypochondriac!" Long story short less than a year later after being dx'd for mesothelioma (initiated by a complimentary CT scan from roaming attorneys while at work) he gathered all the follow up material from the hospital's subsequent scans and showed up in the doctors office, dropped all the material in front of said nurse and replied "Still think I'm a hypochondriac NOW?!" One week later he was informed he was terminal.

You absolutely have to take your healthcare into your own hands, make those calls (if they have a habit of not calling you then call them every day until you get your answers), go to a new PCP if you're not satisfied with the care you're receiving, and question, question, question everything you're told. You have to fight for your own health because the honest truth is that no one cares about it as much as you do.

caye · Mar 30, 2005

No you are not overreacting and this is not the norm. :angryfire I worked for a physician and was responsible for contacting the patients to inform them of their result (normal or abnormal) after the physician had reviewed the results.

Sometimes there would be a delay if the physician was out of town and not able to review the labs. if the results were normal, they would go in a stack of charts for me to call the patients which would manytimes be stacks of charts. Anything abnormal, the Dr. would write a note on and hand it to me to call the pt asap, which would place that chart ahead of the charts with normal results. Depending on if the other office nurse was out and I had to room pt's myself, then I would have to squeeze in the phone calls between rooming in pt's. To ease pt's minds, I would always tell them that I would call with the results, but if they had not heard from me in a couple of days to feel free to call me so I could pull their chart (from the stack to call) and tell them their test results. One thing to remember though; the nurse or Ma can't give out the lab or test results until the physician has seen them first and given instructions as to what to tell the pt.

Personally, I always get a call from my Dr.'s office with results in 2-3 days. I hope this helps.

Caye

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.

Sierralee · Mar 30, 2005

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.

You keep at this! My sister had a very similar thing going, but she one of the people that want that answer. You may want to see an endroc. dr. thats what she did, she had many of those tests repeated and repeated she has finally got an dx of Lupus. She didn't have alot of the familiar symptoms either. Keep speaking up its your body and health. I work in Family practice for 8 years. We called all results Nl and Abnormal. I never may a call unless I had all the information as possible. If I didn't I was on that Dr. to give me a answer so I may call the pt back or I may sure he may the call!. I know this is happening all over. But as pt. you got to stick to your guns. Good Luck

nursemelani · Jan 21, 2006

My dad had an MD who refused to hear more than one symptom at a time... If you had been seeing this doc OP you would have had to make 6 visits, one for each symptom you listed above... My dad made an appt for his night sweats (Oh you're using too many blankets) on the way out he made his next appt where he then wanted to talk about his SOB (oh it's your asthma) then another appt to discuss his growing fatigue (not so much time at the gym Bob...) then the next for...
After several of these appts the doctor's nurse made a comment to him "Bob, I think you're a hypochondriac!" Long story short less than a year later after being dx'd for mesothelioma (initiated by a complimentary CT scan from roaming attorneys while at work) he gathered all the follow up material from the hospital's subsequent scans and showed up in the doctors office, dropped all the material in front of said nurse and replied "Still think I'm a hypochondriac NOW?!" One week later he was informed he was terminal.
You absolutely have to take your healthcare into your own hands, make those calls (if they have a habit of not calling you then call them every day until you get your answers), go to a new PCP if you're not satisfied with the care you're receiving, and question, question, question everything you're told. You have to fight for your own health because the honest truth is that no one cares about it as much as you do.

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.

In another case, one of my pediatric home health patients went in to the hospital for a surgery on his jaw. When they took him off the vent, he was having trouble breathing, and the Doctors urged the Mom to let them do a trach. Fortunately, this Mom was assertive, and smart, and demanded a consult with an ENT doctor. The ENT dr. scoped the kid and concluded that his trachea was swollen from the vent. He put the kid on steroids, and the swelling went down within 24 hours. If Mom had not been assertive, that poor kid would have ended up with an unneeded trach.

TazziRN, RN · Jan 21, 2006

I agree, not overreacting. While it is the norm around here for docs to not call if things are normal, yours was not normal so you should have been called. If I were you I would make an appt with your PCP and speak to him directly about your concerns, including how you were treated.

Something similar happened to my mother in law a couple of years ago. She had an angio done and had a F/U scheduled with the cardio's PA two weeks later. A few MONTHS later I asked her "By the way, what happened with your angio F/U?" She had never gone in because her appt kept getting changed by the office! I blew a stack and got on the phone, basically asked them how they could do such an intrusive test and then not get her in for a F/U? They were apologetic, did not realize the PA kept cancelling her, and got her in with the MD that same week. The MD thought she'd been f/u and the scheduling staff didn't realize it was post angio.

TheCommuter, BSN, RN · Jan 21, 2006

A similar experience recently happened to me. I recently underwent a pelvic MRI to rule out the possibility of fibroids. I was told that the results would be ready in approximately 3 days. No one called me, so I assumed the doctor saw no cause for concern.

About 2 weeks later I walked into the doctor's office and asked the MA for a copy of my results. She said, "I mailed you a copy a few days ago."

I told her, "No. You mailed a letter stating that the result was WNL. I'd like to see the actual MRI report and have a copy for my personal records."

After a 10 minute wait she handed me a copy of the MRI report. I was disturbed to read on the report that I had multiple large fibroids and an enlarged uterus that was compressing my bladder and rectum. I was puzzled as to why these results were stamped 'WNL' when they were clearly not 'WNL'.

That evening I took the copy of this MRI report to UCLA Medical Center and the gynecologist recommended that I immediately have these fibroids removed to alleviate my problems.

Personally, I believe the MAs indiscriminately stamp all results 'WNL' because they lack the prerequisite knowledge to fully interpret the results. Therefore, abnormal results aren't reaching the doctor's desk due to being intercepted by front office MAs.

TheCommuter, BSN, RN · Jan 21, 2006

BTW I've seen LVNs employed at clinics and doctors' offices, so nurses still work in doctors' offices. However, the vast majority of assistive employees in the doctors' offices tend to be MAs.