Anyone have any thoughts on the ER doctor from Los Gatos who has been all over the news today? Apparently a college student came in complaining of an anxiety attack and according to the news, the patient was "taunted." The patient was asking for pain and anxiety meds. I definitely think this is an example of burnout. It seems like the physician didn't think a visit to the ER was warranted and she was upset because she had sicker people to take care of. I'm not condoning how she handled the situation, I just think we really need to address burnout.
The doctor had discharged him, but he refused to leave, stating he couldn't move. At least that was what I read elsewhere.
Every ED should have upper-administration buy-in for an accepted protocol that includes interdisciplinary support for these situations, that's the best way to consistently handle them with respect and eliminate the rogue factor where things become a circus. Doc and SW or RN go to room, have the dispo discussion, provide resources, patient is discharged. No need to get crazy like this. Security can assist them out of the ED if they need help.
"...see if the coworker is willing to consider some help ie sensitivity training, coping mechanisms, continued education that might help her."
Not disagreeing with you in general, you make a lot of good points.
I am trying to imagine though, the reaction of the video doctor if someone suggested sensitivity training coping mechanisms and continued education... !
From the video that was linked to the only thing I could see wrong was at 3:15 where the doctor swore. Everything else was fine. I don't understand how you get pain from 'anxiety' and I don't understand what the breathing difficulty was.
As far as I can see the doctor was not willing to put up with the BS and reacted accordingly.
Specializes in ED, Cardiac-step down, tele, med surg.
I noticed the patient seemed pretty calm for someone having an anxiety attack. I've seen some patients with severe attacks with pulse rates in the 130s, hyperventilating and diaphoretic. I'm not sure why the patient was given a bed in the main ER at all, unless he had abnormal vitals. In my old ER, this patient would have probably got his refill in the triage area and discharge paperwork-we would often have a PA or NP there to quickly dispo patients like these. He might not have even got medication unless he displayed objective signs of anxiety and abnormal vitals. Nevertheless, the last part of the video showed the doctor behaving inappropriately which does warrant some type of correction.
Unfortunately, I have seen a doctor treat a patient worse than this who did have a legit problem. It was cruel the way he treated my patient and I reported him to our manager and he got a talking to. He was stressed out (it's a very difficult job) and that's understandable, but he did not need to take out his stress on my patient.
I wonder if she knew she was being taped. It's not an excuse, but if patients have a right to not be on camera, what about providers? Just wondering.
IMO, she was clearly rattled and overworked in the situation. She never should have grabbed at the patient or swore at him. When she began to feel frustrated, she should have handed him off (if she could) to a different doctor, or even had SW come in and talk for a while to give herself a break.
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
I agree with JKL33 that there should be some kind of multidisciplinary protocol to punt the malingerers. As far as sensitivity training - I think the doctor has probably been sensitivity-trained to death by people who shuffle papers for a living. What she really needs is for someone to take her out after work for a margarita. Or two...
Regarding the video, my impression is that it was taken by the patient's friend or family member. I'm surprised that there aren't more people who try to video me while I'm doing patient care. It's happened a couple of times and I've politely asked the person not to video me. It's never been a problem.
This was probably at the end of the visit. The patient probably is a frequent flier well known to this grumpy doctor. The doctor probably has a history of frequent patient complaints, based on her atrocious bedside manner here.
The nurse probably went to the doctor on the demand of the patient who did not get the meds he desired. The doctor should have have briefly reiterated her instructions then had the unit clerk call security to escort the patient out of the ER.
Instead the Dr had an undignified rant on camera that went viral.
Except that the private world lives and dies by Press Ganey. Press Ganey Has a lot to do with the Opioid crisis and MRSA. How manipulative is videoing this event without the Dr permission?
Specializes in Community Health, Med/Surg, ICU Stepdown.
I agree that patients seeking pain meds without a clear cause for pain are frustrating, but I experience this at least weekly and have never reacted in this manner. As another poster stated, I have literally had a patient attempt to assault me and throw a pitcher of juice on me when the doctor discontinued her pain meds and I still did not resort to swearing. I don't think the doctor's poor reaction had to do with the patient's race but I am pretty sure security is called much more frequently to African American patients' bedsides than people of any other race, and I believe that is due to a totally untrue perception that African Americans are violent. I did not see the reason for calling security as the patient was in no way combative or threatening.
I wonder if she knew she was being taped. It's not an excuse, but if patients have a right to not be on camera, what about providers? Just wondering.
I think it depends on state law. In my state, it's illegal to record without permission. With that said, the best we can do is ask a patient/family member not to record. If they persist, we CAN call the police, but that generally doesn't do anything. It's a he said - she said thing, police can't search the electronic device, and in the end, making a scene usually makes it worse.
...I did not see the reason for calling security as the patient was in no way combative or threatening.
In the ER, occasionally a patient will refuse to leave when they are discharged. This becomes trespassing at that point. If a patient won't leave the room, security is the first step, calling the police is a last resort of course.
We had a patient recently who had returned multiple times for some mundane complaint. He had demanded to be admitted. He was discharged, then he called the hospital threatening our lives. The police were called, the hospital put on lockdown. A nearby hospital was also notified where the patient was eventually arrested.
Patients these days have been given the impression of unlimited rights. They are advised repeatedly of their rights. They are surveyed regarding their healthcare 'experience'. This is the result.
For whatever reason, this physician was not in the right frame of mind to handle a patient/family like this. Maybe it's burn out. These patients and their family are challenging, because it's very clear immediately that he's not having an emergency, saying things that are just objectively not true, and they look at us like were supposed be worries and/or fix it. Should we give intoxicating medications to people who present like this? I usually sit down and explain what I'm objectively seeing and provide reassurance there is no biological, physiological reason for the symptoms. Instead of being a good doctor, she lost it, in a very unprofessional manner. I feel bad for her, because while she might be an excellent physician on any other day or by any other measure, her name is being dragged through the mud and she will have difficulty rebuilding her career.
JKL33
7,043 Posts
Every ED should have upper-administration buy-in for an accepted protocol that includes interdisciplinary support for these situations, that's the best way to consistently handle them with respect and eliminate the rogue factor where things become a circus. Doc and SW or RN go to room, have the dispo discussion, provide resources, patient is discharged. No need to get crazy like this. Security can assist them out of the ED if they need help.