Feeling insulted but not inferior

Specialties NP

Published

I has this discussion with my md today who I had to call for a referral to urgent care so insurance would cover itMe: hi dr soo soo, hate to bother you on the weekend but my asthma is really acting up nebs help but I see a problem brewing. I need a urgent care referralDr soo soo , no you need to go to the ER Me: I get great care at the urgent care that the military has designated for after hoursdr. Soo sooo: I understand you have a little medical training , I'm telling you need to be seen in the ER in case they need to admit yoI was able to speak in full sentences , peak flows borderline yellow/ green. I've been dealing with this my entire life, I knew all I needed was a urgent care visit get some steroids on board and I would be good to go. He insisted I go to the ER so a md could evaluate me. So off to the ER I went. Never once saw a md. I saw a Np at triage and the PA who discharged me both agreeing that urgent care would have been just as good , faster and not be crowding the ER . I'm infuriated by his reference to my education and the fact that this little ER. Visit is costing alot more than urgent care. Rant done

Specializes in General.

Well since this info is in my demographics I don't even have to mention it. I tried lying about my occupation in the ER once for a allergic reaction and my husband ratted on me . :)

Your husband was proud of you and wanted everybody to know you're a nurse!

Specializes in Nephrology, Cardiology, ER, ICU.

Hmmm - I have Tricare also (as my hubby is retired military) - never needed a referral for urgent care....maybe different people have different requirements? Tricare for me is my secondary - maybe thats the difference?

Specializes in ortho, hospice volunteer, psych,.

our insurance has a clause stating that (paraphrasing here) it had darned well better be a real

emergency if we go to the er instead of an urgent care clinic or they might not cover it. our

urgent care clinic is part of a very very large drug store chain, and is closed between 10 pm and

7 am. please do not have an emergency between those hours.

when my husband stepped on a roofing nail late one summer evening, it was shortly before 10 pm

and he didn't have enough time to get to the clinic so he went just around the corner to the er.

painful, but certainly not life-threatening, and insurance paid it.

i was using a sharp paring knife and it slipped and i ended up with a deep cut circling my thumb

and some of the palm and, aside from the fact that i was bleeding like a stuck pig, i wanted a plastic surgeon to stitch me up because i keloid. i usually

go to the clinic but went to the er instead and they refused to pay.

we don't need a referral for either one but insurance does sometimes follow up with the pcp to

check to see if we followed up. if they get suspicious that you're using the er for runny noses and

the like, the require pcp authorization for every er/urgent care visit.

i'm glad you're feeling better now. i'm so sorry that your md was disrespectful about your np training but that's a reflection on him and

not you.

Specializes in nursing education.
I can see his point: YOU diagnosed yourself and wanted him to basically "treat" you without ever having examined you.

No, she didn't. She triaged herself appropriately, needed the formality of a "referral" for insurance purposes, and then was told she was wrong in a way that indicated she was wrong not only about her own condition (which she has had for years and actually doing peak flows-- :up: and an action plan :up:!!), but also as an educated NP!! Ironic, since she probably treats asthma all the time in kids who don't, or whose parents don't, do those things.

Regular nurses, RNs and LPNs, do phone triage all the time. And yes, we would have told you to take yourself to UC if our (primary care) clinic were closed.

Specializes in General.

My doctor will not even consider calling in a rx for conjunctivitis , it has to go to the ER because it involves the eye.

Specializes in General.

No I'm Not looking for sympathy , no I'm not pulling stuff out of my Rectal spinchter either , I'm a nurse practioner and from what I gather from SDN and your screen name you have not even finished your undergrad. Go study for your MCAT

Specializes in General.

No I'm Not looking for sympathy , no I'm not pulling stuff out of my Rectal spinchter either , I'm a nurse practioner and from what I gather from SDN and your screen name you have not even finished your undergrad. Go study for your MCAT

Specializes in FNP, ONP.

His feelings are not likely to change, so i wouldn't bother to confront him. I would find a provider that was a better fit; even if they don't always see eye to eye about the medicine, they should always be respectful of you as as a person. Insulting a patient, regardless of their occupation, is unacceptable behavior and I would never keep such a person as my provider.

Again, I don't really see what the big deal here is. If I was your physician, I wouldn't give out a referral either. Especially if you call me and say you need a referral to get some steroids. That's my license on the line; in the off-chance that you're wrong, I could easily be taken to court for making a judgment call without physically assessing you myself. How can I defend myself in that case? It's an entirely lose-lose situation for me. I wouldn't care if you were an attending or a world-renowned pulmonologist with years and years of experience! I would still direct you to the ER. And I would say the majority of practicing physicians today would do the same. It's simply not worth the risk in the current medicolegal environment.

I think you're over-analyzing this situation and taking things a bit too personally. Relax. If anything, he was probably trying to compliment you with the "medical training" comment, but worded it poorly. Could he have communicated this better? Yes. Do I think he was intentionally trying to insult you? Probably not.

Hope you're feeling better.

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