No, I haven't been scolded, counseled, or even looked at cross-eyed, but after the day I've had, it would not surprise me. Tell me, y'all, if this was you, what would you have done differently?
Case 1) Grandma brings in kiddo, around age 5, multiple c/o: cough, runny nose, sore throat, thinks she has a UTI, vomiting, etc. Typical viral picture. Drainage is clear, vomiting not excessive, 2-3 times over the last few days. Kiddo looked a tad puny, but was responsive and giggling when I examined her. All tests negative. Explained to GM about viral syndromes, symptomatic tx, etc. Did not want to jump straight to an antibiotic, as no real s/s to warrant such. Told GM that I typicall do not do Phenergan for a kiddo that young (and skinny as a rail), and that Emetrol was what we had had success with with this bug. She agreed to the treatment, and left.
Fast forward a few hours, GM is steaming mad, wanting to knwo why all I did was send a med that she already had at home to the pharmacy that she had to drive 30 miles to get. I was stunned. Explained again about viral syndrome, the treatment she agreed to, etc. She was having none of it, said that WHEN she brought the girl back, she'd make sure I didn't see her. Fine and dandy by me. Thank God I always do a note on my charts.
Case 2) Woman seen for an URI 3 days ago, represents and requests cough meds with narcotic, specifically. Was told by the other provider that saw her 3 days ago that she would not be prescribed this, as she was on a narcotic regimen already. I told her that I would not deviate form the treatment already prescribed (no cough heard the whole time she was here, chest clear, already on an antibiotic, etc.) She became irate and tried to say that she was no longer on her narcotic regimen, but as we had no way of knowing this for certain, I declined. She called the lot of us "worthless" and stomped out.
This is an urgent care setting. Both of these patients have PMDs, and no, they had not contacted them prior to coming in. The GM even said she brought the kiddo because the mom did not think she needed to be taken to the doc. Just wondering if I should throw in the towel. Yes, I'm thin-skinned today.
