Is it better working in a larger community? Is there a place where physicians actually embrace the idea of palliative care and hospice and where the rest of the medical community at least is willing to learn if they don't know about it?
For the second time in a month, I've had to deal with an ignorant fool of a physician who insists that hospice is responsible for killing his patients off because we give them too much morphine. I made the mistake yesterday of asking this ignorant horse-behind for an order for morphine as we were heading into a weekend and getting meds in a rural area is very difficult on Saturday and Sunday as we have no Walgreens. I made it very clear to the discharge planner that Horse Behind, MD could refuse the order, and I would understand perfectly, but would someone ask him anyway? That will be the LAST time I ever ask him for so much as a Tylenol for a patient. I met with the patient's family at the home to do the admission and when the issue of morphine came up, daughter showed me a script for 1mg Roxanol q 8 hours PRN. Ok, not what I asked for, but at least it will be in the house, I thought and that shows some progress. THEN daughter says, "Just so you know, Dr. Horse Behind told me I need to watch you carefully because you hospice nurses like to give patients too much morphine and hurt them with it, and I should not let you give him anything because I can't trust you won't hurt him. So I want you to know I AM watching you and you are not to give ANYTHING to my father."
So after picking my jaw up off the floor, I got hot under the collar and said, "I want YOU to know that Dr. Horse Behind is ignorant and knows NOTHING about hospice. In any case, I'm not giving anything to your father: You all are the ones who will do that, should you choose to." Then, knowing I was going to say something I would regret to a family who is not to blame for any of this I asked if we could take a break and I would come back in 10 minutes. I did, and everything went better after that.
I am absolutely furious, even 24 hours later. It wouldn't be such a big deal if it were one physician, but we have 9 physicians in town, and only ONE of them supports what we do, but he is an OB-GYN........We are constantly fighting with the medical community in this town and it is driving me crazy. And I want to get this particular incident addressed somehow because I feel it borders on slander, as there are only 2 hospice nurses in my town. Any advice?