This just gripes the crud out of me...

[AngelfireRN]

Y'all feel free to tell me if I'm awful for feeling this way. I've just seen so much of it lately, I'm sick.

Had one today that absolutely tipped my control balance.

He came in a few days prior, saying that he HAD to see the doc about 'his breathing'. We had no appointments, and he was not in distress at that time, so we made him an appointment for today, and I pulled the chart for review before he was to come in. There was no mention in any previous visit of any pulmonary dysfunction, and also nothing related to lung issues on the medical history form he filled out on his inception to the clinic. No treatment for breathing trouble, nothing.

He came back in, and I questioned him about the complaint.

"Well, I'm filing for my disability, and I want to put my breathing for part of my disability, so my lawyer told me to get to my doctor and get put on treatment."

"I see. And how long have you had this trouble?"

"Oh, YEARS. I've been using my brother's meds, and they really help. I have an awful time."

"Where have you been treated before, and do you remember who treated you and with what?"

"No, no one ever treated me. I just tried my brother's squirter and that stuff you put in that pipe."

"So, no diagnosis of asthma, COPD, emphysema, or anything like that, ever?"

"No, but my lawyer said I needed to get put on treatment so I could claim it on my disability application."

All of this, with no notable SOB, and a pack of Marlboros in his shirt pocket.

"OK, the problem is, sir, you have never mentioned that you have breathing trouble, nor did you list it or any medications that you take for it on your medical history. So, with you admitting that you're only seeking treatment on your lawyer's advice so that you can claim this on your disability application, it looks, well..."

"Suspicious?"

"Exactly." ( My patient's number one compliment about me at this clinic is that I DO NOT LIE to them. Not about anything. This guy was not going to get a candy-coated version, either.)

So, we did some tests, O2 sat normal, lungs clear, PFT normal as could be. The most telling thing, after Doc and I reviewed the tests, and I told him that they were normal, he got irate.

"I DO!!!! I DO have trouble breathing! My work told me that 3 years ago! They said I had the lungs of a 90 year old! They gave me antibiotics! I DO have trouble breathing." All this at the top of said 'terrible' lungs, with not a cough or a wheeze to be heard.

He got a script for a rescue inhaler, and a refusal for an early refill on his pain meds, and stormed out in a snit.

Call me heartless (really, go ahead, seems to be the going thing, lol), but I refuse to lie about anyone TO anyone so that they can cheat the system. I have to go to work every day, regardless of whether I feel like it or not, and I expect every able-bodied person to do the same. And the disability attorney will request the test results, and have a review team see that they were normal as well, so my lying and prescribing unnecessary meds would not have helped in the long run, even if I were unethically inclined.

I guess it gripes me that some of my poor little elderly patients have worked all their lives, only to be unable to get disability for a legitimate complaint, and here's this clown trying to get a free ride.

Thoughts?

[redhead_NURSE98!, ADN, BSN]

No, but unfortunately, in today's society, it's a very apt one. Not all lawyers are fit for that category, but we all know that there are ambulance-chasers all over.

I believe that's what was meant.

It was a very very broad statement saying that "where there's a lawyer there's a lie." As a lawyer I don't appreciate it. If "a lot of lawyers appear to be unethical" is what they meant then they should have said it. They can say it in just a few characters as the statement they made, but chose not to do so.

[AngelfireRN, MSN, RN, APRN]

It was a very very broad statement saying that "where there's a lawyer there's a lie." As a lawyer I don't appreciate it. If "a lot of lawyers appear to be unethical" is what they meant then they should have said it. They can say it in just a few characters as the statement they made, but chose not to do so.

Point taken, I'll defer to them for response. My uncle is a lawyer, and as honest as the day is long, even if he is a bulldog.

[xtxrn, ASN, RN]

To be honest, I'm surprised he hasn't been back in, claiming an exacerbation or some such. With this particular one, that's about par for the course.

Actually, with quite a few where I work, it's something akin to dealing with a small, recalcitrant child. If they don't like the answer they are given, they try again, each time with a different tack, for a different outcome. Thankfully, we see them coming a mile away and can usually head it off, the clinic as a whole is very good about 'having each other's back' in cases like that.

In regard to reporting, can it be done anonymously? I mean, yes, I'd have to be involved to know what I know, but I also don't want to violate HIPAA, even to prevent a potential fraud.

I looked this up a couple of weeks back, and did find something under HIPAA and reporting fraud. I didn't keep the link- but it was under one of the government sites (so not some flaky thing to increase the risk of getting someone nailed for reporting :)).

[kelll]

THIS is a topic I could RANT all day on! bar none people cheating the system is stealing I believe they should be treated as criminals if found guilty! We do all pay for it and there are people I am more than happy to help..honest people who have done the best they can to work thier whole life and are having a hard time...whom are really ill and need help...whom try to care for themselves and take responsibility for thier part of thier health! The unit I work on it seems the people with the least reason to complain have the most UNREASONABLE complaints/requests! We are alll expected to jump when patients/families complain or request things but what about limits???