Thursday, February 7, 2008

A Trip to the ER

I realized today that I've told this story multiple times in person, but have neglected to inform the world at large of my exploits, so here goes.

It all started in our PBL group (that is, Problem Based Learning) when we got a case centering around a "curbside" consult which is medicalese for professional courtesy, or more simply put, free health care because you happen to be in the club. The issue was raised: is this case centered in reality, or is it merely pop fiction that docs can get free care from other docs. I took that issue home as a "learning objective."

My learning objective took me to Smallville Hospital ER [names have been changed to protect the victims]. I cased the joint. Up front was an administrative assistant, who are usually pretty sharp and able to keep the riffraff from getting to the docs. I almost knocked on the back entrance so a janitor I had spied would let me in, but figured she might sound the alarm. Then it came to me: the security guard. A venerable spot in the defenses.

"Excuse me sir, I'm a second year medical student and I need to speak with an ER doc. Is there any way you could let me in?"

After a little finagling, I was past the first obstacle.

A complication! The security guard didn't just let me into the ER to wander about aimlessly, but escorted me to the physicians' desk. As I stood there awkwardly, he explained that I had a question for one of the ER docs. I willed him to go away, but he was impervious to my mind control. So I suspiciously leaned down with my back to the guard, only to be met with a startling,
"Is this a personal health question?"

from the ER doc of choice. Yikes! I wasn't the first with this idea. Not one to be perturbed, I pressed on.

"Kind of. I've actually been fasting for several days and I'm worried about my ketone levels causing kidney damage. Is there any way I could get a urine dipstick."

Here's the shocking part. Without a pause:

"Can you do it yourself?"

Not a "Get out of here kid." No hint of "Your behavior is completely out of line." And definitely no nod toward security to dispose of me properly.

My response: "Sure!" And the doc: "Let's get you a dipstick."

Now my assignment was to find out if a medical professional could actually get lab tests done without being an official patient, so my work was done. I sheepishly explained that I didn't actually need the test and mumbled something about it being an assignment for a class before I took my nervous, sweaty self off the premises. I don't think the doc was too impressed with my covert op skills, but neither seemed too put off at my imposition on his time (for which I expressed my gratitude).

Is this a sad commentary on our medical system? Nah, I think it's pretty cool that we haven't become so bureaucratic as to totally abandon professional courtesy. Medicine seems like a pretty tight-knit group at times.

I'm so in.

2 comments:

Unknown said...

As a psychologist, I find something similar to be true. If I call up a physician (who has no clue who I am) and say "This is Dr. Stinson", the staff break their necks getting the physician on the phone. If a patient of mine calls they can only get to a nurse and may not even get their call returned if they have to leave a message. (Of course, I ONLY use this when its in my patient's best interest!!!!) Can come in mighty handy.

~lady j said...

Smallville Hospital. Nice ;)

It really is amazing what you can attain/receive just by asking-- and also how far you can get by NOT asking and just acting like you belong!