Thursday, November 17, 2005
Fast Times at Greentree Pediatrics
Time to post a few thoughts about the loss of civility ... illuminated by a few episodes at the office.
Today, a Korean family brought their 4-month-old in for a regular checkup and as I began to check the baby, a relative whipped out a videocam and began to record the exam.
Actually I saw a red light out of the corner of my eye as I was probing the left ear canal. It was a bit disconcerting.
Did they even think or care to ask if I thought filming was appropriate, or if I felt comfortable on camera? Nope. So I stopped and asked her to turn the camera off, which prompted a fast discussion in Korean. then a protest from the mom, who speaks English.
"Last time, the doctor let us film it," she said.
I walked out and asked the nurses, who pleaded ignorance. I asked a physician's assistant, who said he saw nothing wrong with it.
Huh? To say nothing of potential liability issues (many hospitals once allowed families to film deliveries, then stopped because of what might the camera might capture)...but the lead doc in the office said he didn't think there was a problem and didn't know if Kaiser-Permanente (where I'm working now) had any policy. Since K-P has a policy for just about everything, I'd bet he's wrong.
Anyway, I went back into the room and on the advice of the lead doc, worked a compromise where they could film a small part, the chest and heart exam, then turn the camera off.
No harm, no foul.
Which leads me to episode #2, last week, when a 16-year-old girl whipped out her camera cell phone during my exam of her best friend (who had a cold) and started transmitting. I threw her out of the room. Most offices have had "No cell phone" policies for a while now, sometimes enforced, but they were propagated before the advent of the cell cam. The girl said something rude on her way out and her mucus-challenged friend looked bewildered. They had NO appreciation of the incivility of their action. They thought it humorous.
And the last, but best episode happened 3 years ago, when I worked at Greentree Pediatrics, off I-279, on the way to the Pittsburgh airport. A patient scheduled for a sick visit at 5:45 pm wasn't seen until 6:20 p.m. because I had to attend to a sick infant and transfer the baby downtown. That threw the schedule back and patients were told of the delay, the cause and offered rebookings.
As I was about to enter their exam room, we heard a knock on the front door.
"Pizza man. I'm here for Exam Room 2. Pizza man."
And there stood the Domino's delivery guy, the quintessential pimply-faced teen, lugging two large pizzas in the vinyl heating pack. The receptionist let him in and he walked over to room 2, where Mom and the four kids were waiting.
"You made us wait and now we're hungry," she snapped. "Now you can wait for us."
Right out of Fast Times at Ridgmont High, but without surfer dude Jeff Spicoli and Mister Hand.
"Hey, my nurses are hungry too," I said in my best Ray Walston impression. "Ever see Fast Times? Your time is my time. Your time is all of our times."
So I yanked away one pizza and told the nurses to each take a slice. This was a smart political move. Nurses will eat anything.
The mom made some idle angry threats and walked out with kids in tow. The family was ex-communicated from the practice in due time, with the 30-day legal notice.
Again, the point is the ever-evolving lack of common courtesy, the acceptance of intrusions unthinkable even 5-10 years ago. The pizza tasted pretty damn good though, even for Domino's.
Today, a Korean family brought their 4-month-old in for a regular checkup and as I began to check the baby, a relative whipped out a videocam and began to record the exam.
Actually I saw a red light out of the corner of my eye as I was probing the left ear canal. It was a bit disconcerting.
Did they even think or care to ask if I thought filming was appropriate, or if I felt comfortable on camera? Nope. So I stopped and asked her to turn the camera off, which prompted a fast discussion in Korean. then a protest from the mom, who speaks English.
"Last time, the doctor let us film it," she said.
I walked out and asked the nurses, who pleaded ignorance. I asked a physician's assistant, who said he saw nothing wrong with it.
Huh? To say nothing of potential liability issues (many hospitals once allowed families to film deliveries, then stopped because of what might the camera might capture)...but the lead doc in the office said he didn't think there was a problem and didn't know if Kaiser-Permanente (where I'm working now) had any policy. Since K-P has a policy for just about everything, I'd bet he's wrong.
Anyway, I went back into the room and on the advice of the lead doc, worked a compromise where they could film a small part, the chest and heart exam, then turn the camera off.
No harm, no foul.
Which leads me to episode #2, last week, when a 16-year-old girl whipped out her camera cell phone during my exam of her best friend (who had a cold) and started transmitting. I threw her out of the room. Most offices have had "No cell phone" policies for a while now, sometimes enforced, but they were propagated before the advent of the cell cam. The girl said something rude on her way out and her mucus-challenged friend looked bewildered. They had NO appreciation of the incivility of their action. They thought it humorous.
And the last, but best episode happened 3 years ago, when I worked at Greentree Pediatrics, off I-279, on the way to the Pittsburgh airport. A patient scheduled for a sick visit at 5:45 pm wasn't seen until 6:20 p.m. because I had to attend to a sick infant and transfer the baby downtown. That threw the schedule back and patients were told of the delay, the cause and offered rebookings.
As I was about to enter their exam room, we heard a knock on the front door.
"Pizza man. I'm here for Exam Room 2. Pizza man."
And there stood the Domino's delivery guy, the quintessential pimply-faced teen, lugging two large pizzas in the vinyl heating pack. The receptionist let him in and he walked over to room 2, where Mom and the four kids were waiting.
"You made us wait and now we're hungry," she snapped. "Now you can wait for us."
Right out of Fast Times at Ridgmont High, but without surfer dude Jeff Spicoli and Mister Hand.
"Hey, my nurses are hungry too," I said in my best Ray Walston impression. "Ever see Fast Times? Your time is my time. Your time is all of our times."
So I yanked away one pizza and told the nurses to each take a slice. This was a smart political move. Nurses will eat anything.
The mom made some idle angry threats and walked out with kids in tow. The family was ex-communicated from the practice in due time, with the 30-day legal notice.
Again, the point is the ever-evolving lack of common courtesy, the acceptance of intrusions unthinkable even 5-10 years ago. The pizza tasted pretty damn good though, even for Domino's.
