Chapter 142: General Medicine
OPD.
My last case of the day. I'm running thirty minutes late already. A woman is under our follow-up for palpitations. She is due an echo as part of her workup in a year's time, during which we follow up occasionally to see if symptoms have changed.
They haven't changed. So this is a straightforward case: see her in six months' time. But, oh boy, is she intent on treating a specialist internal medicine outpatient department appointment into a GP one. Again, this is a specialist internal medicine appointment, not a general practice one.
She talks about having blurring of vision. Which has been going on for two weeks. I don't deal with eyes. OK, I say, this should really be done in general outpatient but I'll refer to Ophthalmology. One letter.
She talks about vaginal dryness after menopause. I don't deal with vaginas. OK, I'll refer to Gynae. Two letters.
She gets her letters -- which shouldn't actually be done by me, as they have nothing to do with the internal medical issue she's seeing me for (should be done by the general outpatient department or a GP), but I was a pushover -- and then she leaves.
When I'm typing up her notes, she bursts through my door again after a single knock, which I find exceedingly rude. The consultation is over. She has left. I could be seeing another patient or busy with something else. You don't get to crash back in after you've left unless it's to get something you left behind. I've literally had patients crash into my next patient's appointment and just hover there when I'm still talking with the next patient as if they had no idea they are listening to confidential information.
"But doctor," she says, plonking back on my chair. "I have these two fleshy growths on my cheeks under my eyes. What are they?"
"Not internal medicine," I reply. "This is not general practice. Please leave."
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