Wednesday, April 11, 2012

I AM RELATED TO --------

   We have a policy in our office . We do help other doctor's family members . They can get in quickly if it is an emergency and try to get samples  etc . I can not do it all the time , but we try . I expect the same from other doctors if I would need any help . This is called professional courtesy. Sometimes it happens and some times not . So this is a story of one of my patients.
   I saw her for the shortness of the breath . Sometimes we have to do investigations to find out the reason for the shortness of the breath and other times the diagnosis is obvious or even clear or known to the patient . This one was the latter case.
   She was 60 years old white female , who was lifelong smoker. She had chronic cough, which had gotten worse, and she was also wheezing. She had continued to smoke and knew what was the diagnosis. She had chronic obstructive lung disease . When I saw  her I had noticed that her name -last name was same as a doctor that I knew and was in practice within less than half a mile of my office. So  I asked her if she was related to him . She was very firm , when she said 'no '. I gave her medicines and schedule her for lung function tests and some blood tests and advised her to stop smoking .
    She was seen by me in next few months few times . Her breathing test showed quite significant drop in her lung capacity and she continued to smoke. every time I saw her she would ask for the samples and I would give her some . Unfortunately these medicines are quite expensive . e.g. one inhaler is $ 200. and it lasts only a month . ( by the way we can get it for $40 in Canada )
   She would complain of the cost of medicine , but I could do nothing about the cost of the medicine . At the one of the office follow up she asked me to close the door . I did . She started saying in low voice , " you remember you had asked me if I was related to Doctor. XXXX. " When I said 'yes' , she continued, " I am , related to him , I mean I was related to him . I am his ex wife . I have no relation left with him , I don't want him to have any relation with my children . " I was not sure where this conversation was leading to . She continued , " I saw that you give discount to the relatives of other doctors. I am related to Doctor xx , could you write off my balance?"
   i was speechless . I have written off some balance many times, 'related ' or 'unrelated ' to doctors. In this case too I did it .

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