Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

A frustrating patient, and how that affects her physician

Lucy Hornstein, MD
Physician
September 8, 2014
472 Shares
Share
Tweet
Share

shutterstock_118293409

There’s a patient I don’t like very much. I’ll call her Mrs. X.

Mrs. X has definite medical problems, though she doesn’t seem to think so. Her lipids and blood pressure really are much higher than they should be. She could stand to lose a couple of pounds, and she really should be more active. She does not concur.

Every time she makes an appointment, she calls and changes it three, four, five times. After all that, she often doesn’t show up.

The first time I saw her, I identified several health issues. I told her that her blood pressure was too high, as was her cholesterol.

Her response: “I disagree.”

Say what?

“I don’t really think I have much of a problem. I’ll see if I can do something about the way I eat, but I’m not really worried.”

That made one of us. The BP was 190/114, with fasting triglycerides over 700. Her liver function tests were also abnormal (no surprise with TGs that high), so I asked her to get an ultrasound of her liver.

“I don’t think that’s necessary.”

OK then.

She agreed to begin a medication, for which I asked her to return in three months for a blood test. She took the prescription, and vanished for a year and a half. After a while, I got a notice from the pharmacy that she was requesting a refill. I refused, telling them to ask her to call for an appointment. Six months later, she did. Then she re-scheduled it three times, no-showed once, called again, and finally came in … late.

Without exaggeration, I can say this patient has repeated this cycle at least three times since I’ve known her.

Make no mistake: I have plenty of patients who are reluctant to take my advice about their health. I’m not even quite sure what it is about this person that rubs me the wrong way.

Why does she expect me to continue calling in prescriptions without seeing her to monitor them? It’s as if she doesn’t seem to feel that the rules for everyone else (coming to appointments on time, for example) should apply to her.

As I say, I don’t quite understand why this particular patient has this effect on me. Suffice it to say that I cringe a little whenever I see her name on the schedule. Then I reassure myself that she probably won’t show up, and two out of three times I’m right. But when she does, I know it’s going to be a frustrating encounter.

Is there anything I can do? Firing her is an option, though a bit of an over-reaction as I don’t really have grounds for something that extreme. Stop prescribing without visits? I have, though I fear for her health.

I guess I’ll just keep on muddling through.

Lucy Hornstein is a family physician who blogs at Musings of a Dinosaur, and is the author of Declarations of a Dinosaur: 10 Laws I’ve Learned as a Family Doctor.

Image credit: Shutterstock.com

Prev

4 reasons why the Ebola vaccine won't matter

September 8, 2014 Kevin 5
…
Next

Miscommunication added to the cost of neurosurgery

September 8, 2014 Kevin 2
…

Tagged as: Primary Care

Post navigation

< Previous Post
4 reasons why the Ebola vaccine won't matter
Next Post >
Miscommunication added to the cost of neurosurgery

More by Lucy Hornstein, MD

  • After #MeToo, have the rules changed?

    Lucy Hornstein, MD
  • A patient’s view on cancer surprises this physician

    Lucy Hornstein, MD
  • Never underestimate the power of pus

    Lucy Hornstein, MD

More in Physician

  • Physicians have no autonomy. Here’s how to change that.

    Diane W. Shannon, MD, MPH
  • The erosion of patient care

    Laura de la Torre, MD
  • Navigating adulthood in the digital age

    Eleanor Menzin, MD
  • The power of business knowledge for medical professionals

    Curtis G. Graham, MD
  • Using the language of art to create work-life balance

    Sarah Samaan, MD
  • Lively communication in the service industry

    Deepak Gupta, MD
  • Most Popular

  • Past Week

    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Inside the grueling life of a surgery intern

      Randall S. Fong, MD | Physician
    • The erosion of patient care

      Laura de la Torre, MD | Physician
    • I’m tired of being a distracted doctor

      Shiv Rao, MD | Tech
    • Pediatricians grapple with guns in America, from Band-Aids to bullets

      Tasia Isbell, MD, MPH | Policy
    • Doctors and disability insurance: Protecting your income

      Amarish Dave, DO | Finance
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
  • Recent Posts

    • Doctors and disability insurance: Protecting your income

      Amarish Dave, DO | Finance
    • Emergency care nightmare: the urgent need for experienced nurses

      Rachel Basham, RN, CCRN | Conditions
    • Physicians have no autonomy. Here’s how to change that.

      Diane W. Shannon, MD, MPH | Physician
    • Understanding intersex health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The erosion of patient care

      Laura de la Torre, MD | Physician
    • Debating the role of psychiatric assessments in medical decisions

      Christian Youssef & Francisco M. Torres, MD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 74 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Spine Surgery Cover-Up? Legal Threats Chill Misinfo Research; The Longevity Industry
  • Upcoming Studies on Dupilumab for Alopecia Areata
  • Early Win for PTSD Drug; FDA OKs AI Sleep Diagnostic; Extreme Social Isolation Tool
  • Doctor or DNP: Who Is Really Providing Care?
  • Who Really Needs a Yearly COVID Booster?

Meeting Coverage

  • New Schizophrenia Treatments Are Coming: Don't Panic
  • Loneliness Needs to Be Treated Like Any Other Health Condition, Researcher Suggests
  • Stopping Medical Misinformation Requires Early Detection
  • AI Has an Image Problem in Healthcare, Expert Says
  • Want Better Health Outcomes? Check Out What Other Countries Do
  • Most Popular

  • Past Week

    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Inside the grueling life of a surgery intern

      Randall S. Fong, MD | Physician
    • The erosion of patient care

      Laura de la Torre, MD | Physician
    • I’m tired of being a distracted doctor

      Shiv Rao, MD | Tech
    • Pediatricians grapple with guns in America, from Band-Aids to bullets

      Tasia Isbell, MD, MPH | Policy
    • Doctors and disability insurance: Protecting your income

      Amarish Dave, DO | Finance
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
  • Recent Posts

    • Doctors and disability insurance: Protecting your income

      Amarish Dave, DO | Finance
    • Emergency care nightmare: the urgent need for experienced nurses

      Rachel Basham, RN, CCRN | Conditions
    • Physicians have no autonomy. Here’s how to change that.

      Diane W. Shannon, MD, MPH | Physician
    • Understanding intersex health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The erosion of patient care

      Laura de la Torre, MD | Physician
    • Debating the role of psychiatric assessments in medical decisions

      Christian Youssef & Francisco M. Torres, MD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

A frustrating patient, and how that affects her physician
74 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...