Friday, August 12, 2011

No Soup for You

An 18 year old male came in with a finger laceration, doing the drama dance.  "It burns!  It burns!  The pain!  I think I cut it to the bone!".  I glanced at this monstrous wound to find a tiny little laceration on the pad of his finger after unwrapping it from within its nest of  1/2 of a cut off tube sock,  and some blue string.  It was a nothing injury, not even bleeding.

Next, he handed me some pharmacy labels.  "I had a car accident and my back is really messed up.  My doctor is on vacation, so can I get a prescription for these too?".

I don't know who would ever put an 18 year old on oxycodone, but my triage note read:

"1.  Laceration.  2.  Requests narcotic refill". 

Most of the docs know that when I number the triage complaints there is probably a much longer story behind it.  The most I have ever had was 6 sequentially insignificant complaints.

Parvati didn't even put glue on his booboo.  But she did ask me to call the provider who was supposedly on vacation.  Guess what?  He wasn't.  The office manager was kind enough to share with me that the patient had called their office only this morning with a similar request for meds, but gee, he had  just been given a 'script only 5 days ago.  He was told he would have to make an appointment since that was way too soon to be thinking about a refill.  Did I still want to speak to the doctor?

Nope.  You can just go ahead and make a notation in his medical record before he automatically gets the report of his patient's ER visit.  Just another little service that we provide. 

I put a bandaid on and prepared to kick him to the curb.    But I did tell him that I had contacted his doctor, who now knows he is on the scam for more oxy.  "I'm only sorry I can't call your mother since you are over 18", I said.

"Oh, that's not good", he said, hanging his head.  He simply turned around and left, and I doubt he will be back...this week.

Thank you, Medicaid, for providing this young man with free doctor's visits, no-cost ER visits, and  the means for an 18 year old to earn some cash this summer.