depressing

wow. just had a remarkable experience. thought i'd post it in order to hear the feedback of others who are in the profession.

by way of background, i've been in private practice for 5 years in southern california. did an rpr/psr, and am in a solo practice. this is my first experience with this sort of thing.

a patient called the office today, completely irate. he asked me if i had ever heard of "cellulitis," and then began to berate me for not catching his. he told me that he had seen a "real doctor," an orthopod, when his foot began to hurt a couple of weeks ago. the doctor gave him antibiotics and told him that he had developed cellulitis from an interdigital fissure of his foot. he had not yet finished his run of antibiotics, so all of this was fairly recent.

i pointed out that i had not seen him in more than two months, and on his last visit to my office he didn't have cellulitis, and also had no complaint of pain of any kind. his immediate reply was that i didn't take the time to look for cellulitis because i was in and out of the room "like a rabbit." any protests that i had in fact examined him were drowned out by a litany of complaints and accusations, varying from criticisms of my "outrageous office charges" to deprecating comments about any doctor who used "an assistant to do the dirty work."

any attempts to actually converse were thwarted by his constant shouting. i was told i was lucky he still had his foot, because otherwise he would sue me for malpractice.

i had seen this patient off and on for the last five years, and he had never previously complained about anything. my best guess is that either by accident or purposely, this orthopod gave the patient the impression that he had had the cellulitis for a long time, and that i should have caught it. the patient also took pains to point out that the "real medical doctor" had "real credentials," unlike "pretend doctors" which i took to mean dpm's.

it probably would go without saying that i do not believe the patient had an infection when he was in my office.

obviously i left the conversation with many unanswered questions... the foremost being why wasn't i given an opportunity to treat the infection when it arose? secondly, where did all the vitriol towards dpm's arise from? if we aren't "real doctors," i'm not sure why he had been coming to me for the last five years.


my best guess is that he went to his primary when he first noticed the pain, and was subsequently referred to the orthopod, who was openly critical of dpm's in general, and me specifically.

this is only a guess, and in any case i will definitely try to learn from the experience. one of my first thoughts is that i need to communicate better with the local primary care providers. also, i am troubled by the notion that my patient relations might be suboptimal. however, as i said, he had never previously expressed any dissatisfaction of any kind.

my patient base is mostly geriatric, and i count among them a number of active and retired physicians and dentists who all have referred patients to me... so i am really puzzled as i don't feel my patient and provider relations are bad. if anyone has had a similar experience or even just some thoughts on the matter i would appreciate it.

thanks.

any feedback is appreciated.