Liar of the Week
DUDE: "I've been throwing up and having diarrhea for a week. I can't keep anything down."ME: Weird. You don't even look dehydrated, and you appear healthy and comfortable. "When is the last time you threw up?"
DUDE: "This morning."
ME: "Have you been able to eat or drink anything?"
DUDE: "Well, I had some pizza before I came here."
ME: So you've been spewing from both ends for a whole week, but now you are able to eat pizza and you feel fine. "So why did you come in tonight?"
DUDE: "My work made me come."
His abdomen was a little tender, so I ordered some IV fluids and blood tests. The nurse returned shortly and said "He's refusing the IV, and he wants to talk to you."
DUDE: "Can I just get a work excuse?"
posted by scalpel at 7:37 PM
10 Comments:
So what is your reply to this dude?
As a non-ED physician, I'm very occasionally presented with this dilemma. I usually flat out refuse to give a work excuse as I've not been in any way involved with the diagnosis or treatment thereof, or write a note exactly to that effect: Patient asks for this work excuse note, but I've not in any way been involved in the diagnosis or treatment thereof, therefore I can not vouch for the veracity of the claim.
I'll give anyone a work excuse that says they were in my ER during the time they were there. If they are truly sick or injured, I'll give them a work excuse for as long as they request, within reason.
This dude got the former.
NAD asks the relevant question: What did you say to liar dude? I hope it was something like "you are abusing system and possibly diverting resources away from someone who is actually emergently ill. Please do not do something like this ever again. Thank you."
Flea
I won't call someone out in real life unless I have ironclad proof. Maybe he really did just feel better. Maybe he didn't want to get a huge bill. Maybe he was afraid of needles. Patients have to be given the benefit of the doubt.
That's why I blog.
Pizza Guy will get a note saying he was in the ER on Saturday between 18:20 and 23:45 and may return to work without restrictions. To say anything more would be a HIPAA violation.
And I hope you made him wait at least that long for the paper.
Poor guy didn't even have the brains to deny the pizza. I'd say his diagnosis was "idgity-ness", heh! (Is there an ICD-9 code for "idgity-ness"???)
At least he wasn't eating pizza in the room.
ditto to scalpel. i give a note, and not a retroactive one (which is often requested... "oh, i've been sick the previous three days, can you cover me?"), stating i saw the patient in the ED.
Prehaps next time he should claim to have his period.
God, I love this blog. Thank you, scalpel. The ER I work in doesn't feel like such a solipsistic hell after I read your posts.
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