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Monday, November 1, 2010

Physician falibility

When we were children we worshipped doctors as gods, and they never got over it. Pardon the borrowing of terminology from an old quip about cats. The older we get (and we are really getting old), we are recognizing that doctors are real people, and people are often mistaken. When my doctor tells me to jump, I no longer ask "How high?" Now I say, "Not until you tell me why." Well, all that verbiage is just to give you a little attitude background for the brief story I want to tell.

Barbara has voluntary surgery coming November 15 to replace her other knee. Kaiser will not let her do this until she takes all kinds of tests and quits most of her pills and takes a class to prepare her for the surgery. That sounds like a good idea, but she has already been through this routine once for her right knee, and she recovered faster than anyone else who was in her physical therapy group. She thinks she knows what to expect. But you know that bureaucracy insists on herding everyone through the same hoops, even though each case is different from the others.

She doesn't mind most of the stuff they have demanded, but it becomes very time consuming.

Today her primary care physician doubled her prescription for a certain drug that will lower her blood pressure. She thinks Barbara has high blood pressure and that makes her a poor candidate for surgery. I was there to tell her that I thought she was making her judgment on too little evidence because whenever she tries the meter at home she has rather low or at least normal blood pressure (120/60 and less).

Actually we had the preliminary discussion about this the last time Barbara saw this doctor. When we assured her that Barbara's blood pressure was low or average, she immediately assumed that our monitor was defective. She asked us to bring it into the office so it could be checked. That seemed like a good idea to us, so that is what we did today.

Her medical assistant tried the office meter and knew it was false because it gave a pulse rate of 140 when by the MA's own count her pulse agreed with the portable meter we brought to the office (80). So she tried the office meter once again, and this time instead of giving us a reading, it said "E 11). She pulled out the code chart and found that E 11 said, "Internal error". She trusted the portable meter we had brought to the office and had to report the office meter as broken.

Now the doctor is trying to tell us that Barbara has high blood pressure by using a monitor that isn't working. I thought that was humorously ironic! But the doctor still likes to assume that posture of a god, dictating terms to her surf.

Now we've learned to trust the Great Physician, whose providential hands direct the fallible physician.

1 comment:

  1. Does you Dr. remember how take blood presure the old fashion way, with you finger and a watch?????

    ReplyDelete