I don’t think I have complained about other providers I worked with in a while. That’s because over the past 2 years, the other providers have been great.
I do have a couple of synopses to share though. When I worked in Ohio, there was a physician there that we jokingly said he thought he was working in Grey’s Anatomy. He was a know it all that was only one year out from residency. Every single day he thought he was diagnosing a patient with an emergency disorder. For instance, one patient he thought she was having a pulmonary embolism and ordered a stat CT scan. Her only symptom was shortness of breath, which is common for patients 65+ years old. The CT scan ended up being negative. Then he had a patient that was beaten up by their son and had a bunch of bruises, pain, and swelling. The same physician thought that the patient was having compartment syndrome and sent him for a stat CT scan, which also ended up being negative.
We call this the “zebra”. It refers to medical students thinking patients have a complex problem when in reality they have a common and straightforward disorder. This happened on a daily basis and it got annoying. Because one, he made the patients nervous about something that was obviously not complex. And two, he prided himself on not referring to specialists yet drove up costs for the patients by ordering all of these expensive imaging.
Fast forward to my current job in Florida. One of the physicians is 9 months in, older guy with lots of experience. He told me he loved nurse practitioners and had a lot of them at his previous practice. I later learned why he loved us so much – he was used to nurse practitioners helping the physicians with their workload. This is completely different to our current practice where each provider, including the nurse practitioners, have our own patient panel.
Whenever he was asked to see a walk-in, he would tell them to ask me. They had to be like “No, she is already seeing another walk-in”. Whenever he didn’t like a patient, he would just have them switch to me. If a new patient wanted to come in sooner than scheduled, he would tell the front desk to schedule them with me. Whereas, I was already the most booked out provider since I was taking in a lot of new patients. So, the new patient he was trying to defer would have been able to get a sooner appointment 4 weeks earlier if scheduled with him versus me. I think he thought I was his assistant!
At our weekly meetings where we discuss our sickest patient, he always had something to say about one of mine. The patient is a needy woman, with history of cirrhosis, GI bleed, and chronic pain. He told me to make sure I am not prescribing her NSAIDs for her pain. My response was “duh”. This physician has a GI background so I was surprised he didn’t want to be this patient’s PCP. I later learned it’s because he doesn’t want any of the “needy” patients. I finally had to have a discussion with him to let him know I am not his assistant, and that he needs to learn how to manage his patient panel independently, the way I am managing mine.
Anyways, I thought it was hilarious to work with these physicians above and just wanted to share some “struggles” of being a traveling nurse practitioner.
