The totally off-topic thread

[Pushka]

IMO then totally unprofessional, nothing that would help you with your condition/symptoms.

It was almost like he was trying to impress me with his generosity.
He made some very disparaging remarks about the public hospital I attended. And the clinicians I saw. A Dr should not say that to a patient, especially a new patient, and as the opening conversation.

 

[JohnK]

Wash your mouth out....and you too JohnK. Not liking cats, what is the world coming to? :shock:

Isn't that par for the course?

Don't worry I've got a head start on you.

 

[coco50]

You drank all that and still posting?

I'd say posting mortem!

 

[QF WP]

It was almost like he was trying to impress me with his generosity.
He made some very disparaging remarks about the public hospital I attended. And the clinicians I saw. A Dr should not say that to a patient, especially a new patient, and as the opening conversation.

I'd be looking at either the AMA or the industry body that represents their specialty. I'd say that they could have breached either Medical Professionalism or Ethical Guidelines for Doctors on disclosing Medical Records as I'm sure the patient hadn't given consent.

 

[Pushka]

I am looking at speaking with a couple of Medical Specialist friends about the appointment in general yesterday plus the GP who referred me. I was put in an untenable position by his diatribe on the Hospital staff and accusations that they were idiots. Yes. He used that word. Requiring me, the patient, to presumably try defend a diagnosis from two other specialists and two radiographers. At one stage I said 'I am just the patient here listening to my Doctors. What do you expect me to do now?'.

It was an awful appointment. The leaking of another patients details was just a part of it.

 

[medhead]

I'd be looking at either the AMA or the industry body that represents their specialty. I'd say that they could have breached either Medical Professionalism or Ethical Guidelines for Doctors on disclosing Medical Records as I'm sure the patient hadn't given consent.

to what end? what will this achieve?
Certainly the doctor did the wrong thing. But there is clearly something else involved as Pushka's subsequent posts imply there was some reason for the doctor to explain themselves. Knowing the name of the other patient isn't that important really, unless Pushka personally knows that other patient. So John Smith has some condition - great. Then what? How is that information going to be used by Pushka to disadvantage the other patient? Is it even going to be disclosed at all?
About the only thing is the potential that the next patient will be told about Pushka's personal situation. What are the potential negative risks if that happened?
If anything, surely the starting point is to informally raise the matter with the doctor - "I don't think you should've told me all that info about the other patient". Perhaps follow up with their complaints procedure.

I am looking at speaking with a couple of Medical Specialist friends about the appointment in general yesterday plus the GP who referred me. I was put in an untenable position by his diatribe on the Hospital staff and accusations that they were idiots.

Yes. He used that word. Requiring me, the patient, to presumably try defend a diagnosis from two other specialists and two radiographers. At one stage I said 'I am just the patient here listening to my Doctors. What do you expect me to do now?'.

It was an awful appointment. The leaking of another patients details was just a part of it.

Maybe they are idiots? I've heard widespread general commentary about the uselessness of one particular hospital to the north of Adelaide. It's like an open secret to never attend that hospital. There aren't many public hospitals in Adelaide that you might have attended.
Has he offered a different diagnosis? I seem to recall there is some uncertainty about your particular condition? Presumably this is why you're at another specialist.

 

[Cruiser Elite]

Windows 10 updates - maybe this is what happened - Microsoft nasty trick.

If posted before Mods please delete.

 

[drron]

It was almost like he was trying to impress me with his generosity.
He made some very disparaging remarks about the public hospital I attended. And the clinicians I saw. A Dr should not say that to a patient, especially a new patient, and as the opening conversation.

Personally I feel you should see another specialist.With attitudes like that it is very likely that he wont acknowledge his own limitations and to me that makes him dangerous no matter how much knowledge he does have.
But secondly because he is obviously not a very nice fellow without the ability to relate well to his colleageues or patients.

 

[Pushka]

Yes drron. Thanks for coming in. I agree and will do this after a break in Queensland. I am very much doctor weary right now, exhausted actually and to have them squabbling over test results in front of me is ridiculous.

Medhead - yes agree there are idiots in the public health sector. But this guy called everyone who worked on the diagnosis as incompetent. That includes 2 GP's, two ultrasonographers, two private radiologists plus an unknown number of PH radiologists, three clinicians, the Medical Consultant plus a Haematologist. ie everyone but himself. Because he said my condition was rare. I effin know that, I always knew that but that doesn't mean it didn't happen.

Oh. He also said the hospital should have done a venous xray of the clot. The hospital said they would not do that for fear of having the clot break and go to my heart first or then lungs (PE). He said - "big deal, so it goes to your lungs and you get a PE. Thats manageable, its not like it would go to your brain and you would stroke or anything". This guy is not a haematologist btw. Can you tell?

After a perfunctory examination during which time he talked of the other patient he said 'ABC' caused my condition. So he had agreed that the condition did occur and latched on to something convenient as a causal factor. I know if I was obese or smoked he would have used that excuse.

And in defence of the PH personnel, they have always treated me with respect. They have called me and followed up after I left Hospital. They care. I had complete confidence in them. He tried to destroy that. That was not his task to do.

 

[medhead]

Yes drron. Thanks for coming in. I agree and will do this after a break in Queensland. I am very much doctor weary right now and to have them squabbling over test results in front of me is ridiculous.

Medhead - yes agree there are idiots in the public health sector. But this guy called everyone who worked on the diagnosis as incompetent. That includes 2 GP's, two ultrasonographers, two private radiologists plus an unknown number of PH radiologists, three clinicians, the Medical Consultant plus a Haematologist. ie everyone but himself. Because he said my condition was rare. I effin know that, I always knew that but that doesn't mean it didn't happen.

Oh. He also said the hospital should have done a venous xray of the clot. The hospital said they would not do that for fear of having the clot break and go to my heart first or then lungs (PE). He said - "big deal, so it goes to your lungs and you get a PE. Thats manageable, its not like it would go to your brain and you would stroke or anything". This guy is not a haematologist btw. Can you tell?

After a perfunctory examination during which time he talked of the other patient he said 'ABC' caused my condition. So he had agreed that the condition did occur and latched on to something convenient as a causal factor. I know if I was obese or smoked he would have used that excuse.

And in defence of the PH personnel, they have always treated me with respect. They have called me and followed up. They care.

Look, I'm John Snow on most of this diagnosis stuff. I know nothing. But a couple of observations:
1. sonographers, I respect them but they can be pretty silly sometimes But over something other than medical things like in your case. They wouldn't have been involved in your diagnosis. Just getting the imaging.
2. Was this guy a cardiologist?
3. I don't really understand the issue for the hospital in x-ray for the clot. I would guess that venous x-ray is less intrusive than venous sonogram. Then again if you've had the sonogram would an x-ray have added any information, or changed your management?
4. That last one is my area of concern - How will the radiation exposure change the management of the condition?

Anyway for your own interest you might like to have a play around with the Diagnostic imaging pathways that they use in Western Australia (also adopted by Dubai) IMAGING PATHWAYS
I don't know any of your details, but if I look at DVT arm or leg ultrasound is pretty much the recommended imaging option. (look at Cardiovascular and then DVT options). They only suggest venography if there is a technical difficulty with ultrasound of the arm.

Or perhaps looking at the imaging pathways is a stupid suggestion, in which case ignore it.

BTW being respectful and responsive doesn't mean they can't do stupid things. Everyone has brain fades. What is probably more important is that they know when they don't know and seek help. That they referred you to this guy is another point in their favour, not his.

 

[drron]

He said - "big deal, so it goes to your lungs and you get a PE. Thats manageable, its not like it would go to your brain and you would stroke or anything".

Pushka that statement proves my first point.Did this guy know your heart was completely normal?If you have a "hole in the heart" a DVT can certainly be the cause of a stroke.Just an illustration that a doctor should be aware of their own limitations and keep questioning yourself re your competency in the various areas of medicine.

 

[Pushka]

Pushka that statement proves my first point.Did this guy know your heart was completely normal?If you have a "hole in the heart" a DVT can certainly be the cause of a stroke.Just an illustration that a doctor should be aware of their own limitations and keep questioning yourself re your competency in the various areas of medicine.

Oh I wish I had thought of that. No, he had no information about my heart. I was gob smacked he thought it was ok to risk a PE.

Will check that out medhead. I agree about sonographers but they can at least create scans if not read them. Her first reaction was a gasp and then she said there was a clot in my jugular. And consequently all those scans were reviewed by a radiologist, both privately and then at the RAH. So one scan was checked 3 times. Because everyone was sure they could not be seeing what they were seeing. I have no clue as to why this guy was so hung up about the scan. It was not his job to review that. It was just one of the symptoms. He ignored the rest.

This guy did not see the scan. He was not a cardiologist. He was a rheumatologist.

I appreciate all the input here guys and gals. I am rather shaken up by the appointment. I had no idea such specialists still existed.

 

[JohnK]

Have a $100 Myer gift card. Briefly went to Myer the other day and almost fainted.

Is there anything at Myer that is not grossly overpriced?

 

[medhead]

Will check that out medhead. I agree about sonographers but they can at least create scans if not read them.

Oh yeah, definitely seen that radiographers/sonographers know what's going on.
Just that they're locked out by those closed shop doctors unions.

Have a $100 Myer gift card. Briefly went to Myer the other day and almost fainted.

Is there anything at Myer that is not grossly overpriced?

they will price match.

 

[Pushka]

Look, I'm John Snow on most of this diagnosis stuff. I know nothing. But a couple of observations:
1. sonographers, I respect them but they can be pretty silly sometimes But over something other than medical things like in your case. They wouldn't have been involved in your diagnosis. Just getting the imaging.
2. Was this guy a cardiologist?
3. I don't really understand the issue for the hospital in x-ray for the clot. I would guess that venous x-ray is less intrusive than venous sonogram. Then again if you've had the sonogram would an x-ray have added any information, or changed your management?
4. That last one is my area of concern - How will the radiation exposure change the management of the condition?

Anyway for your own interest you might like to have a play around with the Diagnostic imaging pathways that they use in Western Australia (also adopted by Dubai) IMAGING PATHWAYS
I don't know any of your details, but if I look at DVT arm or leg ultrasound is pretty much the recommended imaging option. (look at Cardiovascular and then DVT options). They only suggest venography if there is a technical difficulty with ultrasound of the arm.

Or perhaps looking at the imaging pathways is a stupid suggestion, in which case ignore it.

BTW being respectful and responsive doesn't mean they can't do stupid things. Everyone has brain fades. What is probably more important is that they know when they don't know and seek help. That they referred you to this guy is another point in their favour, not his.

That site says it all medhead. The RAH followed appropriate protocol. This guy actually said you could not use an ultrasound to diagnose a DVT. cough.

The RAH didn't refer me to this guy, they wanted to refer me to a Physician in the RAH. This guy was private referred by one of the GP's.

 

[JessicaTam]

Pushka, based on what you have said may I make a suggestion?

Ask for a charge back on your credit card!

 

[Pushka]

Pushka, based on what you have said may I make a suggestion?

Ask for a charge back on your credit card!

Oh. JT. What a lot of fun that could be had here.

 

[medhead]

That site says it all medhead. The RAH followed appropriate protocol. This guy actually said you could not use an ultrasound to diagnose a DVT. cough.

The RAH didn't refer me to this guy, they wanted to refer me to a Physician in the RAH. This guy was private referred by one of the GP's.

It sounds pretty compelling.
But by the same token a big grain of salt is needed with my comments. You said clot in the jugular, I don't know how that relates to checking for a DVT arm or leg. there might be something fundamentally different for your situation.

 

[Pushka]

It sounds pretty compelling.
But by the same token a big grain of salt is needed with my comments. You said clot in the jugular, I don't know how that relates to checking for a DVT arm or leg. there might be something fundamentally different for your situation.

Agree. The rarity is the issue. There is little in the pubmed area about them. Either diagnosis or treatment. So they followed the only protocol that was available to them. But let's put it this way, 8 weeks after heparin and anti coags, the same vein looks completely different. I can even see a blob in the first scan, the second - it's not there. (That's my effort at medical speak). When I touched the vein when the clot was there, it was painful. It isn't now.

 

[QF WP]

The RAH wanted to refer me to a Physician in the RAH.

There's your answer . Second opinion from somebody you are more likely to trust given your past experience.