This was a phone conversation I had with a clinician many years ago. There are several like it that every pathologist can relate to. This for some reason sticks out in my head more than most. Healthcare in 2014:
Me: Pathology, Dr. Kaplan
Dr. Opening: Hi Keith, it’s Mike. Mike Opening.
Me: Hi Mike.
Dr. Opening: You or one of the other pathologists called me a few weeks ago about a case and you were concerned there may have been superficial invasion and recommended re-biopsy.
Me: Yes. I remember the case well. I did deeper levels and showed it around and we could not be definitive but we were concerned.
Dr. Opening: Do you remember the case. I think the patient’s name was…
Me: Yes. I remember the case well. The patient’s name was “Smith” [NOT real name for these purposes].
Dr. Opening: Good. I am bringing the patient back in for a biopsy tomorrow and I really need to know what it is [which would have been a Thursday]. When can you call me with results?
Me: I can call you on Friday. It takes us 1 day to get the slides as we usually process tissue overnight unless you need it sooner.
Dr. Opening: No that will be fine. So, if I do the biopsy on Thursday, you can call me Friday?
Me: Yes.
Dr. Opening: Oh, I won’t be in town on Friday. Can you call me Monday?
Me: Sure. I can call you on Monday. I will be out of the hospital but can call you from my cell on Monday to discuss the case. The results will be in the EMR on Friday.
Dr. Opening: That’s OK. I will wait for your call on Monday unless you call me on Friday.
Me: Sure. I can call you Friday. What number shall I call you at?
Dr. Opening: Give me your cell and I will call you on Friday or Monday.
Me: OK.
Dr. Opening: Or I can check the computer on Monday when I am back and call you with any questions.
Me: Sure.
Dr. Opening: When I biopsied the patient before, the mucosa looked funny. You said it looked atrophic.
Me: Yes.
Dr. Opening: The mucosa looked funny.
Me: How did the mucosa look funny?
Dr. Opening: You know, funny.
Me: No I don’t know. You said the mucosa looked funny. We don’t have a diagnosis for “funny”.
Dr. Opening: You think this is funny? How is this funny?
Me: No. This is not funny. You said the mucosa looked funny. I was worried about a carcinoma.
Dr. Opening: Yeah, the mucosa looked funny.
Before this went too much farther down a Goodfellas parody I tried to re-direct.
Me: I can rush the biopsies for Friday so they come out in the first batch of tissue processed and call, text or e-mail you with the results.
Dr. Opening: Thanks. I need to know right away but I will be out on Friday.
Me: I understand. You can call me when you can. On Friday or Monday. I will give you my cell.
Dr. Opening: OK. I will bring the patient back in on Thursday and do a bunch of biopsies.
Me: Got it.
Dr. Opening: You can call me on Friday.
Me: Will do.
I called Dr. Opening on Friday without response. He never called me about that particular case again.
Comments (2)
Domenic Triolo Dr. Keith J. Kaplan The subsequent biopsy showed more of what he had on prior biopsy – dysplasia without invasion. He was “lost to follow up” after that…
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What happened to the patient?