I am sure this would be a familiar scenario for many of us, doctors, treating patients.
First you hear a commotion outside your clinic. A particularly angry (and impatient) patient is berating your much harassed nurse, usually about being made to wait too long to see the doctor. You can hear your nurse trying to placate, in her best diplomatic voice, the patient without making a scene in a waiting area full of other impatient and potentially eruptive patient. Sometimes your nurse loses it and sets off a shouting match before the tense situation is rapidly diffused by some one more senior. The latter would quickly run into your room to explain what has transpired outside and will usually ask if you would quickly see the obnoxious patient first (sometimes, unfortunately, the loud and obnoxious do get their way!)
And you say “yes”, just so the unpleasant character can be disposed off quickly.
And then you wait in trepidations, wondering what kind of monster will be stepping into your room.
You hear the rapidly approaching footsteps and then a series of soft knocks on your door.
You take a deep breath and say, “Come in”….
And the guy who walks in would flash you a big grin or smile as he greets you and would immediately explain apologetically why he had to create a scene outside or he would quickly recount to you the step-by-step of the apparent injustice that he suffered at the hands of the ‘entire rotten system’!!!
You would be left wondering, “What happened to the loud-mouthed uncouth fella outside?”. It’s as if the mere act of stepping into your clinic has transformed the demon into an angel instantaneously!!
Because patients tend to put on their best behaviour in the presence of the doctor in the consultation room, you get lulled into the false belief that all your patients are angels, albeit fallen ones (in the case of my patients). “They suffer’, you tell yourself, “and therefore deserve the best of my skills, my concern, my care, my everything, so that his suffering can be made less painful, even if it is for just a while more”.
And sometimes it takes a shocking story to jolt one back to reality: that angelic patients can sometimes be merely demons in disguise. Here’s a story I heard not too long ago:
A man who has AIDS has been under follow up at the clinic where I offer my services. And because he has almost exhausted every single anti-HIV drugs (also known as Highly Active Antiretroviral Therapy – HAART) there is in the pharmacy, mainly due to non-adherence to his medications, we had to source for very expensive drugs not commonly available in the country. These drugs are usually imported in and are very expensive. Next we would source for funding, because the patient would invariably be too poor to afford the drugs; either through various charitable bodies or through the social welfare department.
Once the funding has been secured, the drug would then be provided FOC to these patients.
Now, the pharmacy where I practice has a return-unused-drug-for-refund policy wherein unused medications which are not expired may be returned to the pharmacy and the price of purchase of the drugs will be refunded in full to the patient.
One such patient saw a loophole in the system which he exploited for his own benefit.
He would obtain his sponsored medications from the clinic and then a few days later, he would go to the pharmacy with a part of his sponsored medications and ‘return’ them. The attending pharmacists, usually not aware that the drugs were obtained FOC in the clinic, would then refund the money to this patient. So, in essence, this unscrupulous patient not only got very expensive medications to treat his advanced stage of AIDS, he also got a bit of pocket money on the side!! In order to get more medications, he would simply go back to the clinic and claim he was not given enough medications from the last followup!
His modus operandi was brought to light one day when a pharmacist casually mentioned him in a conversation with the doctor treating the same patient!!! The pharmacist mentioned that she found it unusual that this particular patient always seems to have excess medications to return! That was when the doctor realized this patient was doing something fishy!
Amazing isn’t it?
I still shake my head in disbelief when I think about it!
Tues, 130410 @ 2032