A Cancelled Appointment

The call from one of the big city radiologists came out of the blue. A patient of mine at one of the boarding homes had seen a surgeon about an abnormal mammogram and a stereotactic biopsy was recommended. As the primary physician, I was the one who had to order the test. I was in the middle of something when I got called to the phone for Dr. Dinsmeyer’s call.

“This patient, Suzanne Brown, referred for a stereotactic biopsy…”, the radiologist began, “… I looked at the films and I don’t think she needs one. This is benign. I’d like to cancel the procedure.”

I explained that I was just the middleman, and had ordered the test based on the surgeon’s recommendation. The whole exchange didn’t take two minutes, and I went back to what I was doing, feeling terrible about Suzanne travelling to the city for nothing. She doesn’t get around all that easily in her wheelchair.

Yesterday at the boarding home as I began my rounds, I found out that Suzanne was on her way to the city for her breast biopsy.

My heart sank. I had thought Suzanne was at the breast clinic when Dr. Dinsmeyer called. If the appointment wasn’t until yesterday, did the breast clinic assume I would contact the boarding home about the cancellation?

Just then the breast clinic called. “We have a Suzanne Brown here, but her procedure has been cancelled.”

“Let me talk to her”, I said. Very carefully, I explained to Suzanne what had happened when Dr. Dinsmeyer called me. I apologized for the confusion and her inconvenience, adding that she did get some good news after all from a full-time breast radiologist about her mammogram findings.

She seemed okay with that, and I was left more with my own concerns about how errors in communication like this might be avoided in the future.

Today I had most of the afternoon blocked off for one of my least favorite things to do as a doctor, a deposition in a case where a patient of mine is suing another community member for injuries from a car accident a year and a half ago. Two city lawyers and a court stenographer were scheduled to grill me for three hours in our combined lunch and conference room.

I waited and waited, wondering if the attorneys had underestimated how long it takes to drive down here from the city on winter roads. Twenty minutes into our scheduled appointment, Autumn called my patient’s attorney’s office to see if they were delayed.

“It’s been cancelled”, she announced after a brief phone call, “last week – they just forgot to tell us!”

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Osler said “Listen to your patient, he is telling you the diagnosis”. Duvefelt says “Listen to your patient, he is telling you what kind of doctor he needs you to be”.


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