Patient encounters outside the hospital:
The Good, the Bad, and the Downright Uncomfortable!
It’s an unavoidable part of medicine. Your status as a doctor makes you recognizable in.. and sometimes unfortunately out… of the hospital. Patient encounters in day-to-day life can bring out a wide range of emotions – from delight and happiness to terror, embarrassment, or down right irritation. I’ve had all the above encounters in the 4 years I was a med student and the nearly 4 years as a doctor since. Here are a few experiences that hit all the above emotions!
My favorite “good” patient encounter outside the hospital has to do with a pediatric patient I took care of during my first year of anesthesia training. It was a winter weekend and I had been called in as backup to do a few add-on Ortho cases. The first case would be a shy but polite girl around age 8. The poor girl had broken her arm and the fracture was severe or unique enough to justify transfer (I’m no ortho surgeon) to the main pediatric hospital in the state. The parents were pretty distraught even though the outcome of the operation was expected to be excellent. My usual routine with upset or nervous patients is to ask about their hometown – something almost everyone enjoys talking about. Come to find out, they were from a “little town you’ve probably never heard of” that just happened to be the same as my wife. Of course, turns out they were friends of my wife’s parents. The little girl did excellent that day and they repeatedly thanked me for helping take care of her. I’ve since run into them at a wedding and couple other social events back in their & my wife’s hometown and each time they go on about how much better they felt that day simply feeling like they knew someone in the big city hospital they weren’t at all familiar with. It’s little things like this that make being a doctor so enjoyable.
During medical school I lived and attended school downtown in a midwest city. Where I lived at the time was fairly picturesque apartment on a canal in the city (if you were wondering some of the dumb reasons why I have $220,000 in Med School debt). However, it was surrounded by more typical very urban areas which for healthcare feed into the major county hospital just a few blocks away. We did many of our medical school rotations at this hospital, including for me – my OB/GYN rotation. It was late summer at this time and I had just finished that OB rotation. It was one of our most demanding in medical school, but I had largely enjoyed the experience – getting to deliver about a dozen babies. To celebrate the end of summer, a few friends of mine were renting a houseboat for the weekend. I offered to grab some of the alcohol in preparation. Stopping in at the local CVS – I was about to check out when I heard a group of very excited women approach me. “OMG, we remember you.. you delivered my daughters baby! Oh she just loved you!! Here, here – we have to get a picture.” I was nearly shocked with embarrassment, not just because of their heightened animation in an otherwise quiet CVS, but because I also happened to hold a giant bottle of vodka in one arm and a 30-case of cheap beer in the other (and a tank top, and shorts, and flip-flops). Before I could even put my giant-sized alcoholic beverages down, they swarmed me and sent off the picture to the daughter. Lesson learned that day was always be prepared to run into patients, no matter the location or your level of dressed professionalism. We quickly (even in medical school) can become recognizable even if training in large metro communities! So somewhere out there is a picture of a very embarrassed medical student with the mother/sisters of a patient whose baby he delivered. If you find it, let me know – I guess I should put it on my office wall someday!
The Downright Uncomfortable
My most uncomfortable out-of-hospital patient encounter involves (of course) social media. This was toward the end of my 3rd year of medical school and during my surgical rotation. As part of that month, we spent time rotating in certain “specialty” clinics. One of these was a surgical breast clinic in which our medical school highlighted involvement/training in breast exams. I was there only for 1 day, but of course ended up with a story out of it. In this case, it was a comparable aged female who was following up a breast biopsy. I did the usual H&P, staffed with the attending, then breast exam with a chaperone, then saw the patient again with the attending. The attending unfortunately took a bit of time before coming in, so I tried my best to make small talk. The patient was very “nervous” friendly, which was justified given she was there to follow-up on potentially serious biopsy results (it was negative). The whole encounter would have been fairly uneventful… but come about 10pm that night – guess who showed up in my Facebook messages! The messages weren’t weird per sue, but certainly made me uncomfortable given our similar age, the breast exam, and that she’d immediately sought me out on Facebook. I never responded, but she would send a few more messages that week – eventually apologizing for sending them at all. This was in 2012, and social media was certainly not as ubiquitous and tolerated as it is today. That said, I’d still very much recommend being extremely cautious about interacting with patients on social media.
Have you ever had a good/bad/uncomfortable patient encounter outside the hospital? Share your story in the comments!
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