so... early last week whilst I was going about my daily routine trying to finish up with ward work for the morning, I get a call from the radiology registrar. " Hi, I need to see if you still want this CT-scan to go ahead because Mrs XXX's renal function is deteriorating" "Mrs Who??" "Mrs XXX, she was here 3 months ago...." "......er....I have no idea who she is.." " well, ask your registrar, it has her name on the request slip, thanks *click*
me to registrar,' erm, I got a call earlier about some lady needing a Ct-scan, but has deteriorating renal function, do you still want it to happen?" " well, shes got pancreatic cancer, she is 87, she definitely needs someone to be following this up, th escan dosent have to happen urgently, but it needs to happen"
a few phone calls later and another few visits to the radiology registrar, I have yet to make sure this woman's cancer is beign watched. Radiology refuses to schedule a scan until they have evidence that the lady is fit to have it, patients GP is 'part-time' and therefore will not be at the clinic often enough to constantly monitor the renal function and book a repeat scan. Also, patient is NOT IN HOSPITAL.
This situation has bugged me for quite a bit mainly because of individuals refusing to take ownership of a patient who has clearly been seen by them, and NOT ME. Radiology throws at me stupid excuses of rare reactions to contrast if someone's renal function is not up to scratch, GP gives me excuses about the part-time employment. Why can't the stupid radiology registrar just book a date, so that at least some sort of follow-up is in place. Why can't the GP who is in the community just add a reminder to one of her GP programs that is so sophisticated these days?? why am I loking after someone, I have no clue about, let alone not a patient of the HOSPITAL?????
Here I am, in the middle, having to ensure that this lady's cancer is not left to fall through the cracks. She's 87, probably not fit for surgery, and my registrar reckons she might do with radiotherapy?? even non-invasive, it it not without its side effects as we all know.
this is ridiculous. a woman with cancer, and no one seems to care, just because she's not sitting in front of them. I wonder, how many patients are unfortunate enough to fall through the cracks like this woman?? How many individuals have missed out on early diagnosis or intervention, because someone far away decides that a scan needs to be cancelled, and then left up to some one else, in this case me, who has no familiarity whatsoever with this person to make sure things are in order. Am I handling this because it is my responsibility as a doctor with a duty of care to this patient who's notes happen to fall into my lap OR am I handling it because I am a fellow human being?? if so, why are the others shifting responsibility?? am I trying to do the same or convince myself that I am not by putting my thoughts into words to seek clarity...I do not know.