Myself and a colleague who is a psychiatrist have decided to diagnose and name a brand new disease. (Just like that hilarious Monty Python sketch – “E Henry Thripsaw’s Disease“). At my hospital we have an enormous amount of people suffering from a terrible affliction where patients experience the need to storm into the ER and verbally accost the RNs and secretary as to when they will be seen, demand that specific specialists be called immediately upon their arrival (like plastic surgeons for tiny superficial lacerations) , ring the call bell every five minutes, ask a million questions about the food, TV, and magazine selections, expect CT scans and x-rays to be read within 30 seconds of their completion, to hover over us as we try to do our charting, and a litany of other severe symptoms that surely need to be treated.
These people should be branded with this disease so that medical personal can better develop treatments for them.
The disorder is to be called “Entitlement Disorder” and should be assigned a diagnostic code. Treatment that I propose includes:
1. A dose of reality – done by making them sit extra time in the waiting room while real emergencies are dealt with
2. Foley catheters – So we can monitor their precious urine output – and we would not want to use much surgilube since that can “interfere”.
3. Large bore IV’s – because you can never have too large an IV line.
4. Baffling them with Bullshit – Coming up with all sorts of medical terms that they don’t understand (although they tend to look them up on their Blackberries and ask more questions).
5.A Kick in the Ass – something we would all love to give them but alas, insurance is unlikely to pay for it.
In my ED we have found a string of new afflictions…
It all started with acute vicopenia in the 1990’s, that has now mutated to acute percopenia. We are even seeing cases of dilaudopenia now
I know it would violate HIPAA all the way to hell and back, but it seems to me these people need a special waiting room, one with a two-way mirror looking in on the rooms where you’re caring for the truly sick and injured — the rooms where you put the MVA victims. Let them watch the blood fly around while they’re waiting to be seen for their twitchy elbows and stuffy noses.
When we visited the ER last weekend-I rushed in carrying my 5 year old with a towel wrapped around her head- both of us covered in blood- There was a family of 4 trying to get checked in-somebody might have had a runny nose- but whatever it was, did not appear to be very serious- as there was no blood,vomicking, screaming or crying-
The front desk people immediately started assisting me- since obviously, I was having a true emergency- and I am very thankful for that-
However, that family of 4 looked at me with an evil-I dare you look!
Luckily, a RN came out and took us back immediatly so, we didn’t have to sit in the waiting room and get glared at by the people with the runny nose!
“The disorder is to be called ‘Entitlement Disorder’ and should be assigned a diagnostic code.”
Foolish.
80-120 million afflicted in the USA, alone! Secondly, 98% are ego syntonic with its’ characteristics. Therefore, it is as effectively cured as Pancreatic Ca, regardless of the treatment.
The best you can do is to isolate yourself from it, as it is contagious.
Predilections include Irresponsibility, Egalitarianism, and Lack of Integrity.
Despite following infectious patterns of spread, it is definitely familial.
Truth, Reason, and Faith are know to confer modest protection.
If you don’t believe me, you very well may be so afflicted, already… and it won’t be helpful to call your lawyer to see if they can shut me up.
Some identifying signs of the disorder:
1) hinge sign – where the patient leans against the doorsill of his room and swings in and out as you go by.
2) relative hinge sign – see above, except involves a relative.
3) curtain crack syndrome – patient opens the curtain at least 30% to watch their case progress.
4) Patient murmur – Occurs when you are with aother patient in the next room and the patient is loudly overheard complaining about the wait/care/doctor/nurse/food/cleanliness/lack of pain meds. Graded on a scale of 1-6.
5) How-do-you-do sign. Patient or relative comes to nurses station and engages busy staff in meaningless banter.
6) Administrator sign – when the end of the visit results in the patient giving the customary salutation “I am a friend of the CEO of this hospital and he is going to hear about this”. Often followed by a visit from a representative from the carpeted section carrying a clipboard with the standard voluminous “You are a meaningless piece of crap for insulting one of our guests” paperwork.
7) Hyperdocumentation – when the patient starts writing everything you say down, for their lawyer.
(By the way, why is the only verb applicable to arriving at the Emergency the verb “to rush”? Most of the people rush to the ER to wait for hours. Evening news shows love that verb!)
And, ED Pharmacist, not to quibble, I believe the correct term is hypodilaudidemia referring to the low level of dilaudid in the bloodstream. I believe dilaudopenia refers to my prescribing habits for this syndrome.
IglooDoc
Everyone expecting to be treated like royalty is a common problem that is a ’side effect’ in western democracies such as the US…i.e, by wooing, pandering, and propping up the average Joe, and the lowest common denominator by:
-government (‘voting and politics’… giving us the appearance that individuals have ultimate control),
-media (‘call in talk radio’, asking the average person on the street ‘what do you think?’, and ‘everyone’s 15 minutes of fame’) and
-Big Business by pandering( ‘comment cards’, and ‘Have it your way!’ mentality, etc.)
all constantly tell us we are very important…it just creates a monster in the end… like a spoiled, bratty child. thus, bad behavior when we don’t get our way! And I know, I’m a baby boomer and we are the worst!
In realty, we are just not that important…but that is hard for the endulged, puffed up ego to swallow.
[...] keeps pumping out the posts. My favorites from the last week were Entitlement Disorder and Medical Malapropisms – including the comments. The only one I didn’t see there was [...]
Haha, awesome!
I did go to the ER once with acute pain in my flank. I was very nauseous and thought I would throw up. I did retch at home before getting to the ER. You people might think I was just “entitled” or it was “all in my head”, but it turns out I had a kidney stone.
It did take 2.5 hours to get some pain meds. I begged for some pain meds from the triage nurse and said then I would be happy to wait my turn. No meds for me.
Men who have had kidney stones say it is the most painful thing they have ever had. Women, including those with children, say the same thing.
Sorry to bother you with my kidney stones that are “all in my head”.
It took 2.5 hours from the time I signed into the ED to get meds. Yes I tried the standard Tylenol, which did nothing to take the edge off.
Bulrush, the entitlement I am talking about is not people who politely ask in triage when they might be seen, it is those who storm in waving their fists and shouting that they know somebody on the board, etc. It is made worse when they are there for something like nasal congestion.
We have seen a big increase of calls to 911 swearing up and down when we arrive how slow we were and that they are dying and need to go to the hospital now!! even better the call is usually a person bumped their head a week ago and now has a headache but yet no other symptoms ohh and they have a history of migraines even worse is we arrive and find two drivable cars in the driveway and 3 capable drivers in the house. I always think “it sucks that the call that just went out for a possible MI has to wait till one of our rigs can get back in service “
[...] Entitlement Disorder(tm) is a pervasive problem. It rears its ugly head on a regular basis causing distress, severe annoyance, bouts of nausea, and insufferable vexation in health care providers when they are faced with it. There are several ways of dealing with it but generally the preferred treatment, a swift ass-kicking, is not a viable option in the health care setting. Reactive sloth among us treating such patients is much more common. This occurs once ignoring fails. [...]