Do you think I should report her?

Yes! Without hesitation.

The next error in judgment she might make may cost someone their life.

Agree with anne_ct

Yes, I agree that since this doctor is a resident, something should be said. But I would caution you to tell the story in a dispassionate manner, just facts and recommending that this doctor be told about her very unhelpful manner. A resident is there to learn and this one needs to learn how to approach a patient and/or parents in a more helpful manner. I hope your daughter starts feeling better soon.

I have a bit of a different perspective on it. Maybe I'm missing something, but her responses don't seem too out of line, if maybe her tone was rude. I think that it would be more dangerous for a doctor to withhold medical information and assume that the patient/patient's family understands. While your household may be very clean, with good hand washing practices, many are not. Treating you like "I was some idiot parent who didn't know how to keep her kids safe and healthy" is just a standard (because many parents don't and need to be told in very simple terms), though I do agree that she should have an open conversation, not talk down to you. But I do think it would be irresponsible for a doctor to not tell patients about the ways to reduce the risk of spreading contagious illnesses because the patient claims to already know.

Only you can decide if her treatment deserves reporting, as we're only getting your side of the story. I can understand why you might feel offended. I personally wouldn't report someone for feeling offended as I think it's a very serious thing to do. I tend to give people the benefit of the doubt - she may have been having a very bad day. I imagine seeing tragic events in the ER can be difficult, especially for a resident who is still getting used to it. Maybe give yourself a few days to calm down, to get some sleep and make sure your daughter is recovered and then decide.

Glad she's feeling better!

I would say something - but it seems like there were several lapses here. Did anyone feel your daughter's abdominal area or listen for bowel signs? That would have been the first indication of constipation. And with your permission a quick rectal exam could have also confirmed it rather than an expensive CT scan and exposing your DD to perhaps unnecessary radiation. If the physical exam was inconclusive then a CT scan could be ordered. A good physical exam could also help determine if the pain was due to an inflamed appendix. I wonder who examined her in the ER - an experienced ER doc?

Did you ever speak with the Attending physician or just the 2 residents? Residents do make errors but actually the the attitude doesn't bother me as much as what appears to be (from what you have described) as less than stellar care.

Did anyone else in the family or her classroom become ill? I'm glad your daughter is on the mend.

Maire

Why wasn't the resident's work checked by an attending? That's what I'd address. More than anything.

Your daughter threw up again? Why?

We've had nurovirus twice in this house and perhaps it has different infection types and progressions but what you're daughter is going through is not what we went through. In both cases there was throwing up and diarrhea for 24-48 hours, some tired and weakness for the next day and then we were done. I'm not trying to judge your diagnosis (and moms do know best!) I'm just wondering.

My concentration would be on what is still going on with your daughter.

I had the Norovirus this past winter. It hit hard. I was on vacation, by myself not only did I have continuous vomiting and diarrhea for the first 24 hours I developed a fever high enough to suffer hallucinations. I drove myself home after 24 hours and when I got there DH said I was babbling. he put me to bed and I don't remember much of the next two days. Nasty illness. it does effect people differently. Some can have it with milder symptoms. It took the better part of a month for me to feel completely like myself after it was over.

I have a hard time understanding how one could have it and be constipated at the same time. At one point I just climbed into the tub with an ice bucket for the vomiting at the hotel I was staying at to contain contain everything and stay to stay clean and not make a mess of the room. Most intense intestinal illness I have ever experienced and I have had more than a few to compare to.

Thank you for your responses everyone.

Maire- I know they palpated her abdomen in the ER, it was tender all over. Don't know if they listened to it with a stethoscope, my husband is the one who took her, I got there after the doctor had seen her.

blfenton- the doctors sent her stool sample to the labs and it came back positive for norovirus. They said she was still sick and contagious when they released us but since she had kept food and fluids down since Sunday night, they sent us home.

No one else has been ill in our family and only one other classmate has been ill, started at the same time she did but got better around Thursday last week.

I do feel the care was substandard which really annoys me. We have 2 main hospitals in our area. This one is the "fancy" newer hospital and everyone always praises it.

The other, older hospital is the one I've had every procedure at and delivered all my kids at and I've always received excellent care.

We had to go to the fancy one because they contracted with BCBS to be the only in network hospital in town.

If I could go back, I would just take her to the hospital I know and trust and pay out of network.

You should tell the hospital your *whole* experience, ER forward. I'm just not sure to whom you should send a letter. I'd be addressing the top administrator, not to miss anyone! I would send a copy to BCBS because they are contracting with this hospital.

"I would send a copy to BCBS because they are contracting with this hospital."

Don't bother. I can guarantee the insurance company doesn't care. Years ago I had to have a lump removed from my right breast. It was done in a surgical suite at the hospital, but was done under a local anesthetic with IV Valium. My insurance (which, at the time, was BCBS) was billed, but I requested and received an itemized bill from the hospital.

I was shocked to see that I had been billed for 90 minutes use of the general anesthesia machinery. It was quite a hefty sum, as I recall. I called the billing office at the hospital to complain/question it, and was told that "everyone who uses a surgical suite, whether general anesthesia is given or not, is charged for the use of the anesthesia machine" because "some patients do not have insurance that can be billed. That machinery will have to be replaced some day and it is expensive, so the cost is shared by all insured surgical patients whether they used it or not."

I was outraged, and called BCBS and spoke to a supervisor in the Claims department. She told me that, no, they will not disallow that portion of the claim because it's a covered item. She couldn't understand why I was upset, because I wasn't going to have to pay any of it out of pocket. I told her I was upset because (I felt) it was stuff like this that caused our health care costs to skyrocket.

So, if BCBS doesn't care about paying for equipment/services that weren't used, they aren't going to care about a hospital's or resident's attitude.

Edited to add.... Some doctors are excellent clinicians but have lousy bedside manner. If it's a doctor you need to see again and you value the doctor's knowledge and expertise, you just have to "suck up and deal" with the bedside manner. I know that in this instance it wasn't a doctor you necessarily need to see again... just saying...

What would you say? "Boo Hoo, they were mean to me!" ? It isnt about you or your personality conflict with the resident- its about your child's care and thats all you should address.

I don't know if it's the same in the U.S., but in Canada, the newest crop of med students become residents on July 1st every year, so there's the joke that one never wants to go to an E.R. or be admitted in the beginning of July, because the graduates have just become brand new residents. (It doesn't bother me personally, as they always have experienced doctors on hand for consult anyway) If that is the case, then the residents who treated your daughter were at the very least, almost finished their first year of residency internship. I would hope one would have learned a little bit more about dealing with patients and parents at that point. So perhaps a short letter politely addressing the specific areas of concern might be appropriate.

That said, unless there is a 'life threatening' error of judgement made, you probably can't expect any feedback that the resident will be spoken to, as there are, no doubt, so many pressing concerns going on during the training of residents, that unfortunately, teaching them to have a patient, respectful and open minded attitude is probably far down the list. But it'll cost you nothing but a few minutes time, so I'd go ahead on the chance that something does get passed along. Hope your daughter feels better soon!

Go ahead and contact the hospital (head of the department, or administration) and let them know of your experience. You might be providing feedback that could prevent someone else from experiencing the frustration and exasperation that you felt.

Some doctors in training are missing the empathy/communication/kindness/relating on an emotional level-gene. They can be hyper-focused on the clinical, and miss the human component.

The best possible outcome is that your concerns and frustrations are heard by the appropriate person at the hospital, and the the resident gets corrective feedback..

This is as much a part of becoming a good physician as learning how to start an IV line or learning the cranial nerves.

I hope your daughter feels better soon. What a terrible ordeal.

I would write a letter to the resident herself instead of reporting her. She may not realize how she comes across or that she is condescending. A heartfelt letter from you may be the eye opener she needs to become a better doctor and more gentle in dealing with parents already stressed having a sick child.

I had had a very rude anesthesiologist give me an epidural when I had my first child. When I paid the bill, I put in a note that said " perhaps "Dr. Smith" can use this for a refresher course on bedside manner." He called me to apologize. Hopefully, he was more mindful with subsequent patients.

I don't know if it's the same in the U.S., but in Canada, the newest crop of med students become residents on July 1st every year, so there's the joke that one never wants to go to an E.R. or be admitted in the beginning of July, because the graduates have just become brand new residents.

****

If your "doctor" is wearing a short white coat, even worse!

That said, unless there is a 'life threatening' error of judgement made, you probably can't expect any feedback that the resident will be spoken to, as there are, no doubt, so many pressing concerns going on during the training of residents, that unfortunately, teaching them to have a patient, respectful and open minded attitude is probably far down the list.

*****

It would have to be a really, really crappy hospital that that puts this complaint in the round file. Hospitals are a business, and businesses are competitive.

Patient satisfaction is a huge factor on many levels when it comes to the viability of hospitals, their departments, their funding and their residential programs, among other things.

This is a tough situation. On the one hand, I would be reluctant to cause trouble for a resident in light of the fact that it just might have been an "off-day" for her. On the other hand, I believe it is important that the higher-ups be aware of the resident's performance (which includes bedside manner). In an ER setting, a patient/parent would be more likely to present the "full picture" to a compassionate resident...and that can often make the difference between a good and bad outcome.

A letter could approach the problem from a positive standpoint. (While this was a difficult situation for all involved, and we have confidence in R2's competence, we were taken aback by her less-than-stellar "bedside manner". Inasmuch as we realize that everyone can have a difficult day...and a busy ER certainly provides a stressful environment for that scenario...we hope that an attending physician can periodically monitor her interactions with patients/parents.)

Good luck, and I hope your daughter is well soon.

mimi, I'm in total agreement with your points. Yet sadly, there are many patient treatment horror stories that don't seem to get addressed, unless the patient suffers something that might involve a law suit. But yes, it's guaranteed that nothing will change with silence, where at least there's a chance, if one addresses the issue.

It's not JUST about the resident's attitude. There are slip-ups from the ER forward. Just lay them out in bullet points.

I'm in clinics and hospitals all the time, many of which are teaching clinics. All of the residents I've dealt with or have observed with patients have been the opposite of what you've experienced. And always, their attending has been within an arms reach to ensure proper care and training. So I echo the question asking where was their attending? Granted not every medical professional is going to have an attitude or bedside manner that is to each of our own preferences, they obviously can't make everyone happy all the time however, learning to deal with family and children during these types of situations is key and it's the attending's job to be present to teach it. If he/she wasn't it was a diservice to both you, your daughter and the Resident(s). To me poor bedside manners are a symptom of a bigger problem, arrogance and I personally believe there is room for arrogance in medicine. I would speak to someone at the hospital about all the issues you had, including the resident.

omg..talk about waiting..dd2 called be asking if i'd come and get her to take her the hospital...picked her up an hour later, and to the hospital...then came the "WAIT"....yes it was her appendix...WAIT...getting her down for ct scan to confirm...back to her er bed...WAIT...to get someone to take her up to a room...WAIT...from about 11am til nearly 4pm...I was so tired, I don't know how I got home... she didn't return t her room til 6 or so...and what po'ed me? the er wasn't that busy...thanks be her bf took her to his house...(no stairs like we have, or her condo)

I don't blame you at all...write away...

Texas_Gem, I got interupted with life earlier and forgot to say that I'm really sorry your daughter was so ill and I'm glad she's on the mend. There really is nothing worse than that feeling of helplessness when a loved one, especially one of our babies is sick. Every one deserves to receive competent medical care even when you're in a facility that is packed with Residents.

Actually, when you consider the price tag that's attached to medical care these days, I think we as a country are within our rights to expect better than what many of us end up getting.

Susan, my mother just went through a similar experience with the

"wait we need this, wait we need that, wait there's no appt until ??? available" from several doctors while trying to get clearance for surgery to remove a gland chock full of a high level fast growing cancer on her cheek. The fact that it was life threatening made no difference to the offices involved and it's now spread to her lungs. It's beyond frustrating.

I guess what I would do would be to fill out the HHCAPS survey that will be mailed to you since your DD was an in-patient. I would name names. Hospitals care a great deal about these surveys and patient satisfaction, because reimbursement is determined by their results.

sleeperblues

I guess what I would do would be to fill out the HHCAPS survey that will be mailed to you since your DD was an in-patient. I would name names. Hospitals care a great deal about these surveys and patient satisfaction, because reimbursement is determined by their results.

******

Further, we who avail ourselves of these services are actually consumers.

Your daughter was in the hospital and YOU ordered her food? How does that work? Only doctors or nurses with orders from a doctor can order them in my hospital. Families bring our NPO patients food all the time. They bring crap fast food, candy and sweets to our diabetic patients who have sky high blood sugars...sometimes this is the very reason they're admitted! I can kind of understand why she was upset. If your daughter had a blockage she could have died. Feeding her would have made it worse. I realize she had a bm but was it totally resolved and was that doctor aware of that? Yes, she didn't listen to you but maybe the doctor who gave her report didn't tell her all the information she needed to know. Not justifying the doctor not having all the info but I just see a different side.

The resident needs to learn what you said, "Listen to the patient or parent". And you need to tell someone to tell the resident that. The resident is still a learning doctor. That seems to be one thing they are not taught in school.

When my oldest son was 8 or 9 years old, he was in the hospital to get his tonsils out. He had a list the length of my arm, full of medical problems to begin with. After his surgery, he spent time in the Intensive Care section. His doctor said he was going to go home the next day, as long as he continued to improve. The next day, he was with his care giver who was talking to a resident. The resident was horrified that my son was being released. "He's critical! He needs to stay here!". His care giver said, "He's been critical since the minute he was born. Right now, he's very healthy!" The resident got my sons doctor who looked at the resident and said, "if his care giver says he's healthy, you need to listen to her. She knows her child better than anyone." Lesson learned.

You won't get the resident in trouble. You will teach her that she has to get off her pedestal and remember she doesn't know everything.

Kathy- I've never seen a hospital like that before. The doctor puts on the chart, in the computer what the patient may order from the "room service" and those are the only foods the patient is allowed to order. I didn't bring outside food in.

I WAS following doctors orders the entire time.

Also, after the initial CT scan from the ER, she had 5 additional x-rays taken by the doctor, 3 on Saturday alone, to confirm there was no blockage. These were in her charts, everyone else (nurse, charge nurse, previous resident) had seen it, she just didn't look.

Hmmmm. This is a tough one. On the one hand,residents work VERY long shifts, and are often up against ornery sick people and their families. I can just imagine how many patients or their parents come in, pages printed from google in hand, already knowing better than the doctor. It must be frustrating to them to tell a patient or their family to do one thing, and the patient/parent does the exact opposite,because they know better. (I know you said she was hungry, but maybe there was a sound medical reason to withhold food. If there was though, R2 should have told you instead of just barking at you) Perhaps you should have asked to speak to the residents attending physician. On the other hand,if your account is completly accurate, there is still no excuse for her rude manner.

Perhaps, in your highly stressed out state, you may have been a might too sensitive? (Understandable) Then reason I say that is because of the offense you took to her telling you how to avoid spreading the germs. (Your daughter WAS sick, after all. Just saying) However, if upon reflection, you decide that she was in fact, out of line, I would advise you to write a letter to her directly. There are 2 approaches you can take with this. My first instinct (and maybe yours too?) would be to tell her EXACTLY what I think of her and her manner and spare no harsh words in the process. The other, and probably the more effective one, would be to carefully explain why you were offended, and explain that why you understand she may have been feeling overwhelmed that day, you felt it necessary to tell her how her insensitive and condescending manner exacerbated an already extremely stressful situation for your family. I would tell her that you wrote her in the hope that in the future, she keep that in mind when dealing with other patients in her care. Then wait for an apology. If it doesn't come, then contact the hospital. She will not get in trouble, beyond a reprimand most likely.

ETA: The residents are all going to have to get used to patients complaining about the care they received,justified or not. It is an occupational hazard of a physician.The hospital is already used to receiving such complaints,both valid and frivolous. I REALLY wouldn't worry about anything serious happening to her.

Most hospitals have a patient liaison, I would call and report what happened and let the person do an investigation and assigned person will get back to you with the results. I had to do it to a top Boston hospital as my husband, (very healthy), started passing blood after being catheterized, I alerted the nurse who was sitting nearby interviewing a new patient and she said "Clearly, can't you see I'm busy?" To which I stated I could clearly see and I could also see copious amounts of blood coming from a healthy person with no issues in that department. To my surprise, they not only responded in a prompt manner but they gave my husband a settlement which we had never requested.

Just an update: since Tuesday afternoon, she hasn't been able to keep anything down, even with phenergan.

Took her back to the ER last night, this time at the hospital I trust that is out of network.

She was admitted from the ER and they are actively searching for a root cause instead of just watch and wait.

I hope they can figure it out soon.

sorry to hear that your big/little one is still not feeling well. Hang in there.

Oh, this is not good. How old is M?

I was concerned when you were only reporting about her severe constipation! I didn't suffer that as a child, but all my strong emotions would eventually make me 'sick to my stomach'. Didn't you recently post about your DH's father's death, and his issues with the man? (Probably nothing to do with M's ills, but thought I'd ask.)

Hope you have some good news to report soon.

Chisue- she is 8, turns 9 in a few months. She now weighs less than 50 lbs, her hip bones and ribs are jutting out. :(

Good memory, yes my husband's father passed in February. Doubt it is related as my kids didn't like him and weren't upset when he died.

Will post if/when we know more.

Wow, Thanks for the update and I hope she's ok. What a shame that you had to go out of the network in order to get care you trust. Says a lot about the insurance coverage and providers these days. So frustrating.

Here in australia with our public hospital system, you do run across annoying and disrespectful doctors (not even 1st or 2nd yr), especially in the er. After my stroke I was taken back to hospital after a blackout and the mature er doc acted as if I was taking up one of his valuable beds. My brain still wasn't working properly, and I was so frustrated with him talking over me when I couldn't get the words out. I've also dealt with junior docs who are disrespectful (although they probably don't realize they are doing it).

Honestly, does it matter? Is your daughter ok? that's the main thing. sure we would all like to be treated well all of the time, but some docs are just deficient in that area. If they made a huge medical mistake that would be important, but making a complaint because you felt offended seems over the top and it may be the doc or your sensitivity to it as to how you took the instructions. Ignore it, put it out of your mind and forget it, not worth wasting time on. If this was a junior doc, they'll learn, young people can be disrespectful until they mature more, It's no different if they are docs or not

Oh Texas, what a worry for you. My heart goes out to you and your family. I hope the problem is identified soon and is something easily fixed.

Trance, the concern for me anyways is that when a doctor is so arrogant that they feel they can treat a patient that way, they are also often closed minded, reject new practices, refuse to believe that anything outside of the realm of what they already know is ridiculous. That mind set can be and often is dangerous.

Some hospitals are excellent and have excellent docs, others less so and sometimes much less so. You can't judge by your impressions, like whether people are more friendly or if the docs are more communicative. Given a choice, you're going in for the care and not to have great conversations and to make friends. I think most people would rather have great docs who might be a bit socially awkward (so long as not too much so) than having really friendly docs whose skills are sub-par.

When in doubt, head for the nearest medical school, the standards and capabilities tend to be higher. Especially when dealing with something out of the ordinary or difficult to diagnose.

Good luck to you and your daughter, TG.

" the concern for me anyways is that when a doctor is so arrogant that
they feel they can treat a patient that way, they are also often closed
minded,"

I think docs that act like that are often about the medicine and just missing the bedside manner. They just sort of treat you like a "case" instead of a person. As long as they are good at medicine, I can tolerate the occasional disrespectful attitude. It's much nicer when you don't have to deal with it, but I think it's more important that the treatment is good quality.

Maybe I'm just used to it because we have a public health system and you do see it a bit, it's annoying as hell, like I said I was in the er trying to talk to the doc with a compromised brain and the doc wouldn't give me time to even explain what was going on. It frustrated me no end, but they called a doc down from the neuro dept to examine me so it was all good. I told my neuro guy what happened and he said "er docs think they run the hospital, don't worry about it" lol

How scary! I hope they figure out what the problem is and that it's an easy fix. I hope your bills won't be too bad with out of network. It's a shame it came to that.

First, Trancegemini, I'm really sorry you went through that, how scary. It's also pretty amazing that you can let such poor treatment in such a critical situation roll off your back like that. However, your circumstance is the perfect example as to why good bedside manners are so important. There is an increasing overall awareness about how a physicians' interactions with his/her patients' directly influence the care they are able to give regardless of what his/her specialty is.

Maybe that doctor was as you say, just being clinical but the reality is he was also a doctor who lacked empathy. And patients who are treated without (respect or) empathy usually don't have the comfort level to ask pertinent questions or explain in full what their experiencing. And in your case, was the doctor so busy being "clinical" that your input didn't matter? Either way, the result is that patient care suffers and there is a greater risk of error.

So consider this for a moment, while you were in that terrible terrible situation, what if that Neuro guy hadn't been around? What if that doctor had been the only one available to treat you during that crisis? Would the outcome have really been the same?

Edited to add: I'm sorry I forgot to say that I'm really glad he was there, you're probably ok (and I hope you are) because he was.

Texas_Gem, I will keep M in my prayers. And, yes, under these circumstances, I would report the resident. Calmly, and as concisely as possible, as Wanda, and others have said. Use the liaison at the first hospital, and walk through each step of care. I would also contact your insurance company, and explain why you went to the hospital you trust, instead of the hospital that they cover. In writing, as well as verbally. And DOCUMENT, DOCUMENT, DOCUMENT.

It is bad enough when it is adult patients that they don't want to listen to. When it is a parent of a child, who can not advocate for themselves, it is worse. We had issues with an ER Dr. when my dad was in, before he passed away a few years ago. Dr. would not listen to him. My DB & I finally slightly raised our voices. And I do mean slightly, just enough to get his attention, not enough to disturb other patients. Told him to start listening AND hearing what dad was telling him. Not just what he thought was being said because he only wanted to deal with one thing. Insisted that dad had a UTI, when blood work ect. did not show it, just because dad couldn't give him a specimen on demand. Dad worked highway construction. At that time, a port a pot was not provided. You held it until there was a bathroom available. His body got used to going at certain times of the day, and that was it, except in the morning/early afternoon after taking his water pill. And it was NOT a UTI. Dad had been in repeatedly for heart issues, and was concerned because he was having the same symptoms as previous times. Dr. just didn't want to listen. Finally told the Dr. that if he didn't want to listen to what dad & we were telling him, he could discharge Dad, and we would take him elsewhere. He finally listened. And by that time, dad's BP was out of sight.

Hope things improve quickly, and they can find the cause.

I take your point lukkiirish, and yes that er doc I dealt with was super arrogant. This hospital does have a very good neuro dept and afaik they always have docs on shift who will come to the er to assess someone when necessary so I wouldn't have had to rely on that arrogant er doc. He did come back later and told me a neuro doc was coming down and mentioned something about my stroke, at that point he was much nicer to me so I assume he realised by that time why I needed to be checked out and was less dismissive. It's very frustrating when you can't put your thoughts together quickly and people just talk over you after a stroke (happened with family members too).