You instruct your patient to open their mouth and say “AHH” during the exam. Patient opens mouth, but no “AHH”. They just hold their mouth open.
“Ok, I need you to make the noise. Say “AHHH”. Good, I just need to see that hangy downy thing move around a bit.”
(Are the instructions confusing? Two parts. Part one open mouth, part two say “AHH”.)
You walk into the exam room and the patient is sitting on the stool not the exam table.
“I need you to hop up on the table so we can do a proper examination.”
(I know it’s challenging to climb your fat a@@ all the way up to the table, but do try. Pretty please, with sugar on top!)
Patient presents with no symptoms, but they know some type of upper respiratory infection is coming and they want to catch it before it turns into something.
“Well, it looks like you really don’t have much going on at this time. I can write an antibiotic for you to take if fever develops or you symptoms worsen in some way.”
(Does this lady just want to be sick? What is her deal? Using this logic we need to just go and put all the citizens in the country in prison just in case one of them might “turn” into a necrophiliac.)
Patient presents for allergy symptoms, but insists that they need antibiotics because the allergies will become a bacterial infection.
“It seems like your allergies are acting up right now. We can treat this today and I can write you an antibiotic that you can take if fever develops or if your symptoms worsen.”
(What science fiction book have you been reading where a histamine response morphs into bacteria? Give the Immunosuppressants and antihistamines a chance for God’s sake.)
I only take these pain killers when it really, really gets bad.
“I understand, but do to the contract that you signed; you can only get pain medicine refills from your pain management doctor.)
(Yeah, right. Only when it hurts really, really, really bad.)
A male patient refuses to discuss why he needs to be seen with the triage nurse. He only wants to tell the provider.
“So what brings you in today?”
(Listen dude, you are not hiding anything from anybody. We all know you are here because you have a problem with your peter. Either it is not working or it burns like hell when you pee. Rest assured though, I will not speak about this to a single person (HIPPA). However, it will be written all over this chart and the nurse that discharges you will read my discharge notes, the receptionist that schedules a follow up will read the discharge note, the billing department will read the discharge note, your insurance company will read the discharge note, and your wife who is on HIPPA can read the discharge note; so just suck it up and tell the triage nurse from the get go why you are here.)
I always try and wait as long as possible before coming in to get antibiotics.
“I know you do, but it’s good you came in now. You definitely need antibiotics at this point.”
(You wait as long as you can? For real, did you just say that? I am holding your chart “D”, and it is just about to be retired for chart “E”. You told the triage nurse that the symptoms started yesterday. Your massive will-power makes my knees tremble.)
I get a patient that has a chart full of red ink indicating allergies to every medicine known to man.
“So what medicines can you take?”
(Oh sh*#. This is going to be fun. Can’t wait to hear how that medicine made her teeth itch, and that one made her lose her eyelashes on the right upper lid, and the other one made her have a twitch to her left pinky that lasted for 5 months, and she still has a small redish-brown dot located behind her left knee from one of them; although she can’t remember which one did that.)
A patient of the fluffy variety comes in for a visit and they let you know how good they have been doing with their diet.
“Keep up the good work; it’s not easy to have sustainable and maintainable weight loss.”
(The scale shows that not only have you not lost weight; you have gained 10 pounds in four months. You don’t have to convince me that you are working on it, I believe you; but that weight taking machine in the back of the clinic; not so much. The only thing you get from continually telling me about how good the diet is going is that as long as you are talking, you’re not stuffing your face with food.)