My friend, who fancies himself a bit of a comedian, is busy in obs/gyn these days. Normally his sense of humor endears patients to him. However, he REALLY misread his cues yesterday when he quipped to woman presenting in mid-labour..”sooo just so you know, the chart says your pregnant…hope that’s good news for you.”
AT least the nurses and the husband had a laugh at his expense.
One of the nurses in my clinic told us about her recent experience while working with an OB-GYN doctor. I can’t verify the authenticity of the story, but it was too gross NOT to share with you folks…
Dear OB doctor whom I have never met and who operates a practice in a nearby town:
Let me get this straight. A woman can have 3 positive urine pregnancy tests at home, plus she’s been trying to get pregnant, plus she has always had regular periods plus now she’s missed the last two periods… and yet you are still going to require her to “see her personal physician (or a local ER or Urgent Care) to have an official urine pregnancy test result in her chart” before you will accept her as a patient in your OB clinic?
WHAT THE FUDGESICLES??
Are those OTC home pregnancy tests just too unreliable for you? Too many false positives lately on the old pee-stick? So surely the Urgent Care’s urine pregnancy tests will be more accurate, right? (WRONG)
Or perhaps you’re tired of all those malingering pseudopregnancy patients, all trying to pretend they’re pregnant, waddling in with pillows stuffed under their maternity clothing and waving faked-up urine pregnancy tests (all forged up with pink magic marker) and hoping they can con their way past the ultrasound because they really REALLY want to see what a c-section feels like?
Oh, oh! I know what it is! You must have a nice kickback deal going on with the insurance companies — they’ll pay you a sweet little bonus for every patient who has to waste her time and mine just to have a doctor declare, “Well, whaddayaknow, you’re pregnant alright!”
Oh my, just a moment. Perhaps I’m being too tough on you. Perhaps the reason is simple: your clinic has run out of urine pregnancy test kits to use in your own office, and you’re too lazy to order more of them?
Well, whatever your reason, I dare you to send another patient to me for this frivolous reason. Cuz I’m just itching to pour all this dripping sarcasm into an official letter and mail it to you (with a copy to the patient’s insurance company, pointing out how you’re wasting the company’s resources on a pointless doctor visit and lab test that you could’ve done yourself). So bring it on.
ATTENTION FEMALES OF THE WORLD:
You know those over-the-counter home pregnancy tests? Those little sticks you pee on when you miss a period? Well guess what? Those are the exact same tests* that we use to test your pee when you come bustling into the Urgent Care, demanding a “more accurate” pregnancy test to “confirm” the 2-8 tests you’ve already done at home.
*Only difference is, we get to bill you/your insurance exorbitant amounts of money for the test supply and performance. Yay.
And don’t get me started on the “But, but, but I want a BLOOD pregnancy test!” blather. Yes, there is such a thing (it’s called a serum HCG test), but the only medically-useful one is the Quantitative HCG (which is used to determine HOW MUCH pregnancy hormone is in a pregnant woman, especially in cases of suspected miscarriage or ectopic pregnancy). The Qualitative HCG (“Yes” or “No”) is no more accurate than the urine HCG test that you already used — although it can be useful in situations where the urine HCG test is “inconclusive”.
TRANSLATION: YOU DO PEE TEST AT HOME, IT SAY “YES” OR “NO” PREGGO, YOU NO WASTE YOU MONEY AND MY TIME WITH SAME TEST IN CLINIC.
If you are 3 months pregnant, and have been bleeding “like maybe I’m having a period even though I’m pregnant?” —
The correct thing to do is go see a doctor right away.
The tragically-sad very-wrong thing to do is to “just keep on using tampons for 4 days, but it won’t stop.”
(This 20-something woman had been pregnant once before, but had no idea that “heavy vaginal bleeding during pregnancy” is almost always BAD. Tough conversation.)
At my medical school, students do 1-2 half-days a week during their OB/GYN rotation at the county health department. I had OB as my first rotation of third year, so I was at the health department the very first week. My first few exams were supervised by attendings or residents, but once they were sure I could do it, they let me do them on my own (with a nurse chaperone, of course).
So I go in the room for my very first unsupervised pelvic exam. It was on a young girl who was 11 weeks pregnant with her first child, and she didn’t speak any English. She was very nervous.
As soon as I inserted the speculum (before I even opened it), she started bleeding. I’m not talking a spot or a little blood on the pap smear brush. I’m talking flowing. Remember, this is the first or second week of my third year. Alls I know is: bleeding pregnant lady = bad. So I calmly turn to the nurse and said, “could you please go get me a resident? Like RIGHT NOW?”
*sniff sniff, blows nose loudly* Good story!