Clearly my penmanship needs work

*phone rings*

Me:  Yes?

Billing staffer:  I can’t find the diagnosis code for malaria.

Me:  Malaria?  Why do you need the diagnosis code for malaria?  We don’t have any patients with malaria.

Staffer:  Isn’t that what you wrote on the billing form for [healthy, thriving patient]?

Me:  Noooooo!  That’s “miliaria”!  “Miliaria.”  As in, “heat rash.”

Staffer:  Oh.  That’s very different.

Me:  Yes.

Russell Saunders

Russell Saunders is the ridiculously flimsy pseudonym of a pediatrician in New England. He has a husband, three sons, daughter, cat and dog, though not in that order. He enjoys reading, running and cooking. He can be contacted at blindeddoc using his Gmail account. Twitter types can follow him @russellsaunder1.

59 Comments

  1. In 11th grade, I had a substitute administer a U.S. History exam. I walk up to the desk and turn in my exam. She looks at it, kind of turns the paper like she’s trying really hard, and says, “So I see that you’re planning on being a doctor.” I, with no clue what on earth she’s talking about, “Huh? No, not really.” Her, “Well, you should really consider it.” It took until I got back to my desk for it to hit me.

    Since then, my handwriting has improved (depending on your definition of that word) enough to garner the exclamation, “I’m pretty certain this says, ‘sex tapes,’ but I’m also pretty certain you didn’t write ‘sex tapes.’ This is either the worst-best or the best-worst handwriting I’ve ever seen. And I don’t know which.”

  2. >Since then, my handwriting has improved (depending on your definition of that word) enough to garner the exclamation, “I’m pretty certain this says, ‘sex tapes,’ but I’m also pretty certain you didn’t write ‘sex tapes.’ This is either the worst-best or the best-worst handwriting I’ve ever seen. And I don’t know which.”

    Tis totally cracked me up.

    • We have an EMR, and it’s for reasons such as the one above why they are so important. It doesn’t interface with our billing system, however, so our billing forms are still filled out by hand.

      • > It doesn’t interface with our billing system, however

        RANTY IT GUY IS RANTING.

        • I wish every place I ever worked had a ranty IT guy, instead of an irritable this-is-how-we-do-things-so-shut-up-and-put-up IT guy. (With the notable exception of my husband, whom I met while he was the IT guy at my workplace. He is indeed irritable, but he likes things that interface with one another.)

          • he likes things that interface with one another

            (Whistles, innocently.)

        • Let me put it this way.

          Let’s say I win the lottery, the uber-billions, and for entertainment I buy my way onto the board of Major Healthcare Providing Corporation.

          Some day, someone from the IT department is called to present a status update for the board, and they pull out a laptop and start running through a presentation and on slide 4 there’s a systems diagram that notes that the EMR system they’re rolling out is not connected to the billing system by a line.

          I would stop the presentation, and ask quite bluntly when the billing system and EMR system are going to be integrated. If the answer is, “that isn’t in the project scope”, I’m going to find the committee that drafted the project scope, and I am going to yell at them for much longer than is socially allowable even given my extreme latitude as crazy rich guy.

          • familiar with Hipaa? I’m not super familiar, but I think it’s relevant.

          • At my previous job, they were integrated. Where I am now, they are two totally separate programs.

            As I understand, one of the upcoming EMR “builds” will be an interface between the two.

          • Yes, I’m familiar with HIPAA. It’s crappy law, by the way. Not as bad as SOX, much worse that FERPA.

            If you want to be more covered from liability, you would definitely want to have a uniform system.

        • A) I like IT guys like Pat.

          B) I don’t know if anyone else has noticed, but Mike Schilling’s been on a roll lately. Dude’s gonna owe me a new pair of pants if he keeps it up.

          • I have noticed. The guy cracks me up, even when I don’t comment.

      • My wife works in informatics and constantly has to deal with things like this from the docs too old school/lazy/crotchety to conform to new regs.

        • Try providing IT to a university with tenured professors.

          • Every tenured professor I know is easy-going and open to change. They wish to explore new ideas and new ways of doing things. Your job must be unremittingly pleasurable.

          • Rose,
            you know that’s the problem, right?
            “Oh sure, now test this on every platform we’ve got. We’re going to release it to The World, you see!” (Sun, Irix, Linux, Mac, Windows… and pray it works on everything else!)

          • It just occurred to me that I have not read A Wrinkle in Time before IT got its new meaning. Could be an entirely different book.

          • “Every tenured professor I know is easy-going and open to change. They wish to explore new ideas and new ways of doing things. Your job must be unremittingly pleasurable.”

            I have it better than most, to be certain. But that’s an aside.

            This, by the way, was *hilarious*.

          • Try providing IT to a university with tenured professors.

            True story here.

            A few years ago we all had to submit our updated CVs to the administration in electronic format, to keep the accrediting agency happy. Old English prof says, “who’s going to type this on a computer for me?”

  3. Two quick observations:

    1. Having a post titled “Why male circumcision is (sometimes) morally kosher” immediately followed by one titled “Clearly my penmanship needs work” is space awesome.

    2. If it had been me, the last line of this dialogue would have been followed by disappointment that I hadn’t just gotten something really cool to work on to break up the day to day. This is one of many reasons it’s a good thing I’m not a doctor.

    • That tension between “cool” and “oh, dear” informs the experiences of many medical providers.

      A while ago we had a patient who had been diagnosed with leprosy. (Yes. Leprosy.) We are all very glad when that diagnosis was eventually overruled by another physician (and were all a little skeptical to begin with), but it was ever so slightly disappointing, too. (Lest you think us heartless ghouls, leprosy is actually much more curable than the Bible might lead you to believe.)

    • >1. Having a post titled “Why male circumcision is (sometimes) morally kosher” immediately followed by one titled “Clearly my penmanship needs work” is space awesome.

      Heeee!

  4. Prelude: One of my cats is named Bustopher (More specifically, Professor Bustopher Jones IV*. There were no other Bustopher Joneses, professors or otherwise. This is not relevant to the story.)

    [Phone Rings]
    Vet: Hello. Is this Butt Stuffer’s owner?
    Wife: What? No. Who?
    Vet: You aren’t the owner of Reese and Butt Stuffer?
    Wife: [aside, to me] She thinks Bustopher is named Butt Stuffer.
    Me: [to wife] Let me handle this. [Takes phone]
    Me: [into phone] Yes. We are Butt Stuffer’s owner. [aside, to wife] Best. Name. Ever.

    * Super double bonus points to anyone with any sense of where this name is derived from. NO GOOGLING!

    • I love this. Love, love love it.

      And my dog is named Flippy IV. But she really is the fourth Flippy. The Flippys in my family date back to the 1920s.

    • Bustopher Jones is not skin and bones. In fact, he’s remarkably fat.

      Does it help that: 1) I am gay? 2) My Dad is from England, so I was exposed to “Old Possums Book of Practical Cats” at a young age? 3) I went through a regrettable Andrew Lloyd Weber phase in junior high? (See point 1, above.)

      Also, this comment made me giggle for at least two minutes, nonstop. I am not exaggerating.

      • >Also, this comment made me giggle for at least two minutes, nonstop. I am not exaggerating.

        I know. Me too.

      • Ding, ding, ding!

        The truly unfortunate reality is that we named Bustopher that when we thought she was a he, only to find out later we were wrong. I suddenly went from thinking many of her behaviors were cool and badass to thinking they were annoying and bitchy. I realized I was sexist… against cats.

        • Our first cat Charlie started off as Barbra till Mom explained. When I was little I thought cats were girls and dogs were boys

          • “When I was little I thought cats were girls and dogs were boys…”

            … you mean there’s more to it than that?!?!?!

    • Phone rings at our house. I answer.

      “Hello.”

      “Hi, could I speak to Shoney L—-?” [L—- is a family member’s name. I think the caller just said “Joni,” maybe. But then… hmmm….]

      “I’m sorry, who?”

      [Slower.] “Shoney L—-.”

      “Oh. Shoney L—- lives in North Carolina. And he’s also a cat.”

      • Okay, this is no Butt Stuffer. But it’s related. This happened a year ago.

        Phone rings.

        “Hello?”
        “This is the disability department from Social Security. Could I please speak with Mr. [son’s name]?”
        “I’m his mother. Can I help you with something?”
        “You are not an authorized representative to speak for Mr. [son’s name]. We will need to speak directly to him.”
        “He’s a severely intellectually disabled 19-month old. He’s not much of a talker. He can make a sign for ‘Twinkle, Twinkle,’ if that helps.”
        Pause. “In that case, you’ll need to come together to the office and have him sign documents authorizing you as his representative.”

        • The result of an incident in (IIRC) 2002 that is substantialy similar to these “Bustopher,” “Shoney,” and “Twinkle” stories, that gave birth to the internet pseudonym under which I write to this day.

          • Oh, God, I’m going to read your moniker as “Butt Likko” for at least a week now.

      • I’ve gotten pre-approved credit card applications in the name of our Shih Tzu. I’d return it if I knew what he’d want to buy.

    • One of my cats was named “Orion”.

      He was perpetually being called “orry-ahn”, except for the one vet tech that called him “Onion”.

      • That’s how the town of Lake Orion in Michigan is pronounced. Maybe everyone in your vet’s office were Michiganders?

        Michigan folk, by the way, can’t master the pronunciation of Oregon, even though it’s precisely the same as Muskegon. Weird folks.

      • i.e. the Butt Sniffer thing. Tears to my eyes from laughing so hard funny.

    • I’m glad Butt Stuffer’s story is resonating! Probably my favorite story of the past year, which is saying a lot seeing as how I got married, bought a house, and moved. We still call her that every now and then…

      • Kazzy, this was a wretched day of being sick, and our nanny called in sick, and I had to grade a mountain of papers, and I read far more about lubrication and genital injuries than I had hoped, and I had to live with the knowledge that I had brought that last on myself.

        In that morass, Butt Stuffer was a ray of light. I thank you.

  5. … we forgot how much Advil the doctor had prescribed my husband…
    So we called him back, got the nurse on duty…
    her comment: “The dosage he’s written here is a horseshoe. Let. Me. Go. Get. Him.” (as in, he actually drew a horseshoe rather than writing down an acceptable numeric answer).

    • “You have nothing to worry about. The last patient I gave one of those to won the Kentucky Derby.”

      (No credit for that one; in fact, 10 points from Gryffyndor if you don’t recognize it.)

  6. I didn’t know Emily Litella worked in medical billing these days.

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