Re: Dr. Scott Poole Woodson HS
Date: February 29, 2016 04:42PM
lisah Wrote:
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> The tyranny of doctor’s notes
>
> Russell Saunders / April 3, 2012
>
> This post is both an observation and a related
> query. I want to know if what I’m seeing is
> particular to my area, or if it’s happening all
> over the place.
>
> As one might imagine, I see patients for all
> manner of medical complaint. Some of them are
> complicated and severe, and some are minor and
> self-limiting. Because common things are common
> (a medical truism, of which we are reminded in our
> training when we go off investigating bizarre and
> rare diagnoses), I see many more patients for the
> latter kind of problem than the former. Strictly
> speaking, a lot of people come in to see me for
> things that probably could have been monitored at
> home without medical attention. Mind you, I am
> not complaining about that fact, as these sorts of
> “bread and butter” visits are what keep a
> medical office’s doors open.
>
> A large factor in parents’ decisions to bring
> their kids in for a visit is their own caution or
> anxiety. Educating parents about major vs. minor
> symptoms, what can be treated at home vs. what
> needs to be seen, etc is an important part of my
> job, as is allaying anxiety to whatever extent
> possible. Taking care of parents is as much (or
> more) a part of my job as taking care of the kids,
> which I think almost any honest pediatrician would
> say. If I didn’t like dealing with worried
> parents, I shouldn’t have entered the field.
>
> That said, I have had a truly stupefying number of
> appointments that the parents themselves view as
> totally unnecessary. They don’t think their kid
> needs to be seen, and they know I don’t think so
> either. They’re missing work they don’t think
> they need to miss, and are languishing in my
> office for reasons they consider ridiculous.
>
> Why are they there? Because their kid’s school
> demands a doctor’s note. Any absence attributed
> to illness must be verified by me, with a note
> documenting same. Otherwise it is unexcused, for
> which the student is penalized. It matters not if
> the illness is as minor as a cold, or if the
> student has an otherwise spotless attendance
> record. It makes no difference if the child was
> sent home by the school nurse (in which case a
> note stipulating that the child is well enough to
> return is required) or kept home at the parent’s
> discretion. Every absence requires a note, which
> requires a visit.
>
> This is, of course, totally idiotic. I am
> providing a service when I see ill children, even
> if the illness is mild and the service is really
> for the worried parents. Those visits have value,
> even if they’re not “necessary.” A visit
> for the sole purpose of verifying the parent’s
> claim of sickness is a complete policy fail. It
> robs parents of their authority and subjugates
> them to the dictates of the educational
> bureaucracy. It contributes needlessly to medical
> costs and wastes everyone’s time. (Were I in
> cahoots with the local school nurses, I could not
> design a better kick-back scheme if I tried.)
>
> When did this happen? I seem to recall that my
> mother’s say-so was enough to keep me home from
> school for a few days. I think a doctor’s note
> was required for lengthier absences, but for a day
> or so all that was necessary was for her to tell
> the school I was sick. When did this change?
>
> An addition wrinkle to my observation is that it
> is not consistent with all parents/patients. My
> office is situated in an area with great
> socioeconomic diversity. Many of my patients
> attend the local exclusive and famous (you’ve
> heard of it) private school or the affluent public
> school nearby. Many of my other patients live in
> the much poorer surrounding areas, and attend the
> much less well-off schools. Whenever I offer a
> note to the wealthier parents, they wave it away.
> Apparently their word is still good. It is
> students who attend the less cushy schools who
> need the notes from me, and it is their parents
> whose authority has been usurped. If my
> observation is a true reflection of reality, then
> it reflects something disgraceful.
>
> So, here comes the query — is this true where
> you live? If you have kids, can you keep them out
> of school for a day or two due to illness without
> needing to schlep them to the doctor? Or must you
> also procure a perfectly useless note from a
> medical provider? If so, how do you feel about
> this policy?
>
> April 3, 2012 in healthcare policy.
tl;dr
By the way Lisah, you never told me whether or not you do anal...