By Paul Goldfinger, MD, FACC, Editor@Blogfinger
Scene: Internist office in Neptune. I have been ushered into an examining room by a woman who is dressed in a colorful uniform with flowery pants and top—like pajamas. She doesn’t identify herself or her job description (eg nurse? aide? proctologist?). She takes my BP and my pulse. While she is doing that, I say “70,” amusing myself while trying to predict my heart rate. She looks up and says “75.” She is not impressed with my accurate guess. She then says that she will take my temperature in my ear. She sticks a probe into my ear and says, “96.5” She doesn’t know that I am a physician.
Me: 96.5?
She: Yes
Me: What happened to 98.6?
She: You’re normal.
Me (incredulous) What?
She: Oh yes, out of 500 patients here, most are 96 or 97.
Me: What do you do if you get 98.6?
She: Oh, that’s fever.
Me: 98.6 is fever?
She: Yes
Me: (to myself—–“Should I find another doctor? Should I complain to the doctor? How can I start a ruckus over this inane conversation when I am constantly finding things wrong whenever I go to a doctor? Medical practice is going to hell in a hand basket. What does that mean anyhow?”)
Me: Thank you.
BEE GEES:. FRom the movie Saturday Night Fever. “Night Fever.”
“…then I get night fever, night fever.
“We know how to do it
“Gimme that night fever night fever.
“We know how to show it.”
A ‘normal’ thermometer reading for me is in the 96.5 to 97.5 range. Call me crazy, but the only time my temp rises up to the standard 98.6 mark is when I’m feeling under the weather. 99.5?…I’m burning up. No idea why.
Hah couldn’t help but laugh at the “What do you do if you get a 98.6” “Oh, that’s a fever” – just when you think it can’t get any scarier.
To Me: YES! Get another doctor.
My GP had me bring in my home BP machine (an omron, arm cuff, plug in) to his office after I said my BP was all over the place. During that visit he phoned my cardiologist and they agreed to change my Rx.
Even though his nurse takes my BP and enters it in the machine before the Dr. comes in, he always does a reading himself.
Appleation: My BP measurement was not done properly. She did it manually with a mercury machine, but she released the air so quickly that there was no possibility to gets a precise reading. Another failure of technique in BP measurements is failure to use the correct size cuff. In addition, those office machines, including the electronic ones, should be calibrated periodically, and I wonder if that is done. Finally, if a doctor asks a patient to do home BP checks, that’s great, but the patient should be told to bring his machine to the office to check the accuracy of the home BP device.
I often find disturbing signs of sloppiness in the office practice of medicine. Often the issue is with office policy and procedures, but sometimes it is with medical personnel including doctors and nurses. I try not to nitpick and to only criticize if something important has occurred, but all too often I find fault anyhow.
You’re not alone. This happens at my “office visits” all the time. I wonder what she might think at 101.5.
Was you’re BP anywhere that you might have guessed?