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  • Senior partners "stealing" patients

    Hi everyone,

    I wanted to tell everyone a story to see what your thoughts were. I took care of a patient for issues "X" including (a) ordering a CT and reviewing the results with the patient (b) giving abx and steroids which temporize his symptoms and makes him feel much better (c) had 3 office visits with the patient examining him and explaining why he need surgery.

    After 3 weeks, I realize he never followed up. I open up his chart and see that 5 days after seeing me the 3rd time he saw a senior partner in my group (there are about 25 of us) and scheduled surgery.

    I am just out of training so I understand where the patient is coming from. But I am more upset at the senior partner for (a) booking the patient without telling me he was basically taking over the care (b) not supporting me and telling the patient to go back to me for the surgery I had already suggested he get.

    Just really not cool move by my senior partner. I wish he would have called me to at least let me know why he was taking over care. I know there is probably nothing to do but bite the bullet, but does anyone have any advice?

  • #2
    I’m only 5 years in so not a pro, but have found that asking questions to figure out what actually happened is helpful. Maybe the patient did their research and requested the senior partner to be their surgeon. Maybe the senior partner isn’t great at using the EMR and never checked/genuinely didn’t know you saw the patient. (That happened to me my first year… but I was the offending surgeon who almost took a case away from someone much more senior than me).

    There will be more patients and surgeries, and an open, honest convo with your senior partner phrased in a learning context might help. Maybe you can offer to ‘assist’ and explain that you are invested in your patients and want to see it to the end. This one case is small potatoes, you will have more cases. But cultivating a relationship with your senior partner, communicating your humble expectations, that is where the future value is at.

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    • #3
      Yeah, I'd just ask to see what happened. A casual, hey I was checking on a patient's chart for results and saw you scheduled them for a surgery and see what they say.

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      • #4
        Totally different in my world. I love when my patients decide to change to the new guy. I was that new guy a few years ago and got all the disgruntled people. Now that it is reversed it is leaving me with the more gruntled. Win win win.

        But I get it when it comes to surgery that kind of blows. Sorry you have a dushy partner

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        • #5
          I would wait until the patient was already under for surgery and then I'd run into the room, put a chloroform rag over the other doctor's face, then I'd perform the surgery. I want to be clear that this is one of many options but it's still an option.

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          • #6
            Maybe it’s a robotic case and you can hack into the Davinci and take over the case that way.

            Or like cord said wait until they’re scrubbed in, but gently sneak up behind them and put your arms through the sleeves of the gown too… kinda like ghost

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            • #7
              Originally posted by Nysoz View Post
              Maybe it’s a robotic case and you can hack into the Davinci and take over the case that way.

              Or like cord said wait until they’re scrubbed in, but gently sneak up behind them and put your arms through the sleeves of the gown too… kinda like ghost
              LMAO.

              OP what kind of case was it? Good reimbursement?

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              • #8
                Originally posted by Nysoz View Post
                Maybe it’s a robotic case and you can hack into the Davinci and take over the case that way.

                Or like cord said wait until they’re scrubbed in, but gently sneak up behind them and put your arms through the sleeves of the gown too… kinda like ghost
                *Unchained Melody starts playing in the background*

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                • #9
                  Make no mistake by any measure, wRVU’s count in a procedure based metric. In academic, incentive or fixed employed comp they get counted differently, but it comes down to “eat what you kill”.

                  Sorry that happened. One way to approach it would be to “apologize” for not referring his patient initially to him. What did I miss?
                  I doubt the senior will just admit they took for meal. Listen to the answer. It may make sense.
                  Oh, you stole my patient? I wasn’t hungry anyway. It sucks, Does no good to challenge. Very open, if I have your patient, just let me know.

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                  • #10
                    Happens here and there for me, going both directions. I'd probably just let it go but see if it becomes a pattern. I'm not sure it's necessarily stealing. Very well the patient felt uncomfortable with a young attending and asked to be switched. Probably won't hurt to ask but it can also be kinda awkward. I wouldn't necessarily hold it against your colleague. I've had patients leave senior colleagues for me because they didn't like them.

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                    • #11
                      I’d chill a little. No one is “stealing” patients. The patient made an active decision to look somewhere else for their care. What was the specific surgery?

                      You’re new. Give it more time - you’ll see other people’s patients and you’ll lose some to them. You can’t be a perfect fit with everyone nor do you knock it out of the park with each patient. Plus, patients can be nuts, shop for the answer they want to hear, or just want a second opinion. Just put your head down and move on.

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                      • #12
                        Originally posted by ENT Doc View Post
                        I’d chill a little. No one is “stealing” patients. The patient made an active decision to look somewhere else for their care. What was the specific surgery?

                        You’re new. Give it more time - you’ll see other people’s patients and you’ll lose some to them. You can’t be a perfect fit with everyone nor do you knock it out of the park with each patient. Plus, patients can be nuts, shop for the answer they want to hear, or just want a second opinion. Just put your head down and move on.
                        Yep, I wouldn’t assume malice or sleaziness right off the bat. Your partner probably didn’t want to have an awkward conversation with you where he has to lay out why this patient wasn’t feeling comfortable under your care. No big deal, move on.

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                        • #13
                          The patient was just not comfortable with you. Move on.....

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                          • #14
                            I cared about similar things when I was at your stage.

                            Now I couldn’t care less. So I would echo others in saying don’t worry about it and move on.

                            oh and if you ask why you might learn about all the nasty things that patient thought of you. Sometimes best for your mental health not to ask

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                            • #15
                              If a patient wants to switch surgeons in our group, my team gets a transfer of care request. I'm 99.9% sure all Drs say yes to the request. Typically the request is my neighbor/mom/cat had surgeon X instead of Y. Works both ways. I get a few my way and I lose a few.

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