BABYSITTING PATIENTS

That's what I feel I do some more than others, then I let them go, trusting their family members will care, but then I get stuck again.

Patient #1 among millions: History of multiple strokes with uncontrolled diabetes and hypertension. I've typed out her med list. I see her back and her blood pressure and diabetes are sky high. Her daughter is with her and explain everything (she doesn't seem competent). Another son and daughter come in, I explain med list. Pt comes back with med bottles with a lot missing compared to the extensive med list I typed out. I then call the "responsible" son and after weeks, I decide to type out exactly what each pill box should have for am, noon, and pm Finally some success.

Patient #2 among millions: New patient to me a year ago off meds, doesn't know her history too well and never with any family members. Labs show uncontrolled DM and renal failure. I get her controlled after a couple of visits. Had to get some urgent study done and have to drive to her house to make sure she knows about the appt b/c she never answers her phone. Throughout the year her diabetes, chf vacillates among her non-compliance. YESTERDAY: shows up with ONE THOUSAND AND ONE sugar, elevated potassium , renal failure. I finally meet her daughter and granddaughter who are yelling at the patient for lying to them that she was going to her doctor appointments.

There are tons of patients like these who don't want to take responsibility for their own health or can't and have families who don't want to either. Then, they show up in our walk-in clinic where they are squeezed into our already bulging patient panel. The patients in the waiting room complain b/c they're waiting forever to be seen while I'm busting my butt attending to these train wreck walk-ins.

What is worse is that the other day I had a hoarse voice, and gnawing toothache that was hardly ameliorated with tylenol (as I could not take anything stronger w/ the pregnancy).

I need an efficient solution.