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       #Post#: 67008--------------------------------------------------
       When medical assistants contradict the doctor. End Of Story: rep
       ly #12
       By: SnappyLT Date: June 3, 2021, 3:19 pm
       ---------------------------------------------------------
       The following story is so minor that I am almost embarrassed to
       share it. I am curious about what others have done in similar
       situations. (If this matters in the situation, I am a
       retirement-age male in the USA. Everyone else mentioned here is
       female - if that makes a difference.)
       This is an etiquette question. Please, no medical advice!
       I had a telephone misunderstanding with my doctor's employees
       today.
       My last doctor's appointment was a "tele-visit" online on
       Monday. During the online appointment, my doctor ordered some
       blood work. She told me to make an appointment with the
       phlebotomist at her office for my blood draw.
       I mentioned getting an early morning appointment for my blood
       draw, because I'd be fasting. My doctor said no, that this one
       time she was only going to be looking at the ___ and ___ test
       results, so I did not need to fast this one time.
       Yesterday mid-afternoon I left a voicemail for the phlebotomist,
       asking for an appointment to come in this afternoon to have my
       blood drawn. The phlebotomist did not return that call.
       Late morning today I called again, and this time the
       phlebotomist returned my call at once. The phlebotomist declined
       to make an afternoon appointment for me, saying that I must be
       fasting for her to draw my blood.
       I explained that my doctor had specifically told me that I did
       not need to be fasting this one time. The phlebotomist raised
       her voice a little and repeated herself that I must be fasting
       for her to draw my blood.
       I explained again that she (the phlebotomist) was contradicting
       my doctor. She wouldn't budge.
       So I called back and selected a different option at their
       switchboard. This time I spoke with my doctor's medical
       assistant.
       The medical assistant just repeated what the phlebotomist told
       me. I said that what she was saying was the exact opposite of
       what the doctor herself had told me. I asked her to have the
       doctor herself return my call. The medical assistant said she
       would have the doctor call me and then abruptly hung up on me.
       Questions:
       1.) Has anyone else here had a similar experience?
       2.) I'm assuming my doctor will return my call and will tell me
       again that I don't need to fast.
       What do I say to the phlebotomist when I do go in for the blood
       work? What do I say to smooth things over (and hopefully avoid
       the blood drawing being more painful than necessary)? (The
       phlebotomist wouldn't retaliate, would she?)
       #Post#: 67009--------------------------------------------------
       Re: When medical assistants contradict the doctor
       By: Nikko-chan Date: June 3, 2021, 3:36 pm
       ---------------------------------------------------------
       so the doctor will likely call and you can clarify with her. You
       might even say "Yes the phlebotomist and medical assistant BOTH
       stated that I needed to fast, and the phlebotomist has refused
       to schedule unless I fast. "  If the doctor reiterates that you
       do not have to fast: "SO just to clarify: I am able to eat
       before my blood is taken?" if thats a yes, you can then say "Is
       there anyway you can put down on the paperwork that this is a
       non-fasting blood draw?"
       You do not have to say anything to the phlebotomist about this
       interaction, period. Just a "I'm SnappyLT here for my bloodwork,
       heres the paperwork"
       And no, the phlebotomist wouldnt retaliate against you, you
       should be fine. It is likely she wont even remember you, or that
       you'll get a different phlebotomist.
       #Post#: 67013--------------------------------------------------
       Re: When medical assistants contradict the doctor
       By: sandisadie Date: June 3, 2021, 4:05 pm
       ---------------------------------------------------------
       In my experience, your doctor has the final say as to how things
       are done.  The other medical workers in the office are secondary
       employees and don't have the right to go against what your
       doctor has told you.  I agree that you need to speak to the
       doctor and inform her what has happened.  She should speak to
       the other people and inform them how they went wrong in
       instructing you.  Perhaps the doctor is wrong.  But by bringing
       this matter to her attention she can sort it out.  I've had
       disagreements similar to this in the past but don't remember the
       underlings being rude.  Usually they discuss it with the doctor
       and someone gets back to me.
       #Post#: 67026--------------------------------------------------
       Re: When medical assistants contradict the doctor
       By: Aleko Date: June 4, 2021, 5:06 am
       ---------------------------------------------------------
       I wouldn't entirely blame the phlebotomist and assistant for
       their insistence. I don’t doubt that they routinely have
       patients turn up who didn’t take in what the doctor said
       about fasting, or forgot, or didn’t read the instructions
       they got sent in the post, and are extremely angry when told
       ‘sorry, we can’t do your blood draw because of this,
       you’ll have to make another appointment’.
       It’s likely one of the most stressful parts of their job.
       And it wouldn’t surprise me a bit if some patients are
       prepared to claim quite falsely that the doctor told them
       fasting wasn’t necessary in their case (because of course
       they’re special).
       Of course they ought to have agreed to check with the doctor and
       get back to you; but if they thought s/he was likely to snap
       ‘Oh, for God’s sake, don’t you know by now
       that bloods for XYZ have to be taken fasting? Why are you
       bothering me with this?’, I can see why they might not
       have wanted to.
       #Post#: 67033--------------------------------------------------
       Re: When medical assistants contradict the doctor
       By: oogyda Date: June 4, 2021, 7:34 am
       ---------------------------------------------------------
       [quote author=SnappyLT link=topic=2064.msg67008#msg67008
       date=1622751584]
       What do I say to the phlebotomist when I do go in for the blood
       work? What do I say to smooth things over (and hopefully avoid
       the blood drawing being more painful than necessary)? (The
       phlebotomist wouldn't retaliate, would she?)
       [/quote]
       You say nothing.  Since she's the one who was mistaken, it would
       be on her to apologize to smooth things over.  Although, if you
       don't get one when you talk to her about scheduling it, you
       probably won't.
       Assuming you've had blood drawn by this person before, if you
       think she's retaliated you should report that right away.
       #Post#: 67037--------------------------------------------------
       Re: When medical assistants contradict the doctor
       By: kckgirl Date: June 4, 2021, 8:28 am
       ---------------------------------------------------------
       You can also ask for a lab request form and go elsewhere for
       your blood draw.
       #Post#: 67038--------------------------------------------------
       Re: When medical assistants contradict the doctor
       By: Jem Date: June 4, 2021, 8:56 am
       ---------------------------------------------------------
       [quote author=Aleko link=topic=2064.msg67026#msg67026
       date=1622801176]
       I wouldn't entirely blame the phlebotomist and assistant for
       their insistence. I don’t doubt that they routinely have
       patients turn up who didn’t take in what the doctor said about
       fasting, or forgot, or didn’t read the instructions they got
       sent in the post, and are extremely angry when told ‘sorry, we
       can’t do your blood draw because of this, you’ll have to make
       another appointment’.  It’s likely one of the most stressful
       parts of their job. And it wouldn’t surprise me a bit if some
       patients are prepared to claim quite falsely that the doctor
       told them fasting wasn’t necessary in their case (because of
       course they’re special).
       Of course they ought to have agreed to check with the doctor and
       get back to you; but if they thought s/he was likely to snap
       ‘Oh, for God’s sake, don’t you know by now that bloods for XYZ
       have to be taken fasting? Why are you bothering me with this?’,
       I can see why they might not have wanted to.
       [/quote]
       I think the phlebotomist and assistant should just do their job
       and draw the blood. The results will be what they will be. The
       doctor will order another blood draw or not. The phlebotomist
       and assistant do not order the testing. The doctor does.
       I do share the frustration with poor communication in the
       medical field, however.
       #Post#: 67040--------------------------------------------------
       Re: When medical assistants contradict the doctor
       By: BeagleMommy Date: June 4, 2021, 9:04 am
       ---------------------------------------------------------
       By all means clarify with your doctor.
       If the phlebotomist had questions she should have called your
       doctor to clarify; same with the medical assistant.
       When you speak with your doctor, be sure to mention the snappish
       attitude of both parties involved.
       #Post#: 67043--------------------------------------------------
       Re: When medical assistants contradict the doctor
       By: Gardensgrey Date: June 4, 2021, 10:03 am
       ---------------------------------------------------------
       All lab work requires a physician’s order. Ask to see that, and
       take it from there. If the order does not indicate
       “non-fasting”, or is truly for a test that is normally fasting
       (example: most blood chemistries), then tell the tech they need
       to verify the order with the doctor, which they are obligated to
       do in light of the discrepancy between normal protocol and the
       patient’s recollection of instructions.
       #Post#: 67045--------------------------------------------------
       Re: When medical assistants contradict the doctor
       By: Hmmm Date: June 4, 2021, 10:24 am
       ---------------------------------------------------------
       [quote author=Jem link=topic=2064.msg67038#msg67038
       date=1622815007]
       [quote author=Aleko link=topic=2064.msg67026#msg67026
       date=1622801176]
       I wouldn't entirely blame the phlebotomist and assistant for
       their insistence. I don’t doubt that they routinely have
       patients turn up who didn’t take in what the doctor said about
       fasting, or forgot, or didn’t read the instructions they got
       sent in the post, and are extremely angry when told ‘sorry, we
       can’t do your blood draw because of this, you’ll have to make
       another appointment’.  It’s likely one of the most stressful
       parts of their job. And it wouldn’t surprise me a bit if some
       patients are prepared to claim quite falsely that the doctor
       told them fasting wasn’t necessary in their case (because of
       course they’re special).
       Of course they ought to have agreed to check with the doctor and
       get back to you; but if they thought s/he was likely to snap
       ‘Oh, for God’s sake, don’t you know by now that bloods for XYZ
       have to be taken fasting? Why are you bothering me with this?’,
       I can see why they might not have wanted to.
       [/quote]
       I think the phlebotomist and assistant should just do their job
       and draw the blood. The results will be what they will be. The
       doctor will order another blood draw or not. The phlebotomist
       and assistant do not order the testing. The doctor does.
       I do share the frustration with poor communication in the
       medical field, however.
       [/quote]
       I realize you are not in the States. When a procedure is
       performed in a way that causes it to have to be redone it
       creates issues with health insurance payments. The phlebotomist
       has probably had it driven into her head to never do a
       non-fasting blood draw because insurance may not pay for a
       second one in a short amount of time causing either the patient
       to have increased out of pocket expenses or the doctor office
       not being reimbursed.
       Given that both the phlebotomist and the medical assistance took
       such a hard stance, it sounds like doing a draw when not fasting
       is very much out of the norm.
       I don't think there will be retaliation. I mean it's unlikely
       she'll even remember who she had that conversation with let
       alone be so upset by it that she'd intentionally cause
       additional pain.
       If the doctor comes back and says that it doesn't need to be
       fasting, then I'd call make the appointment and when asked if
       I'd been fasting, state yes I have followed the doctor's
       directive around fasting.
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