ADVERTISEMENT

Hax: Doctor asks for insider information

  • Article by: CAROLYN HAX
  • December 26, 2013 - 1:17 PM

While I’m away, readers give the advice.

On helping a loved one whose health is at risk:

I often wish advice columnists would counsel neighbors, relatives and friends who are concerned about someone to send a letter to the patient’s doctor. It’s usually easy enough to find out names of people’s doctors: Most people keep their meds in the bathroom medicine cabinet or on the kitchen counter, and the doctor’s name and phone number are right on the pill bottle. If not, asking for a referral works, too. Include the patient’s full name, date of birth and/or address so we can connect the letter to the correct patient’s file, and then be as specific as possible about any observations and concerns. We can’t respond to the letter because of HIPAA regulations, but a reputable doctor will take it under advisement. The letter writer can request anonymity.

It’s usually not too hard for me to make up a pretext about why I need to see the patient, and with a few routine questions and physical exam maneuvers, I can take good care of my patients without disclosing the letter.

This could be useful for concerns about driving safety, dementia, mental illness, elder abuse, domestic violence, sexual abuse, child abuse or substance abuse. These are all situations in which neighbors, friends and family members can provide history that patients may hide, and thus doctors may miss.

Of course, we can’t “cure” any of these problems, but with this information in hand, we can offer the patient our candid professional assessment, support and appropriate referrals. Physicians are legally obligated to report cases of potential child abuse, so writing a credible letter about that may trigger an alert to the relevant authorities. For patients with drug and alcohol problems, we can choose medications less likely to have harmful interactions. For victims of physical abuse, we might think twice before prescribing blood thinners, or order an additional X-ray to check for internal trauma. We can keep the alleged abuser busy filling out forms while we screen the patient privately for abuse.

Writing a letter could help us do everything possible to keep the patient alive until they’re ready to choose the help they need. — A Physician

On partners who call you by an ex’s name:

On my wedding night, when we were finally alone, my new husband turned to me and said, “How does it feel to be Mrs. Name.” And the name he supplied was his ex-wife’s.

He was completely horrified and I just laughed — not because of the look on his face, but because I was standing there and she wasn’t.

It is 27 years later and he doesn’t call me by his ex-wife’s name anymore; he just calls me by the pets’ names, our daughter’s name, or his assistant’s name. But that’s OK, because I’m still standing here. — A.

E-mail Carolyn Hax at tellme@washpost.com, or chat with her at 11 a.m. Friday at www.washingtonpost.com.

© 2014 Star Tribune