José Menendez is an elderly patient of Dr. Juárez, a board-certified urologist.
ID: 125946 • Letter: J
Question
José Menendez is an elderly patient of Dr. Juárez, a board-certified urologist. José has a history of recurrent UTIs dating back more than 10 years. When he becomes symptomatic, he has been instructed to call Dr. Juárez’s office and schedule a urinalysis. Dr. Juárez’s receptionist has just received a call from Mr. Menendez. He says he knows he is supposed to come in for a urine test but that he just wants a prescription phoned in to his pharmacy instead. The receptionist asks Emilia, Dr. Juárez’s medical assistant, to take the call from Mr. Menendez.
Emilia listens as Mr. Menendez recounts that he is experiencing dysuria—painful, burning urination. She asks him to come in for a urinalysis, explaining that, as per standing orders, a clean-catch midstream specimen needs to be collected. Mr. Menendez repeats to Emilia that he does not want to come in to the office. “Why can’t you call in a prescription for Bactrim? That is what I took last time, and it helped.”
Provide detailed answers for each of the following questions. Your response should be one (1) page in length.
What is your response?
Should the responsibility for this call have fallen on Emilia, or should the receptionist have either handled the call herself or passed it on to Dr. Juárez?
What, if anything, could or should Emilia say to Mr. Menendez to persuade him to come in for the urinalysis?
Might the cost of the procedure be a factor in the reason why Mr. Menendez does not want to have a urinalysis, and, if so, what, if anything, can Emilia do or say about the cost?
Is it appropriate in this case, given the patient’s extensive history, to indeed call in a prescription for Bactrim?
If not, how should Emilia handle Mr. Menendez’s request for his prescription?
If so, what procedure should Emilia follow to arrange for a prescription?
How should this telephone call be charted?
What, if anything, should Dr. Juárez be told about the conversation with Mr. Menendez?
Explanation / Answer
What is your response?
Emilia should probably just try her level best to convince MR. Menendez to come to the physician’s office and do the regular test. Even though it may seem the same UTI, it may be more severe or a further spread infection. She should also advice about never to self-medicate.
Should the responsibility for this call have fallen on Emilia, or should the receptionist have either handled the call herself or passed it on to Dr. Juárez?
Emilia would be held responsible if the medication would do any harm to the patient. Therefore it is in the best interest of the patient that he visits the physician as per the discussion and suggestion Emilia provided.
What, if anything, could or should Emilia say to Mr. Menendez to persuade him to come in for the urinalysis?
Emilia could suggest and the same as she discussed in the conversation above. Also she should state the side effects of self-medication and receiving prescription for diagnosis assumption that it’s a as usual UTI. On the other hand Emilia is just the receptionist and cannot give doctor’s orders.
Might the cost of the procedure be a factor in the reason why Mr. Menendez does not want to have a urinalysis, and, if so, what, if anything, can Emilia do or say about the cost?
If the cost of the prescription and procedure is the reason for the patient, Emilia can suggest different insurance options includes (Medicare and Medicaid options).
Is it appropriate in this case, given the patient’s extensive history, to indeed call in a prescription for Bactrim?
No. This is because numerous times that there are chances that the infection might have spread to kidney. The extent of infection and discomfort of the patient can only be found if the patient makes a visit to hospital. Also if it’s a recurrent infection, it may be that the infection may turn resistant to Bactrim.
If not, how should Emilia handle Mr. Menendez’s request for his prescription?
Emilia should try persuade him to come to the physician and also say that it is non ethical on her part to play the doctor’s role to call out the prescription.
If so, what procedure should Emilia follow to arrange for a prescription?
NA.
How should this telephone call be charted?
This conversation should be charted as patient not willing to meet and asking for prescription without urine analysis.
What, if anything, should Dr. Juárez be told about the conversation with Mr. Menendez?
The whole case needs to be narrated to Dr. Juarez, this is because if the patient becomes ill for not visiting the doctor, in unfortunate case dies, the doctor and receptionist should not be held responsible for it.
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