What’s The 411?

October 5, 2005

I enjoy a good colonoscopy. There. I said it. The wife thought it was strange when I argued with the insurance company to pay for a repeat screening procedure, but there was more to it than a couple o’ polyps, honey. And I don’t think I’m alone, though I’ve never brought it up with friends directly. In third world countries, I hear they don’t even use any sedation. Nice. You know what they say, “In love and medicine, a little gentle pressure is all you need.”

Dr. Mort Kandless

Speaking of the third world, I’ve personally gone and explored the depths of Asia to see what medicine is like there. Sadly, I couldn't arrange for any colonoscopies, but I could see that the patients actually say "Please" and "Thank You" to their doctors - unlike here in the U.S., where lawyers are ready to pounce if you fail to catch a single PVC. And, the broader issue here is that the same folks who will sue you for not keeping your white coat finely pressed are also the ones who won’t follow your instructions.

One of my patients, R.J. “Phil” Kittering III, which we’ll call him for the sake of anonymity (i.e. that’s not his real name - some of the initials are his, but in a different order, not including the “III” at the end), was peeing every 3 minutes and had no feeling on the soles of his feet. So, I checked his sugar, and it was as high as Tom Cruise on Oprah! After spending the better part of an hour doing some diabetic education, I sent him on his way with a big pile o’ scripts, directions to call, and a return appointment.

Anyhow (cue the eerie music), I never saw or heard from R.J. “Phil” Kittering III again. No, he wasn’t consumed by a flesh-eating virus or SARS or anything. He just didn’t freakin’ come back to my office.

He did, however, make an appointment six months later with my wife, who’s an internist across town. Apparently he didn’t care for my “flip” demeanor and said I had a really bad “comb-over.” Unfortunately, by the time he got in to see her, his uncontrolled diabetic neuropathy had rendered his left great toe mushy hamburger. Ultimately it had to be whacked off. And not one of those scripts I wrote had ever been filled; nor had a single fingerstick glucose been checked.

But that didn’t stop the bastard from suing me! He and his attorney claimed I should have called when he didn’t show up for his follow-up. After what he said to my face about my comb-over, he's lucky I didn’t poison him or something!! (Well, actually, he didn’t really say anything at the time, but I'm pretty sure he pointed and laughed.) Now don’t misunderstand me here. I remain sympathetic to this man’s loss. I too value my big toes. But I must say, without much apology, that the fate of each man lies in his own hands, so I don't take lightly being preyed upon by this sort of frivolous litigation!

Six months later, with my insurance company having settled out of court for $500,000, I can proudly say that my office has successfully streamlined its patient follow-up system. With a menu of pre-recorded messages from me, we’ve covered nearly every legal loophole you can imagine. And I’m looking at hair plugs as a real option to improve patient satisfaction - because in the end, the customer is "always" right.

I’m Dr. Mort Kandless and ... That’s what I think.

Remember: Quality Without The Q Is Just Uality!