Venting, but also looking for insight or simply sharing anyone else's similar stories and how it went.
You know the drill. You're scrolling reddit reading some random thread about someone who was horribly misdiagnosed or nearly missed. Suddenly the whole discussion becomes about how evil, condescending, and dismissive doctors are. Or you are in clinic and a patient is insistent that they have some extremely specific condition that their symptoms, history, and exam does not support--yet they either request a test you really don't think is necessary or you straight up have never ordered in your life.
They hit you with the, "Then I want it documented in the chart that you are refusing my request."
In person it is naturally a bit more involved than online where you can roll your eyes and keep scrolling. I usually stick to my guns related to my previous decision and explanation of why I do not think it is warranted, or I tell them if the test is relatively accessible and there is an iota of it being indicated that I will order it based on patient request. It can be a gray area that is situational, however while they seem to think it is a monumental Jedi Mind trick I just enter "patient specifically requesting ____ in this case" and then move on without a second thought.
But good lord, online you really get insight into the hate for physicians and how they think "saying the magic words" will "get you the care you deserve." As if doctors are a cartoon bureaucrat just trying to deny them paperwork to keep a 3hr lunch, but if they say "Document I was refused" they seem to think physicians will sit up straight and see them in a different light and just turn the caring and resource valve on and give you all that you want.
We've all been surprised by unexpected results, usually something incidentally I CHOSE to order or even had to CONVINCE the patient they should get. And it's humbling in a way that patients will never truly know. But try explaining that or the practical use of resources to some 30yr old tech bro with too much money and googling on their hands who demands a "full blood panel" for no particular symptom. Or they demand you take responsibility for their $6000 full body MRI they got from a different state.
Tune in for part 2 when they then blame you for their massive medical bill or increasing societal medical debt or extended wait time for overutilized resources.
But in the mean time, back to reading about how the most recent budget bill will even further **** future doctors into financial insolvency.
EDIT: yes I see the typo and appreciate the irony. Will be doing a MOCA on myself.