Neurology

Today, I accidentally laughed out loud at what I thought was a hilarious joke a physician said:

We had just finished admitting yet another patient with likely psychological causes of symptoms (conversion disorder and our earlier admit had munchausen syndrome). For completeness sake, he ordered a new MRI on the patient, even though she just had a huge Neuro work up (including CT, MRI, EEG, the works!) only one week ago. It was completed at another area hospital, so he felt like another MRI done at our hospital was warranted, despite the patient not admitting to any new, or acute, symptoms. It felt like a complete waste of over $3000...

So the next patient we were consulted to see elicited the following conversation:

"We need to assess her liver function, to see if the medication has caused any hepatic damage...Do you know if I need to order ammonia separately from liver enzymes?" -MD

"yes, they're separate labs here. But you know, you could just order a CMP (Complete Metabolic Profile) instead of a BMP (Basic Metabolic Profile) to check the liver function." - ME

"oh. Right. Well we already have a BMP from the Emergency Department, I don't want to waste our healthcare money unnecessarily; it comes out of our - yours and mine - pockets!" -MD


...yes. I am painfully aware of those couple of dollars you just saved the hospital and insurance companies. Saving the world, one penny at a time...!