Arrogant TIT

First, I must apologize for not getting to my own blog let alone reading anyone else's this week. The weekend started well and went downhill in a handbasket come Tuesday morning all because of the afore mentioned arrogant TIT. I must first explain TIT, for those of you unfamiliar with my saga at work. It involves one micromanaging physician who is shorter in height than I who is currently "temporary" managing the trauma service. To say the least, it has not been a smooth transition under his tutelage. He will remained unnamed but his first initial is Dr. T. Now, not many aspire to be like Dr. T but there are those few that will go to great lengths to kiss his ass. I would NOT be one of those. But I work with some of them, mostly residents.

So Tuesday clinic starts with a kink in the schedule before the first patient is even roomed. My OTS 3 Chief Resident has scheduled two surgical cases on a day that is to be dedicated to his outpatient clinic and cast room. Now, OTS Chief 3 is a brilliant doctor, he is from Columbia, he is near completing his 5 year ortho residency and has been accepted to a prestigious traveling hip fellowship next year. All these things are impressive BUT...and I mean a big BUT...he literally oozes arrogance. That is one personality characteristic that I can't stand. In addition to his arrogance, he likes to impress those above him. The current person at the top of his of "people to impress" is Dr. T. He so much wishes to impress Dr. T that he has assumed certain characteristics of Dr. T...including strutting down the hall with his chin in the air and his hands clasped behind his back gazing downward at all of us mere colleagues. Thus...he is a TIT, aka T in Training.

So the TIT begins Tuesday clinic by informing myself, the nurses and the desk that he wants his patients in a room even if their x-rays aren't done yet because he as two operations to perform. That rubs all of us wrong right off the back. There is a system, it isn't a great system but it works when used appropriately. We say fine, we will room your patients without x-rays in an attempt to get him through his patient list faster. Then as he sees every patient he continually asks, where are their x-rays, come on people, get their x-rays. Doctor...May I remind you that you asked for them to be roomed even when their x-rays weren't ready?

So in his impatient idleness Dr TIT decides to look up his cast room patients. He finds on the list that should have gone to staff at her last cast room appointment. Again, there is a system but it has glitches. He starts ranting at me and I quietly ask, who say the patient. He raves "you did". I again ask, are you sure? He looks...the reason I ask again is because I saw the date on the note. I was on I-90 between mom and dad's and Rochester on the date that patient was seen. Does he apologize for assuming the error was mine? Nope. We go on our grumpy way through clinic. The last patient is scheduled for 11 am.

At 10:15 Dr TIT says, so and so is a no-show, I'm going to do my cases. I said, he isn't a no show until it has been an hour past his scheduled appointment time but Dr TIT says, he didn't show for his x-rays (which were scheduled for 10). I said, fine and he leaves. WELLLLLLLL...low and behold at 11:50 Mr. So and So shows up for his appointment. He is NOT a no show because as the system dictates, a patient is not canceled unless he or she shows up greater than one hour later than their appointment. This is where the date went sharply downhill and led to me being so angry I had tears welling in my eyes.

I page Dr TIT to let him know our last patient is in clinic and that his x-rays are on the way. I have not gone in to see this patient yet but I have seen him at all his past appointments (that is why I was hired so that patients that are left over at quarter change at least have one person in the clinic that has seen them before). Dr TIT throws a fit (hehehehe...aren't I cute) He his raising his voice on the phone to tell me to reschedule the patient for another day. I say no....the patient isn't late enough to be rescheduled. I also point out that the patient is a nursing home patient (because of his injury, not because of his age) and that he has been using transport services to get to his appointments. Now, I haven't seen the patient yet but the entire time I had been caring for him he was as described....in a nursing home and receiving physical therapy and not able to drive. I tell Dr TIT he needs to be seen. He grumbles "fine!"...YOU see him and call me when his x-rays are there.

That is what I do. I go in and start talking with and subsequently examining the patient. Good news, his therapy progressed since his last visit and he was able to be discharged to his home. No longer in a nursing home but lives 4 hours away. Great! I do my exam and as I walk out the door, I am greeted by Dr. TIT who sees the patient as the door closes behind me. He proceeds to start yelling at me in the middle of the hallway as I attempt to make my way to the work room. Understand there are at least 3 nurses and 2 or 3 clinical assistants in the hall. He is yelling at me because the patient doesn't appear to be in a nursing home. I quietly tell him the patient has been discharged since the last clinic note. He continues his tirade..."Do you WANT me to go in there and ask him how he got here?". No Doctor, I reply. Then...then...the arrogant TIT as the gull to flat out call me a liar! THAT went over like a lead brick. He starts going on about how one can't "assume" things in medicine and that I lied to him to get him to come see the patient yada yada yada. Since he won't let me get a word in edge wise I simply walk to the desk to check on the x-rays. My desk staff looks at me and I'm on the verge of tears. When I get angry, that happens (I hate that trait of mine)!

Sooooo, I stand there stewing and Dr TIT eventually wanders to the desk to demand the x-rays. I say they aren't here and then ask if he would like to hear what my exam showed or not. And I said it just like that...without giving him a chance to answer I rattle off that the patient has blah blah blah shoulder ROM, with grossly decreased rotator cuff strength. He just nods and turns around with his hands clasped behind my back. I want to SCREEEEEAAAMMM!!! Shit head!

So, long story short, he called me a liar, the patient was seen because I insisted on it, he was released to advance his therapy and Dr TIT went to do his scheduled OR cases while his senior resident and I see his cast rooms. F&#$-er!!!

Now this quarter I only have 3 more clinic days with this doc (I survived yesterday in clinic with him by smothering him with smiles and kindness) but after a six week break the TIT comes back for an entire 3 month quarter. Please pray I don't rip him a new one