Dr Attending: Okay! We’re almost done here! Just need to print your paperwork. So we’ll just diagnose this as “neuropathy”… type that in to the “diagnosis” field box here… click “yes”… excellent!
Dr Attending: And we’ll just order you that Gabapentin, so… type Gabapentin into the box here…
Me: *after a long pause in which I awkwardly hovered over his shoulder* Oh, see – your mouse cursor is still the diagnosis box.
Dr Attending: Yes, I know that. *clicks angrily* Why isn’t it working?
Me: … well, you want the order box. That’s the diagnosis box. That’s why the only option that popped up was “Gabapentin-induced toxicity in a newborn or fetus via breast milk or placenta.”
Dr Attending: It’s not letting me order generic Gabapentin! Ugh, I guess I’ll just order this one. *clicks “yes” and adds aforementioned diagnosis to list* God, I hate this EMR.
Me: … You just added “Gabapentin-induced toxicity in a newborn or fetus via breast milk or placenta” as a diagnosis.
Dr Attending: *waves me away* How do I order regular Gabapentin? I can’t believe this EMR. See, that’s the problem with computers.
Me: *moves mouse to “orders” box* … Here, try now.
Dr Attending: “g-a-b-a-p-e-” Hey! That works. Great. Thanks. *clicks “print” decisively* Printing! All done! Nice meeting you, Mr. Patient.
Patient: Nice meeting you too.
Me: …. but… the patient is now diagnosed with gabapentin-induced toxicity in a newborn or fetus via breast milk or placenta. It’s on his diagnosis list. It’s –
Dr Attending: Next patient! Let’s go!
As it turns out, not only did Dr. Attending set that as a visit diagnosis, he actually clicked it angrily enough that he somehow made it the PRIMARY visit diagnosis.
Unsurprisingly, the insurance company called to inform him they will not, in fact, be paying for gabapentin to treat “gabapentin-induced toxicity in a newborn or fetus”
Dr. Attending was not pleased.