VA Diabetes Obesity & Endocrinology Center

Dear *** ***,I am writing this letter in response to one of my patient's complaint regaining her dissatisfaction with the response she received from our office(My staff and I)It is unfortunate that *** *** *** felt that we failed to provide her with the
appropriate response to her request, I will start by chronologically stating the dates and facts of our encounters togetherI will do my best to verify some facts that were misunderstood by her and made her react with anger,First, I would like to start by saying my patients are not customers and we do not provide services in that senseWe take pride in excellent medical care as our reputation precedes us.I first saw *** *** on 09/03/2014.I apologised to her for having to wait to see me that dayI give every patient I see my full attention and time as needed; hence the delayI do not recall how long her waiting time was but we have a policy of calling our patients in advance to let them know when we have delays.She was provided with excellent careHer medications were changed, labs were ordered, and was given a follappointment.On 09/29/2014, she was seen again to discuss her lab resultsDuring this visit, she was instructed to collect a 24-hour urine analysis to evaluate her kidney stonesIn addition, other sets of labs were ordered as well, all was asked to be done before her next visit.On 01/21/2015, her hour urine analysis was not done as requested and we had to order a new once, I told her once I receive the lab results I will review the reports and determine if she needs any medications/adjustmentsIn which case, we would send it directly to her *** Home Delivery pharmacy.On the same visit of 01/21/and before she left our office, she was asked to contact us upon completing her urine analysis, so that my staff can follon the results with the labAlso, we provided her with an online portal account to facilitate communication with us and allow her to address any concerns that she has directly to me in privacy*** *** failed to active her portal, which resulted in poor communication and misunderstanding.After reviewing her urine analysis results, I prescribed her medication and the prescription was sent with instructions to her *** Home Delivery pharmacy on 02/25/would like to mention that our EMR system does not allow us to send a prescription without any instructions(Please see Attachment A- copy of the original prescription that was sent to her pharmacy) I have personally contacted *** Home Delivery pharmacy and they are looking into this situationI will fax their response as soon as I receive it.*** *** claimed that she contacted my office asking about the instructions for her medicationAccording to her, she called multiple timesNeither I nor my staff recall receiving any messages from her in that regardHowever, I did receive one message from her during my vacation that was not in any way related to the complaint at hand.I had given *** *** a call to investigate about the issue and she was very angry claiming that I did not call her when she had a medical questionAt first she was accusing me of sending her prescription to her pharmacy without including the instructions, which is when I asked her to send me a picture of her prescription bottle(Please see Attachment B- picture of prescription bottle) She was also upset about needing her records faxed to her new physician, which were faxed electronicallyShe had sent me messages back to back calling me unprofessional and in all of this I was trying to understand what exactly she needed(Please see Attachment C- pictures of messages)I have personally and not many providers do, provided my personal cell phone to all my patientsOur office voicemail is set up as the following: “Thank you for calling the office of DrNahrain A***, if this is a medical emergency, please hang up and call If you have reached this message we are either busy or on the other linoThis voicemail is for non urgent messages onlyIf you have an urgent matter that cannot wait for a return call, please call or text DrA*** at ###-###-####, Thank you.” *** *** failed to take advantage of my phone number that is publically available to anyone who needs to speak to me urgently.Finally, I would like to apologize for all the misunderstanding between my office staff, myself, and *** ***I wish her all the best with her new physicianI do believe it is a shared responsibility between the patient and the provider to communicate appropriatelyThe medication provided was not an urgent matter and could have been addressed at her next visitPlease do not hesitate to contact me if you have any further questions Sincerely,
Nahrain A***, MD