The Patient Who Cried Wolf

One of Aesop’s Fables was about a shepherd boy who tricked villagers in his town by yelling that a wolf was coming when no wolf existed. After he had played this trick several times, a real wolf came. When the boy yelled for help, none of the villagers responded because they had caught on to his trick. The moral of the story was that “Nobody believes a liar … even when he is telling the truth!”

After a while, medical personnel may react like the villagers when caring for patients who either are not truthful about their medical problems or when caring for patients who they perceive to be taking advantage of the medical system.

There are multiple patients who tend to abuse the medical system at our hospital. A few people stand out in my mind and one couple is at the top of the list. We see this husband and wife team, Hansel and Gretel, on at least a weekly basis. They live about four or five blocks from the hospital, yet they usually call an ambulance for transport, so they are getting on the nerves of the EMTs, also. In fact, we have a scanner in the ED and when we hear the call go out and the address, there is a universal moan, followed by a flurry of lighthearted argument over who is going to take the patient and what the complaint will be.

Hansel and Gretel’s complaints range from chronic abdominal pain and chronic chest pain that has been worked up to the hilt to anxiety attacks that have resolved by the time they arrive in the ED to minor bumps and bruises, to feet swelling to the latest call which was for a “medication problem.” As in … “I ran out.” For this call, the paramedics got to their home, took their vital signs, told them that neither one of them had a medical emergency, and refused transport. Before the paramedics left, Hansel and Gretel got a little lecture about proper use of emergency services.

The night was busy and ambulances were in and out. During one run a medic was really hot under the collar about one of the calls they received. About an hour before, they received a call to a new location near the hospital for an “unknown problem.” When they arrived, they found Hansel and Gretel sitting patiently on a neighbor’s porch – ready to be transported to the emergency department.

I was going to end this post by saying “and just then a wolf howled in the distance,” but I thought it would be too corny.

Yet another problem with our current medical system: there is no disincentive for patients who cry wolf. And medical providers who don’t go “running to the shepherd’s aid” every single time he cries for help get their britches handed to them if there is ever a bad outcome.