GMRyujin–did the doctor ask you what happened when you took PCN? I only ask because a large percentage (a majority, I’m told) of people who say they’re allergic to PCN are, in fact, not. Many of them will describe something that happened after they took PCN that sounds nothing at all like an allergic reaction, and probably had nothing to do with the PCN. That probably isn’t the case with you, and even so, it doesn’t excuse the doctor–when someone tells me he’s allergic to PCN, and there is another drug available that I can use, I’ll use it.
He obviously thought he was treating cellulitis–which, from your description, would be reasonable. (That’s also why he was talking diabetes, I imagine.) If so, steroids would be exactly the wrong thing to prescribe, and you would need an antibiotic. It’s always hard when the patient’s idea of the cause of a particular symptom differs from the doctor’s, but the doctor usually has to go with his own judgement–after all, it is his opinion the patient is paying for.
I don’t want to sound like I’m defending your doctor–there’s no excuse for not listening to a patient, and very little excuse for leaving the patient with the impression that you weren’t listening.
As for why I’ll ask the patient what brought him or her in, even though the nurse already asked, there are many reasons:
–We are taught to develop a fairly standard interviewing technique, and it usually starts by eliciting a chief complaint.
–I like to hear it in the patient’s own words. I can tell quite a bit from the way a patient tells me what brought him in.
–The primary function of the nurse asking you what brings you in is for triage. If you tell her that it’s a crushing pain in your chest and a cold sweat that came on at rest 30 minutes ago and hasn’t gone away, I expect her to get me out of whatever room I’m in.
–The nurse’s interpretation may not be my impression. If you say you have “pain right here”, putting your hand over your lower chest/upper abdomen, she might write down “abdominal pain”, but when I start asking about it, it might sound like fairly typical angina. If I come in and say, “So tell me about this pain in your abdomen,” it colors both your description and my interpretation.
–If I didn’t ask, then a lot of patients would complain–“he doesn’t do anything. His nurse asks all the questions, and he just blows in and writes a prescription. $70 for that!” I’m screwed either way.
All this said, there is a large amount of bad medical care being provided out there, and I’ve provided some of it myself. (Hey, I’m an intern. I’m less incompetent every single day.) Hell, medical care is frustrating when everything goes well. Some of us are trying, though.
Dr. J