A 32 y/o male had been to the Emergency Room (ER) for lower abdominal discomfort.
Labs (blood and urine), as well as an abdominal and pelvic CT scan were normal.
I could not interpret the hand written medical record.
It didn't appear to include a physical exam.
The patient confirmed this observation.
No diagnosis or treatment was given.
He was told to see his primary care provider (me) the next day.
I did not know the ER doc.
On my exam, palpation of the epididymus of one testicle reproduced all his pain.
He was involved in a long term monogomous relationship.
He was told to use supporting underwear and given a prescription for an antibiotic (filled at a local grocery store for free).
A week later, on re-check, he was fine (cured!).
He had already received one bill from the ER for approximately $2200.00.
I decided not to let him know that additional bills (from the radiologist, etc.) would be arriving in the future.