Pride? Ego?

I just knew i felt real angry and irritated during the encounter, but i couldn't tell why till i thought hard about it after my clinic ended

I have been seeing this lady with OA knees for the past 4 months, a total of 3 encounters. As usual, i started her on meds and physio, hoping she could get away without an operation. However, she came today and complained that the pain was not getting anyway ideal. I asked her if she would mind doing a knee replacement..... Then it happened.

Her daughter whipped out a piece of paper and said meekly:" one of my relatives told me to find this surgeon in another hospital.. Can you help me write a letter so that we can see him?"

It was quite common for patients to want to go elsewhere for operation, so i gave my usual warnings that they will be charged private rates etc. And we went on to compare a bit of the price if an operation were to take place there vs here. She persuaded me again and again for the referral saying that it will be an earlier appointment if i wrote the letter though i told her again and again it will be the same since she will be a private patient there. I gave in after my clinic assistant pushed me a little.

I carried on again to tell her we will stop the appointments here since she will already be going elsewhere. But the daughter went on to say:" oh can we keep the appt? because if we go there then if it will the same treatment but if too expensive then we can come back here right?"
I almost exploded (but i didn't know why then) to top it off my clinic assistant said:"they just want a second opinion la.. give them a date lor..)

I gave whatever she wanted and was glad that she was out of the clinic in what felt like eternity. Fortunately that was my second last patient.. i was in a super foul mood and i had real difficulty forcing smiles on my face when i saw the next patient.

I thought about my anger again an again after the day ended. I would usually just laugh off things that anger me during work.. like demanding patients or unreasonable nurses, but this time.. it was different, it hit me real deep.. I finally realised why.

1) I had to write a letter to another orthopaedic clinic for this patient who wanted a second opinion, meaning they are thinking my treatment was crap. And i even have to provide 'after service' for them to give them another appointment!!

2) So if this big name surgeon happily did a TKR and the patient happily walked without pain afterwhich. This daughter will happily say:"wa this surgeon so good! see him once then operate then good liao! not like this other doctor in this other clinic! See him so many months also no use!"

3) The daughter was obviously not listening to me when i tried to explain we were trying conservative first then operative if it was not successful

4) The clinic assistant was not helping me at all!!! Why wasn't she like most others who would feel the same way and played by ear with me?? Doesn't help that the hospital they want to go to was the one she was from previously and she had a good impression of it.

I don't know if it was my pride or ego that was hurt, making me feel this bad. But i will definitely feel injusticed if the op was done elsewhere and the daughter were to complain about bad treatment from me or the clinic i was working in..