Can’t We All Just Get Along?

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Most people have a love/hate relationship with their doctors. You need them, but you loathe them at the same time. Why is that? It’s probably because doctors are assholes, but so are patients. You read that right. A-S-S-H-O-L-E-S. I have been a patient and I am a doctor, therefore, I have experienced both sides. Here are some tips for patients AND doctors to improve their relationship with each other:

 

 

  1.  Short story. Patients should be quick, but concise when telling their story. I once had an 80 year-old woman tell me about her current respiratory problem by explaining a gynecologic exam that she had in her 20’s. Her uterus was long gone and had absolutely NOTHING to do with her recent breathing issue. My eyes rolled, I searched for the time, and I hurried her along. Get to the point. Answer the questions asked. Do not elaborate beyond the issue at hand. Try not to be evasive. Your doctor will understand and come to their own conclusions. Just don’t waste their time.
  2. Doctors need to slow the freak down. Why all the rushing around all the time? It’s simply a matter of cost/efficiency. Doctors generate ALL the money required to pay their staff, rent, all of their medical supplies, electric and water bills, as well as afford their Mercedes. This requires seeing as many patients as possible in the shortest time, kind of like being a factory worker. Patients don’t feel heard and they feel rushed. Doctors need to balance the financial burden of a busy practice with the expectations of a patient to be heard in a time of great need. Doctors should be present and engaged with each patient interaction. Stop daydreaming about the golf course.
  3. NO bodily fluids. Unless specifically asked, DO NOT offer your bodily fluids to your provider. A simple explanation such as color, amount, smell, or presence of blood or mucous is more than adequate for the doctor to use their imagination and develop a plan for your treatment. If they need a sample, they will get it or ask for it at the time of your visit. Do not bring a sample of your urine in your Tupperware container and then ask for your container back and then try to deliver fresh baked cookies a month later in that same container.
  4. Ask for bodily fluid samples or do that extra test. Sometimes a doctor just has to do that extra test to reassure their worried patients. I know that the 42 year-old female with a sore throat that works in a dry cleaners DOES NOT have strep, but if I just DO the strep test and its negative, she will be reassured when I explain that she DOES NOT need an antibiotic. Patients like tests because tests are right and doctors can be wrong. Tests can be wrong, too, by the way. I usually KNOW what the test will show and it usually just backs up what I’ve already said, but once in a while I get surprised and have to give that lady the antibiotic.
  5. One call is enough. Stop calling the office 18 times a day for the same reason. Don’t call the office 18 times a day for different reasons. Make one call. Then find something else to do until someone calls you back. Every time you call, it takes time away from the staff that helps the doctor get to their messages. You are only making it take longer to get a phone call back. Chill out. Find a hobby.
  6. Answer your messages for God’s sake. If seeing 20+ patients a day wasn’t enough for the poor doctor, they also have an onslaught of phone calls, messages, paperwork and prescriptions to go through day in and day out for an eternity. It’s the in-box that never ever goes away. They can barely get to the golf course for all of the busy work that comes with taking care of people. Doctors typically answer all messages by the end of the business day. Efficient doctors answer messages from the morning before lunch and messages after lunch before they go home.  Staff are trained to alert a provider to any emergent messages that can not wait. You will not be forgotten and no man or woman will be left behind.
  7. Google is not medical school. I went to school for a very long time. I know stuff. I understand that you spent some time on Google and have a pretty good working knowledge of Von Hippel Lindau Syndrome (VHL), but you don’t have it. Nobody does. It’s really freaking rare. OK some people have it and that is unfortunate. Diagnoses are built on blocks of information that accumulate. It takes time to rule in and rule out different illnesses. Be patient. Trust your provider. If things are not progressing and answers are not forthcoming, it is OK to seek consultants’ advise and expertise. Rome was not built in a day.
  8. Zebras do exist. Every medical provider has heard the saying, “when you hear hoof beats, think horses, not zebras.” WTF does that mean, you ask? Horses are common and zebras are rare. When one refers to a “zebra” in medicine, one is referring to a rare and surprising medical disease. “Horses” refer to medical illnesses that are commonly encountered in the medical field. Doctors are taught about the “zebras,” but are aware that they will likely never encounter most of these in their entire careers. Patients get excited about the “zebras” and think that they will be the lucky one to have it like some kind of demented medical lottery winner. They never do, until that one and as a provider you don’t want to miss that one. Don’t underestimate the “zebra”. It’s OK to consider it, rule it out and move on.
  9. Would you like fries with that? You know what irritates me more than anything in my job? It’s when a patient tells me what prescription to write for them like they are placing an order at McDonalds. Why does this irritate me so? See #7. The typical scenario is a patient with cold symptoms for 3 days. They have a sinus infection and need a Zpack, their words, not mine. They have tried nothing over the counter to ameliorate their symptoms, but they know that this is the only thing that will work. After much explanation and no prescription written, the patient leaves disgruntled and proceeds to call back (18 times) because they are no better. They need the Zpack that they asked for and probably would have been better by now had I given it to them in the first place.
  10. A rock and a hard place. Yikes. Do I give them the prescription knowing full well that I am encouraging such behavior? Do I withhold the prescription and they end up going to urgent care or the ER to get what they want? Fighting against a society that has expectations of instant gratification is a no win situation. Studies showing increasing antibiotic resistance in even the most benign bacteria encourage providers to withhold such medications so that they will remain effective when they are most needed (like a little kid or your elderly parent). When your doctor does not willingly give out antibiotics, it’s because they are doing their job and you don’t need one. You probably should skip the side of fries, too.

Doctors and patients can and should get along. When this relationship is healthy and balanced it can be one of the most rewarding that either person can have. A patient can fully trust in the provider to listen to them, respond in a timely manner with the utmost respect, professionalism, and knowledge required to provide state of the art medical care. A doctor can rely on the patient to respect their knowledge, insight, training, and rely on their abilities to diagnose and treat their complaints. Mutual respect and communication are key components in any relationship including the doctor/patient relationship. Homemade cookies in a disposable store bought container (not Tupperware) can also go a long way in maintaining this relationship.

 

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