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10 Things Your Primary Care Doctor Does That Should Make You Run for the Hills
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Dr Orrange received her BA in Biology at the University of California San Diego and a Masters Degree in Health Sciences at the Johns Hopkins University School of Public Health She received her MD from the USC Keck School of…
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Things Patients do that Drive their Primary Care Physicians Crazy
Whenever I hear there is a shortage of primary care Physicians in this country I think: how can that be, this is the most rewarding specialty ever! Well, there are times it is hard, and I know this blog will get us all fired up BUT as a patient and a Physician I hear these things over and over again. In a previous blog (http://dailystrength.org/blog/274-10-things-your-primary-care) I wrote about things your Physican does that should make you run for the hills so now is the other side. There are things you (we) are doing that are driving our Physician crazy. Primary Care Physicians are privileged to play an important role in your lives. Let's be honest though, we all form first impressions and I have heard from other Physicians consistent themes and small things patients do or say that worry or annoy them. I'd like to share them with you.
1) Right as we enter the room for the visit, tell us why you have just left the previous 4 doctors you had. We are now the canary in the coal mine.
2) Tell us you didn't refill your blood pressure medicine because it's difficult to meet the co-pay and your blood pressure is through the roof. Then pull out the BAG of supplements you pay for and take daily. We all need priorities in this economy.
3) Mention JUST as we are leaving the room from the 20 minute visit a very worrisome complaint. "Oh I forgot to tell you I've been having night sweats and weight loss." You needed to START with that complaint.
4) Carry a water bottle to the visit. Carrying a water bottle with you to the visit just says "high maintenance" to some physicians. I am guilty of this as a patient.
5) "98.9 is a fever for me. I usually run around 97.1" It doesn't really work that way. 98.9 is not a fever. We start to worry at 100.3 no matter what your baseline is.
6) "I wish someone would do something about how fat I am." I had a patient today literally yell at me "how can you help me lose weight." I will discuss weight loss medications, specific diet changes and exercise regimens and after that....I can't do it for you but I can support you.
7) Worry about the wrong things. Your blood sugars are too high, your blood pressures are too high and you haven't been taking your medications. We want to talk about that. You want to talk about the twinge in your side that you get twice a month and lasts a couple of seconds. Focus on your main issue
8) Tell us that your heel has been hurting when you walk in a certain shoe. It just hurts EVERY time you wear that shoe. What is it? I'm not sure but DON'T WEAR THE SHOE. Same thing with an activity "when I do the elliptical after 20 minutes my thigh hurts right here". Don't continue any activity that causes you pain.
9) Tell us the truth. If we believed everyone who told us they were just "minding my own business" you would be sure that was more dangerous than riding a motorcycle without a helmet or paragliding. Just tell us the real story. When you have the classic boxers (brawler's) fracture or a black eye and tell us you were minding your own business and aren't really sure WHAT happened, that's a problem. Be forthcoming. Tell us how many cigarettes you really smoke a day.
10) "I know it's a virus but it will turn in to a bacterial infection in me." We're on the same team here and we know there are times we all want antibiotics for viral upper respiratory infections (dry cough, sore throat, hoarse voice, runny nose) BUT the antibiotics won't help you for a virus. Please understand that antibiotic resistance will soon be one of our biggest healthcare issues.
11) "Generics don't work for me." With rare exceptions (antiepileptic drugs a good example) generics perform as well as the brand name. Generics should work for you so give them a try because fighting your insurance company for brand name drugs is painful.
OK, bring it on....and what did I forget?
Dr O.
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Displaying comments 145-126 of 145
Got a Question?
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On a funny note, I was watching a House re-run last night. Dr. House was seeing a patient who kept drinking water and swinging her water bottle in his face. After getting very annoyed at her, he used the excess water drinking to diagnose a medical condition. The patient said other doctors had diagnosed her as OCD. I was laughing out loud given the comments here, lol.
I agree with # 139 that the problem is the system. Last week I saw a specialist who showed me how it should be done. He spent over two hours with me, encouraged me to ask questions, treated me with respect, and was amazingly humble. But he is at a well-respected and extremely well-endowed teaching/research institution that is ranked # 1 in the USA in his specialty. Do you know how rare that is and how hard it is to get an appointment with someone like that? I bet it's not the insurance company that is paying for his time but the endowments. We need to fix the system, not attack the physicians.
1) There are no stupid questions
2) Physicians created patients' perception of the need for antibiotics by over prescribing in the days prior to bacterial resistance. It's okay that physicians caused the problem, but unacceptable for patients to follow patterns that the physician created? Do you just expect them to know the risks and differences in prescribing practice? Your obligation is to help them understand, not be irritated because they don't.
3) Expectations by physicians that patients can, and should tell you what you believe to be the most important complaint is totally a lack of good assessment skills on your part, not your patients. You may believe that taking good care of a patient is based solely on control of blood sugar or hypertension, and that the side pain the patient is clearly concerned about is totally irrelevant, but think again. Listening and taking the time to tease out and deal with their concerns is your job, period. Don't expect a patient to prioritize their concerns in a way that gives you the information you think is the most important in the shortest amount of time is selfish and unrealistic. Maybe you should consider giving your new patients a an orientation class in what you want to hear and what you don't, how much time you are willing to give, and questions and comments that are unacceptable. Or maybe you should become a lawyer instead.
4) Most of my patients are there because they are ill. You claim to have been a patient, but I see no evidence of understanding the difficulties sick people have in trying to communicate their symptoms and problems under less than ideal circumstances (fever, pain, anxiety, fear, lethargy...), and to a physician who wants it done just so, and quickly.
5) I am not perfect, and I too become impatient, but not because of the patients. It's not their fault we are overbooked, under-staffed, working under an unethical and oft abused reimbursement system that resembles dollars for widgets, and not care for human beings, nor should they carry the burden to have the medical knowledge required to stay off of your Top 10 list. You may have great clinical skills, but your attitude and opinions would mean I would never refer to you.
I know some people can get annoying...I am a counselor for troubled teens but you don't see me going and complaining about my clients...that's because I would never discourage anyone from seeking my help. Writing this blog, that is what you did; you discouraged a lot of people from seeking help.
1. You forgot to put the referral in and I came by the office to remind you...but you are too busy just for me to tell you one little thing even though you just passed by me...do you actually think you are "celebrity status" and refuse to talk to someone without an appt?
2. You tell ME what kind of medication to take when you are obviously blinded by pharmaceutical companies bringing you donuts everyday. It's my disease, I should pick my medication because I am going to be experiencing the side effects, not you.
3. You barely listen to anything I have to say so much that I don't even bother seeing a doctor anymore.
4. You never let me finish my sentences, you are always talking...how are you going to know what's wrong if you never let me talk?
5. You don't inform me of lab results...come on, I've worked in a primary care clinic...it's really not that hard to send out letters or make simple phone calls...plus you're not the one that's gonna be doing it anyway, you'll just pawn it off on one of the nurses.
6. You chalk up findings in radiology reports as "artifact" when in fact it could be an idication that something is wrong...believe me, it happened to me.
7. You treat everyone like they're beneath you just because you got your medical license...congratulations you parents are very proud...doesn't mean you have to treat me like an uneducated loser.
8. Your exams aren't even exams...i can't even remember the last time a doc checked my lungs and heart...
9. You get frustrated with patients that are hard to diagnose so you just say it's depression or fibromyalgia.
10. Honestly, I really rather not see any of you, just give me my prescriptions and I will be on my merry way then you can go back to your office and eat your donut and coffee from your pharmaceutical rep.
Pam
My blood pressure was through the roof and I was on blood pressure meds for years with all kinds of side effects and even on the meds, my BP was still high. I finally started to see a naturopathic doctor who took me off the prescription meds and put me on supplements and my blood pressure is now perfect 110/70 with no side effects of the prescriptions. Doctors get a total of 2 hours nutritional training and zero training in supplements so of course they dont promote them, not to mention they get perks from the big drug companies from writing prescriptions.
the day i recieved the hep c diagnosis the freaking doc was so uncompassionate his only comforting words were "at least it's not aids". at the time i was so upset i couldn't wrap my brain around it but today i would love to find that doc and tell him that suffering is suffering and for him to trivalize it so, was just simply uncalled for.
today i have 3 tumors on my liver, i have yet to hear the word cancer from a doc, he wants more poking and poding tests that keeps me stressed out. i mean how many test does one doc need? i mean he has been testing for a yr now. when does it become insurance fraud? i need to know so i can plan accordingly and the doc is playing mind games with my life and my time by not being truthful and dancing around the issue.
so if a bottled water gives off the impression that i'm high matinance then so be it, but shouldn't the docs just assume that the patiant was just simply thirsty? i mean if one must assume that is.
can't afford co-pays, but smokes 1-2-3 packs of cigs per day.
2)have an overbook patient b/c they have the flu or sinus type symptoms, say you'll see them and then have a ton of other things that they want addressed. or they have to be seen that day b/c they're sick, and they've had symptoms for 2 weeks.
3) patient's showing up 20+ minutes late for their appts, you agree to go ahead and see them. Then they get upset because they have additional things to discuss but b/c they were late there's just not enough time, so they get even more upset if you ask them to make another appt.
4) Letting kids play with all the instruments, getting out tons of gloves, tongue depressors etc... Beat the goose neck lamp up against the wall. Please control children when they are in the rooms.
I have worked in the ED prn, I had a patient come to me with back pain that began after he started sleeping on an old matress at a friends house. GET A NEW MATRESS.
I also think that alot of docs don't give enough credit to their patients opinions...like the fever thing. If I know my normal, 99.6, the nurse always asks me if I've been sick.. or if I'm feeling ok...at any docs office. I know if it goes down, not up, it's usually when I'm not feeling well.
You have to understand that some docs out there don't listen to their patients...prescribe what they always do...don't take the history into consideration...and almost KILL their patients who aren't smart enough to know better. I've learned the hard way a few times...there are good and bad docs, just as there are good and bad patients.
I know I'm a 2%'er...if there's a 2% chance of it happening, I'm usually the one. Those of us with health issues know the meds they shouldn't take... I do agree about putting the priority on what is really a symptom to tell the doc about first thing...I always figure I have roughly 5-8 minutes to get in what I need to...so I prioritize.
Kinda funny though...i can only imagine some of the things you hear...