Primary Care Physician
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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10 Things Your Primary Care Doctor Does That Should Make You Run for the Hills
Posted in Alcoholism by Dr. Sharon Orrange on Oct 03, 2008

In the last year I've had the opportunity to be a patient and a Doctor. I have frustrations like you do so I came up with my list. 


1) Dr X leaves you waiting more than 45 minutes in the room on more than one occasion without an explanation or a quick apology when entering the room "I'm sorry to keep you waiting." Another way to handle it is to have the nurse let you know "Dr X is running 30 minutes late today so you can grab a coffee or a magazine"


2) Dr X's office provides no way for you to reach a HUMAN VOICE afterhours or on the weekends if you have a medical issue that requires attention THAT NIGHT.


3) Dr X smells like cigarette smoke. I get it...it's a hard habit to kick....but you can't smell like cigarettes when you are going to counsel your patients about modifying their risk factors for stroke and heart disease. You should cut it out during your clinic day.


4) Dr X doesn't touch you. You have a specific complaint (shortness of breath, knee pain, sore throat) and your primary care doctor doesn't look or listen to the affected area....maybe I'm old school but the answer so often lies in the physical exam


5) You are having severe pain (i.e. back pain after you lifted a couch), not relieved with over the counter meds, and Dr X is unwilling to prescribe pain meds for breakthrough pain because "they are addictive". We are dismal at treating pain in the primary care setting for unfounded fears of this. Short term use of Vicodin, Tylenol with codeine, etc for treatment of acute pain is completely fine for most patients.


6) You are talking about feeling depressed, sad or discussing a painful life event (the recent loss of a parent, etc) and you start to cry.... and you notice Dr X appears uncomfortable and tries to change the subject. Bad news.


7) A recent study showed that during 30% of primary care visits the doctor spent more time talking about themselves than they did the patient. Ok my patients often ask me how my kids are. 30 seconds...that's the amount of time I spend talking about myself. This visit is about YOU and we are already limited in what we can do in 15 minutes.


8) Dr X says "that's just part of getting old" when you have a complaint. Its true: arthritis, visual changes, decreased hearing, sun damaged skin are among the fun things that go along with getting old but WE CAN STILL HAVE A PLAN to deal with them and alter their course.


9) Dr X delivers bad news (loss of a pregnancy, a positive STD test, a new cancer diagnosis) with language that is short, sharp, rushed and without emotion. Some news will change a person's life forever and they will always remember that moment.....to add to it with a cold delivery is just painful.


10) Dr X can't say "I don't know what that is....but let's make sure it's not something worrisome". Often a patient has a pain, skin lesion, weird symptom that occurs only when they are doing such and such activity and I don't know WHAT it is. But it's your doc's job to admit that...and say they will do their best to monitor it and rule out worrisome things.


Am I missing anything? 


Dr O.





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Displaying comments 58-39 of 158
58
I would say the doctor that doesn't say anything. Just working as a physical therapist, I ask the patient after their follow-up visit, "So what did the doctor say?", 60% of the time I get, he didn't say anything, just continue your therapy. He also left the room in under 3 minutes. Just a thought.
By heartache101  Oct 07, 2008
57
Dr. does ultrasound and some lab tests, then calls you at home, the eve of Thanksgiving to tell you that your 5.5 week pregnancy is non-viable (no embryo, no heartbeat, hCG high etc.). Since it's a holiday, he will make arrangements for a D&C first thing Monday. This was my first pregnancy, so I was obviously distraught. Googled some, then called the Dr. saying "I looked this up, and at 5.5 weeks, one might not see the embryo or heartbeat, maybe you are wrong about this?". Dr. insists this is not a viable pegnancy, and that they don't go by weeks (??what?) but by hCG levels (?why?). I check out this last thing, he had a single measurement which is useless in my situation, so I call him again and I said "I looked this up, and what you say doesn't make sense". He gets really furious - not at me, but apparently at his son who, god forbid, entered the room while he was on the phone. He was really nasty to him, and I overheard all that, and really felt bad for the boy. Then, very tersely, he told me that I could have another ultrasound "if I really insist". It was Sunday by then, I was totally a mess, so Monday my husband and I drove out to a clinic in the suburbs that could see me on a short notice. We got a picture of the baby (that he insisted was not developing). I basically payed out of pocket just to put my mind at ease. Come Friday, we had another ultrasound at the Dr.'s hospital, and there was the baby, heartbeat and all! That is now my 3-year old daughter. His nurse called to let me know everything was OK. The Dr. didn't call to appologise.

So, now...
1) I felt he was really twisting my arm to get a D&C, and quick!
2) He lied about his diagnostic process. The tests cannot be used that early or the way he was presenting it to me. There is NO WAY he could have been speaking in good faith (and still retain his licence). It's all pretty basic stuff.
3) There is no need to set up a D&C at the first place - the miscarriage can occur naturally. There is no need to insist on an early D&C when one might simply observe for a week or two.
4) He is the head of the Reproductive Endocrynology Clinic at the hospital. He is in business of helping women concieve - artificially. With some stretch of imagination, one might interpret the events as him getting rid of a real pregnancy, with the final result of possibly getting another patient for his clinic.

I decided not to be so cynical, but I still wrote a letter to the President of the University. Before I did that, I spent about 4 weeks trying to figure out the appropriate office to mail it to. No such place in our hospital. I actually asked an MD that I collaborate with at work, and he laughed - no oversight for the MDs. So I mail the letter to the President, it gets shunted wherever, and I get a reply signed by a REGISTERED NURSE. More or less, the reply was "we have no record of these phone calls happening, and besides, none of our doctors would do something like that". I kid you not. (For all the fellow BP or mental sufferers, this happened WAY before I had a dignosis or was 'on books' in any way. It is NOT the stigma. It is the broken system of no accountability.) So I write another letter to the President, saying basically "I don't lie, please address my concerns", and I never heard from anyone at all.

In case you think this is a community clinic somewhere in the sticks - no! This is a big-ass hospital at a big-ass University and medical school, a teaching center and the whole nine yeard.

This experience left me very shook up. I used to trust what my Drs. tell me, for they went to school, and I did not. It was a very reality-warping experince to go back and try to coax truth out of a Dr. based on my own research. I used to not give myself that much importance. I am much better prepared now. I don't trust ANYONE. It has served me well many times. It sucks though, to have to do this. I went to school to my thing, not do pretend to be a medical practitioner. I HATE it. I think Drs. should have their salary docked for errors. Moreover, I want to retain the right to not pay for botched service. There has to be some accountablility.
By cb72  Oct 07, 2008
56
Thanks Dr. "O" for understanding, Another one is when you can hear Dr. X thanking his real estate broker or contractor, on a dpersonal telephone call. This has happened to me twice. I do not see these doctors anymore.
By reenee  Oct 07, 2008
55
Dr X dismissed a physical issue I was having as being all in my head. I thought this only happens in bad TV dramas! He sent me to a shrink!!
By SpaceshipSorrow  Oct 07, 2008
54
I had to endure several years of being told my pain and fatigue was all in my head. I would get frustrated when they wouldn't believe me and they would hand me scripts for antidepressants. I wasn't depressed. I WAS IN PAIN! By the time 9 years of this went by, I was so sick I was hospitalized. I had Lupus with kidney nephritis. I almost died. I would have say that doctors who dismiss female (or male) complaints of pain and fatigue as just "depression" need to be re-educated! I was told later that I "made being sick look good" . I can't help it that Lupus is an "invisible disease". I certainly wouldn't have made appts. to find out what was wrong with me to just for fun! I was a busy active nurse!
By BeautifulDreamer  Oct 07, 2008
53
lol i hate the doctor's that you see in replacement for your doctor, they try to undo your normal doctor's work with med's, i am on a spacific medication and another dr i went to see because mine was away told me she diddnt like it that i was on this medication and wanted me off it!! needless to say i complained to the surgery and my normal doc, he wasnt pleased witht he female gp but she was foreighn, spoke broken english so its a wonder how she ever undrstood me, then she had to refere to a manual to look for my symptom's when i already told her what i was diagnosed with!! silly moose... sadly my doc has just retired so i got to go with another one :os i think it's good when a doctor engages in general chat too, it show's an interest and you get to know them a little better which is good if your nervous about talking to stranger's, thaught number 3 was funny, im a smoker and so was my old old old doctor, he tried hard to discuise the smell of smoke but i still smelt it then he told me it was bad for my health laa de blah and all that so i asked him if he ever tryed to quit, he had on several occasions but found it hard to kick the habit so i told him well when you manage to quit then so will i, needless to say nothing more was mentioned over the matter lol best one is hospital's when you have a baby, i was told that there was a problem with y son then they left me waiting for hours before assessing me and telling me that they knew all along it wasnt a seriou's thing just distress grrrrrrr helloo comunication!!... some dr's are really fab and im blessed to have had the experience of being a patient to some of the finest :o)
By mazz1983  Oct 07, 2008
52
Dr. O, what a good post!Alot of times, I get so frustrated because I drive 2 hrs to IU, I wait for an hr in the waiting room . And I get 5 minutes.I'm stopping my Dr. with questions as he's walking out the door :)
Or when I have an appointment and they call on the morning of the appt. to cancel and I'm already there!
Rudytrue :)
By Rudytrue  Oct 07, 2008
51
Yeah this thread is long. Lots of horror stories out there.
Wish the AMA could see it. Not that they'd DO anything, but they should see it.
By ALC67  Oct 07, 2008
50
ya, what if ur docter is really shy and it takes alot to get info out of him other the an being dx.
By meme88  Oct 06, 2008
49
How about having a Gynocologist tell you you're going to hell because you have a tattoo. THAT was fun. Then he told me to lay back for the exam! I refused and he actually seemed stunned and bewildered.

How about showing my painful knee to a doctor and him telling me its nothing because his wife's knee makes noises all the time.

Or how about this one: Go into the ER with the worst headache of my life, I can't speak right and my left arm is twitching uncontrollably. The doctor came in and in two minutes (without even doing a cursory physical) told me that if I wanted pain meds I picked the wrong doctor. Uhm... I didn't bring up wanting pain pills, I just told him I took an Excedrin and the headache didn't go away. I still don't know what was wrong with me.

I'm now a huge advocate of "They work for you, so if they don't work- Fire Them".

Great topic!
By gemiwing  Oct 06, 2008
48
my psycologist that i use to use diagnosed me with depression and put me on meds. i told her about how i had beliefs that i may have bi-polar disorder cause i have two aunts with it and i do have occaisonal mood swings, just that they are short term and i normally am just depressed. She sort of brushed these off and ignored them like it wasn't possible that i could have bi-polar disorder. She asked me what i knew about it and i had done some research on it so i told her what i knew, and she sort of brushed it off and told me i didn't have it.

i don't know i guess the main point of this is that doctors should take a serious look into any concerns with disease esspecially if there is a family history of it
By betteroffgone  Oct 06, 2008
47
My word this thread is getting long! OK here are my ones;

You are a teenager with type 1 diabetes and fluctuating blood sugars. The test results you have written down are clearly false. You cannot make every single clinic appointment but instead of trying ton work around that the clinic drops you totally with no treatment for your diabetes.

Years later, your blood sugars are still fluctuating but you have started to work on them and very very hesitant and scared. You are also going through a very difficult time in your life and have come to ask for depression meds. Instead, the doctor treats you like a politician evading the question on Newsnight and harangues you about when you last took your blood sugars until you are in floods of tears, then tells you time is up and you should leave. Nobody helps in the reception area and it is left to another patient to calm you down and help.

You have finally got yourself onto an education course and been told you need ketone strips in case you get sick. You turn up at the GP to add these to your repeat prescription and are told by the doctor that they are already on there - turns out they did not know the difference between blood strips and ketone strips!

You are in for your regular prescription review - pointless since you get checked out and tested much more thoroughly at the clinic, but anyway, if you don't go they will take your meds off you. So you go. The doctor says you should be on cholesterol meds (at 25!). He looks up some information on why and what they do. He looks some more. After 15 mins of looking online and in reference books, he has found nothing and seemingly cannot explain it himself. You leave without the cholesterol meds.
By Lizzie  Oct 06, 2008
46
I was recently diagnosed with congestive heart failure and it was very blunt and scary. The doctor said "your heart is beating itself into failure right now and its very important that we get you admitted and on the right drugs to prevent the two valves you have that are leaking-quite badly actually-from giving out entirely. That would mean emergency open heart and we don't want that now do we?" then he just smiled and walked out. I came in thinking I had a simple case of pneumonia. You're right, I will remember that day for the rest of my life.
By Rockerhunee  Oct 06, 2008
45
I had a Doctor in 2006 tell me my CEA was to high. And said I had a long road ahead of me. Well 2 years later and thousands of test. I still don't know what is wrong with me. Been told about 3 dozen different diseases. That's just peachy.
By TrishaW  Oct 06, 2008
44
I went to a Dr for skin rash, recurring fever, aches, etc...(my mom has DLE, so I wanted to be sure). This Dr wouldn't do the punch biopsy because he said I "didn't look sick" to him. Needless to say, I found a new Dr, but I STILL don't have a diagnosis.
By bellybel  Oct 05, 2008
43
cb72: We had this blog that I wrote on our homepage about 6 months ago before we officially had blogs...I reposted it because I get so so so many comments about lousy doctors.
Dr O.
By DrOrrange  Oct 05, 2008
42
I went to my doctors when having a miscarriage, he wasnt there so I saw a new doctor and my regular doctors wife came to take my blood pressure, she couldnt get the machine working, after 3 tries she announced in front of the doctor that I always cause problems like this when Im pregnant. My daughter is 11 and when I had a smear the nurse made me bleed all over the floor. Nice or what? 1 lm loosing a baby, 2 lm made out to be a slapper in front of a doctor I dont know. No I didnt get an apology.
By ifail  Oct 05, 2008
41
I have read this somewhere before, and not too long ago.
By cb72  Oct 05, 2008
40
HAH, .. I would be happy to have a doctor who speaks clear English!!!
By WanderingVet  Oct 05, 2008
39
I just found out I had Type 2 Diabetes and went for my first Dr. appointment. I am only 25 (not that is really matters my age), but after being asked "Why are you here" - 3 times. And, "Are you sure you dont have gestational diabetes" (pretty sure I'm not pregnant)- knew it was a bad sign.

Then, she told me to stop watching TV and stop eating cheese burgers, as if that is the only reason I have gained weight and developed diabetes! Then when I told her well, i dont really watch tv nor do I eat cheese burgers (red meat bothers me) - She looked and me from under her brows and said, "hmph, You just need to stop making excuses" - I left and found someone else!!!

I admit im overweight, but I also have Insulin resistance and PCOS - can make weight loss more difficult, but I am trying. This too was after I told her I had already lost 20 pounds, to which she replied, "Well obviously you need to loose more" -

I wish I were making all this up, but I'm not - needless to say I did not pay for the visit!!!
By Neonpurple363  Oct 05, 2008

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