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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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10 Things Your Primary Care Doctor Does That Should Make You Run for the Hills
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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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.
Or when I have an appointment and they call on the morning of the appt. to cancel and I'm already there!
Rudytrue :)
Wish the AMA could see it. Not that they'd DO anything, but they should see it.
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!
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
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.
Dr O.
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!!!