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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TOTAL COMMENTS: 158 - View All Comments »

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Displaying comments 38-19 of 158
38
I'd like to add something on #5. They aren't willing to prescribe pain medicine for people w/severe, chronic pain. We, as a nation, outlawed cruel & unusual punishment for criminals no matter how heinous the crime. But those of us who live w/chronic, severe pain, through no crime or fault of our own, are given a life sentence of severe, unremitting pain if we're unlucky enough to have the wrong doctor. Yes, you can go looking for another doc, but if you live in a small community, you're labeled a "doctor shopper."
By crowmother  Oct 05, 2008
37
The worst thing about all of this, second opinios cost money, time off work which ends in lost wages, it's the domino effect.
Here is one of the worst blunders Dr. X can do:
A patient suffers from sever migrains, patient has been diagnosed with having nerve damage due to the severity, patient now has palsy type numbing down one side of face (left) during these episodes, forhead litterally gets a gap the size of the width of your finger, temperal artery also bulges during these times, VERY expensive tests are ran, yet Dr. X puts patient on anti-depressants and dismisses that it is a psychological problem.
I have actually had the luxury of being able to tell my family physican exactly why I stopped going to that neurologist. Bottom line is, I have other responsibilities that I have to take care of like put food on my table, why would any of us want to continue to spend money on doctors who truly lack the old days compassion that once was?
So in summary, the next on the list:
Dr. X thinks it's all in your head
By riascollectables  Oct 05, 2008
36
Yep, you missed a biggie Doctor X is a liar! You pull your Medical records and find computor generated notes that state"Patient appears to be a well nourished xx year old male, there appears to be no lesions or bruising around the knee area" and so on and you know this doctor has never even touched you much less had you drop your laundry where he could see this particular body part.
I was shocked to see a lot of my records from different doctors when I had to pull them all for a disability hearing!
Most recent was my letter of recommendation for GBS. My x physician stated that we had exhausted all avenues of diets and medications for weight loss and felt that this was the next logical step. Then upon my request to have him send in office notes so I could finish the approval process, he told me he couldn't even remember me being on a weight loss program, and said we;d have to start a new one for 6 months.
My first thought was can you say "insurance fraud", as this would guarantee a monthly billable visit for the next 6 months.
I just completed a new one with a different doctor.
By DeltaLimaTango  Oct 05, 2008
35
I went to my doctor about my weight. He handed me a two sided sheet of paper with an eating plan for two weeks. Like that will cure my ills. My insurance pays you good money so spend time with me and show me what to do.
By soulsearcher83  Oct 04, 2008
34
My doctor(s) have had the tendency to whip out the Rx pad before even trying to examine or determine the cause of the complaint.

They also have made me fill out the same are you depressed / do you wish to hurt yourself / questionnaire over and over again (follow up visits to the original exam).

so, I'd have to say doctors that INSIST that the only answer is to take a pill.
By slimeyapple  Oct 04, 2008
33
Will you be my doctor?.......your patients sure are blessed to have you as their physician. Hugs
By benice53  Oct 04, 2008
32
Oh yeah, I have another one; if you arrive on time for your appointment and your doctor takes someone with a LATER appointment before he takes you.
If your doctor loses your previous medical records or refuses to forward records to a new doctor even when asked to do so...in WRITING.
By ALC67  Oct 04, 2008
31
I have another one; you're seeing a doctor for the first time and you detail your medical history and after a cursory examination the doctor tells you you DON'T have something that you've been treated for for several years. Happened to me. I never went back.
How about...if your doctor and his staff are rude?
By ALC67  Oct 04, 2008
30
These stories are FREAKING me out...it looks like we've all learned NOT TO STAY WITH THOSE DOCTORS
By DrOrrange  Oct 04, 2008
29
Dr. X calls you to confirm the diagnosis of a chronic autoimmune disease and tells you "it is no big deal" when you are upset. They then proceed to mock your choice of treatment and tell you that "it will fail anyway' . I've since divorced that endocrinologist and am doing very well on the treatment that was supposed to fail.
By Singersue  Oct 04, 2008
28
How about a Dr. getting caught with pot or getting a DUI
By Hockegal12  Oct 04, 2008
27
when i told a doctor i was having chest pains she suggested i was just being hormonal. i had Costochondritis, not sure i spelled that right. my chest was inflamed. i find that doctors often dismiss my concerns. i don't enjoy going to the doctors so i'm not making the trip for the fun of it and it makes me angry to not be listened to. most time they don't even check to see whats wrong and i always feel rushed out. i suffer from chronic pain but most look at me and see a normal person who couldn't possibly be in that much pain on a regular basis. i went to an urgent care clinic and was told the fact i had a severe migraine for over a week was not something that was serious for them to see me at urgent care. i'd like to see them have the high level of pain i did for over a week and see if they still feel its not urgent enough!
By tayiadragonbite  Oct 04, 2008
26
The doctor declines reports from his predecessor, attempts to treat you for several months, botches things up, can't figure out how to treat your disease, and then sends you for a second opinion to a university-based psychiatric clinic that uses trainees and outdated technology.
By Glinda  Oct 04, 2008
25
You walk into the waiting room and look around. Pharmaceutical reps have done the interior decorating, from posters to tissue boxes to magazines and magazine racks to pads of scratch paper and pens to brochures and brochure racks to stickers and other freebie gifts to ads with coupons. None of the doctor's own personality comes through. I read it as the doctor is a drug dealer.
By Glinda  Oct 04, 2008
24
One time i had a doctor who could never figure what was wrong with me, and he would never say whats wrong, but diagnose me with this we KNEW werent wrong. So instead of admiting he didnt know he pumped me full of pills which made my ulcers at the time much worse. We all need to admit defeate, its how we find a way to win
By KrusH  Oct 04, 2008
23
Just a few more to add on this one...

When the doctor tells you you are anxious and should take anxiety meds because you finally broke down in tears in front of them because they just told you... what you have is a pain in the neck, it will not kill you and you have to get over it! (fractured my vertebrae twice in my short life time and he wants to tell me what kind of pain it takes for me to break down in tears? will not even run more testing on my back to figure out why it is hurting worse now than it ever did- without fractures?) But he was more than willing to keep feeding me pain killers and anti-depressants I AM ONLY 23!

Or how about if the doctor tells you... the patient, that a symptom you have described and is happening all the time actually doesn't exist? Sorry, reverse psychology doesn't work with migraine auras!

My all time give away...
When you walk in to see a rhuematologist you had to wait a month to get in to see and they take one look at you sitting there, laugh and say that I am simply too young to have anything that they treat!

Sorry but I still haven't found the right doctor for me, I have been through 13 different kinds in the last two years... Apparently they are not that good in my region? LOL.
By IC2Much  Oct 04, 2008
22
Everything you say is so wrong. If I am not totally satisfied by any of my doctors, I just find myself another one and most times that other one is so much better! I have had a rheumatologist for 5 years, but it came to the point that if I didn't do his crazy ideas, he would become furious with me! He wanted me to have cold laser therapy on my back by a chiro, so I went online only to find out that's not even FDA approved for that purpose. When I told him that, he went into a rage and I won't tolerate his nonsense anymore. My parents were of the generation who believed their doctors can do no wrong, when in fact, the last one they had before they moved to an ALF, actually neglected their health probably because they are just old people. Crap. I just changed their dr. from an internist to a geriatric doctor with 2 fellowships.

For me, it's all about being kind and caring and thorough. I hate alarmists and refuse to see them. But, also don't treat me like I am a moron because I do a lot of reading about each of my disorders online.
By flip12flop  Oct 03, 2008
21
Those are very good warning signs to watch for, but may I add some more?

#1 After moving to a new state, your new doctor looks at you after you have spent the last 10 minutes explaining your symptoms, all the treatment and diagnoses that you have had from your prior physician(s), and even offering him copied of all your medical records and tells you that there is no way you can have X disease because it does not happen to people your age. (And also that you cannot have X disease because he has "never heard of anyone having a genetic condition that predisposes you to that disease.")

#2 The new doctor looks at you after you tell him that you have Fibromyalgia and tells you that there really is no such thing as that disease.

#3 Your doctor takes a call from your employer without your permission and discusses your medical condition with the employer; then calls you to let you know all about it.

#4 The new doctor refuses to look at the medical records that you have brought from prior physician, order the medical records from the prior physician, or even talk to the prior physician when he calls to try to get it through to the new doctor the severity of your health problems.

And finally, #5 After running the "normal" tests to try to find the cause of certain symptoms and coming up with negative results refuses to do any more tests or do any more research to find the cause of the symptoms. And to do this even though there is obvious damage which could lead to gangrene and/or amputation if the cause, and proper treatment of the disease which is causing the symptoms is not found.

(Yeah, I have a lot of stuff going on with me, and not a lot of doctors that are willing to really look into this to find the cause of most of my problems. They are just "treating the symptoms," and now that the treatment is no longer working, they have thrown up there hands and says that they don't know what else to do. I am at my wits end, especially since my husband is out of work and we no longer have insurance!
By aqualady2001  Oct 03, 2008
20
The doctor I had when I was first diagnosed with diabetes would prescribe some lab tersts to monitor my progress, but would only increase my dosage of humilin insulin. I finally found another provider who changed my insulin from Humilin to Levemire and Novolog. This has helped my termendously.
By Warriorhlh  Oct 03, 2008
19
Thanks for this! I am now seeing a much better doctor who has not done any of these things. I will try to remember these things for the future.
By squeaker87  Oct 03, 2008

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