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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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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
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.
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.
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.
How about...if your doctor and his staff are rude?
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.
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.
#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!