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 18-1 of 158
18
Great article Doctor. Can you do a followup one on how to find a new doctor, who isn't a Dr. X? Thanks!
By Hope_From_NY  Oct 03, 2008
17
thanks for posting this message. my old dr fitted into every one of those categories, and it nearly cost me my life.

on one occasion i went to see him with a lump on my neck, and he insisted it was a muscle. he said 'im the dr, this is my opinion, take it or leave it'... because of this my chemo was delayed by months.

unfortunately, it seems that the person i was finally referred to, is just as bad or even worse....

im glad you posted this message and i hope people who feel this fits the description of their dr, consider leaving and finding someone who will care for them. i only wish i had done that before i needed the dr for something more serious that a cough.
By pinky  Oct 03, 2008
16
Thanks for sharing this. I guess I am one of the lucky ones then. I had to have a phsical and a sign off when I was 14 so I could learn to SCUBA dive. MY doctor turned out to be a diver and spent time talking to me about some of the dangers, and some of his own positive experiances. Over the years (20 now LOL ) he's been supportive and friendly as I dealt with depression, a few broken bones, and fertility problems with my wife and I. I understand short waits in the room. I have not experianced the negative things you mentioned. Good article though that will open the eyes of many I am sure.
By UnsoundMind  Oct 03, 2008
15
Thank you, Doctor. Seems like all the doctors I have dealt with over the last twenty years or so are "Dr. X's" Someday maybe I will find the other kind.
By RichieD  Oct 03, 2008
14
My mom who had lung cancer surgery in 05, moved and 6mons later was referred to supposedly the best pulminologist in the city. I was with her when he walked in with his "entourage" (med students probably) and during the visit said, "call me if you start coughing up blood!" (was that supposed to be funny to a lung cancer patient???) Mom was horrified. She never went back and found another doctor who didn't make jokes about a life threatening disease.

Another reason to not go back to a doctor? How about when you only see the "PA" and never the dr. My last visit to my dr (or PA, cause I never saw the dr) was a few years ago when my irises turned red. The PA said it was pink eye. I knew it wasn't as I had pink eye all while I was a kid. I told him it wasn't pink eye but he ignored me. When my symptoms didn't go away, I went to an eye dr who said it was UVitis and very serious condition that left untreated can cause blindness--never went back to that stupid PA!
By piratewench  Oct 03, 2008
13
Great list Dr. O!!!

In regards to your #6: Dr. X hands you antidepressants without finding out what's wrong or at least suggesting therapy in conjunction with the meds.

May I add a couple more?

1) Dr X opens the door, says s/he'll be right back and you never see him/her again (i.e. when Dr. X is ready to move on to the next patient, s/he doesn't bother to ask if you have any questions/concerns AND doesn't say good bye)

2) Dr X attributes every complaint to an existing dx.

3) Dr X disregards patient's concerns, even tho the patient knows his/her body better than Dr. X

4) Dr X gets upset or is insulted if you want a 2nd opinion

5) Dr X informs you that a certain illness/disease/syndrome doesn't exist or can't happen in your geographical location

Another huge issue is that many doctors don't know anything more about prescription drugs than what the pharmaceutical sales reps tell them or what is in the highly slanted brochures. They also aren't aware of side effects or the difficulties encountered when trying to stop taking a drug. I have finally found a dr who subscribes to www.uptodate.com. She prints out info about my meds, supplements and medical conditions. This info also includes references to studies, etc. Now this isn't the be all end all of medical info, but it sure beats what most drs I've had in the past do.

Even the pharmaceutical websites post limited information. For example, I discovered some alarming facts about the side effects AND WITHDRAWAL issues for Effexor by clicking on every link shown in the drug info section of their website. What I found hidden was very scary. And obviously something they don't readily disclose as I had to click on several levels of links to get to the facts.
Nothing is as good as an informed consumer/patient asking questions.
By SeaNymph  Oct 03, 2008
12
Arlene48: GREAT ONE! Be leary of anything that is sold in your doctors office (supplements, vitamins, laser therapy) your doctor is making money off of those....
Dr O.
By DrOrrange  Oct 03, 2008
11
Great article. I'm thankful that my doctors seem to be very happy to listen to my concerns. I'm thankful that I've seemingly hit the jackpot!
By baldbeauty98  Oct 03, 2008
10
*Its a 3HR DRIVE :P
By SarahLynn  Oct 03, 2008
9
Well I know for me here in Canada its really hard to get a doctor in the city. I end up going back to my family doctor clinic that I have went to since I was a baby. So after about 3 hrs to make a doctors appointment I went in and after the inital consultation asked if I could ask her a question or something to which she replyed something like "yes but make it quick". 3 hrs for crappy health care? I understand that its a busy feild, but why get into it if you don't like people enough to make time, exeptions, or be empathetic to their needs?
By SarahLynn  Oct 03, 2008
8
How about doctors who sell supplements from their practice? I had a friend who wasted $160.00 on "amino acid therapy". His MD promised all sorts of good results (i.e. weight loss, less depression, more energy, etc.), but all he did was waste the money. I think those "supplements" were more about the MD making more money.
By arlene48  Oct 03, 2008
7
Wow, I've hit the jackpot here. My PCP exhibits none of these traits. He is so thorough and.. warm.. he's just a great doctor. I'm sad because I know hes going to retire within the next few years. Thanks for posting this!
By mmc613  Oct 03, 2008
6
Thanks. I'm really disappointed right now because I had a good internist. And old fashioned very through guy who took medicare and medicaid. He took good care of me. But because of mal practice insurance premiums he can't sustain a practice any longer. And the bright young minds aren't going into internal medicine these days. It doesn't pay. What are we left with? Luckily, I found in the nick of time before my meds ran out a new one. But her office is very large, impersonal and bureaucratic. It's run like a government office. It feels like the DMV with the attitude of the front desk. And my doctor isn't as concerned about me as he was. Or so it seems. She didn't make me wait forever, though. And we did discuss my bipolar disorder without her seeming to express any stigma. She asked if I had any support around me. I thought that was a thoughtful question. So it's not all bad.
By RKB  Oct 03, 2008
5
Yesterday i took my daughter to see Dr. Y. He did a few physical examinations and took her history, before sending us to the lab to do some tests. All this time i was facing him, explaining things about my daughter. I return 30 minutes later with the result and hand it to him, but without the baby. He gazes at me for 2 minutes, then asks me 'so madam, how may i help you, what are you suffering from? I had to expalain that i was there 30 minutes ago, and he says 'sorry i think you changed your dress, followed by 'i must be tired'. thats better but i felt hopeless, especially after paying consultation fees!
By ferrie  Oct 03, 2008
4
Arrogance. lol I had a doctor ask me what my symptoms were, so, I attempted to give him background information which I felt was relevant. He cut me off without any ceremony and said in a haughty English accent, "No, no, no. When I ask you what your symptoms are, you don't say, 'I'm wearing a yellow dress'. Just answer my damn question." Ha ha ha ha. He really did say this. He was dead serious. It was only much later that I found the humour in the situation, but I don't think that was his intention.
By bato  Oct 03, 2008
3
THANK YOU!!!
By rhonda1964  Oct 03, 2008
2
Thanks for the article. My ex doctor fell into most of these categories. She also scolded me for something I told her once that didn't coincide with her religious beliefs (what I told her had nothing to do with religion at all!). All of these reasons are why she is an ex doctor. My new doctor is amazing! I wish everyone could have her for a doctor! Thanks again.
By wakinyantechate28  Oct 03, 2008
1
My GP falls under almost every single one of those categories. Is that good reason to change doctors? For so many reasons lately I have been in to see her and voice my concerns about my health and she just acts like she doesn't care and doesn't suggest something to do. Aren't they supposed to help?
By havenofear  Oct 03, 2008

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