by Madeleine KandoI commiserate with a friend at my health club about all sorts of things. That’s one of the advantages of relating to someone on a ‘locally specific basis’. You know, someone you only meet at the supermarket, or when you get your coffee at Starbucks every morning at 9 am. It’s a safe way of letting off steam because you know you won’t see that person anywhere else that day.
My locally specific friend talks a lot about her ‘doctor’. She is so enamored with him that her choice of words borders on adoration. ‘He is very very famous, you know, MY doctor. He is in the paper and on t.v. He really likes me.’
I thought of her when I went to see MY doctor yesterday. Of course he is not MY doctor at all. He is so many people’s doctor that his three secretaries have to go through terrible contortions to try to cram the enormous amount of patients’ charts onto the shelves behind their neatly lined up workstations.
One of them was wearing a Micky Mouse hat with a big red ribbon that matched her red sweater stretched tight over her expansive bosom. It was Halloween, you see. As I was waiting, I was watching her step onto a wobbly stool, one hand holding a chart, the other holding onto a cabinet. She was engaging in her daily struggle to squeeze one more patient onto the already overstuffed shelf.
MY doctor is a very famous spine specialist. He doesn’t know my name and I doubt he remembers any of his patients’ names. To him, I am an L5 with a bulging disk.
I have been whisked into one of the many examination rooms, waiting for MY doctor to come in. My ‘friend’ at the club would be proud of me. He only made me wait an hour.
He comes in, shakes my hand without looking up from the sheet that he is holding in his hand. He asks ‘how are you?’ in a tone that does not expect an honest answer. So, when I answer him truthfully that I have seen better days, he looks up, a bit surprised.
He is very laconic, with a flat affect. I recognize this as a trick of the trade, a way to discourage patients from asking too many questions. That would risk extending our meeting and an L4 with narrowing disk space is waiting in the next examination room. I know how she must feel and with a guilty conscience I ask MY doctor to at least look at the expensive MRI that I brought with me.
Ten minutes later I am back in the hall, wondering what happened. I had a shitload of questions, but somehow the person that I was talking to in there did not seem very interested in me. I had the distinct feeling that my condition didn’t pose a special challenge. He was either thinking of his next patient or what he would eat for lunch.
I was really open to the possibility of getting to know him. I could have told my ‘friend’ at the club, that I too had a nice, famous doctor. But I think there is a point in some doctors’ career where the patient load reaches a critical mass, where there are just too many patients squeezed on a shelf. They must start blending together, like pureed potatoes.
I don’t feel terribly sorry for MY doctor. He has chosen the path of least resistance to fame and glory. But his secretaries… well, that’s different. I have a suspicion that my chart will start gathering dust. I can already hear the sigh of relief when, instead of stepping onto her wobbly stool, the big bosomed secretary will toss my chart in the wastebasket. Phew! One less potatoe to worry about. leave comment here
5 comments:
I think your experience is typical.
It doesn't have to be this way.
If you get a rare and deadly disease requiring expenasive and disabling treatment, you might find a closer and more genuine relationship with Specialist MD. That was my experience for a coupleof years.
I am much happier now, having returned to being no more than an ordinary pationt with an unusual history.
I suspect much of the hypochondria I see in friends and family lies in the desire to be closer to the doctors.Having been the "anointed one" who gets the personalized attention, I can tell you that the doctor is not your friend. A doctor can save your life, but he or she not your friend.
People who really want to be "understood" might be best served by an experienced professional counseler.
Steve:
Your case is illuminating. I suspect some specialists would rather not interact with patients at all.
Some new kind of technology might fit their temperament better, where we could FedEx our ailing body part and have them return it overnight with a 'special delivery' surcharge.
To get the best medical service, we always find it helpful to present our questions in writing, faxed to the doctor before an appointment, or presented to him during the appointment. These notes get filed in the patient’s chart.
Specialists generally DO know their patients and their condition. I’ve worked in health care for 20 years, and I have found most physicians (and their nurses/office staff) to be remarkably caring and compassionate. I cannot count how many times various doctors have sent me information while they are working at 1:00 a.m. at home, trying desperately to find a way to help their patients. A doctor was once late for her appointment to deliver research notes to my office -- she had to pull into a parking to cry because she had lost a patient that day -- a young girl whose life she had tried to save. Not only are they very caring people, doctors and nurses get spat upon, cursed at, threatened – sometimes even when they are in the act of saving that very patient’s life in the ER. Their hours are long; their salaries aren’t always as high as the public thinks.
We should also cut the staff a little slack. We need to be compassionate toward those who might be overworked, underpaid, struggling to keep their jobs - like waitresses, secretaries and many others.
Of course, there are rotten apples in every barrel. There are bad doctors, bad teachers, bad car mechanics, etc. There is always the option of switching doctors. We have done that.
If you switch doctors, be careful that you don’t dismiss what might be the best specialist for your condition. We all want a warm, fuzzy and chatty doctor, but what we really NEED is medical competence – a doctor who will do everything in his/her power to cure you! I’d choose competence over warm and fuzzy any day. In fact, I’ve done exactly that. Being faced with a dire medical condition, I was treated in a “warm and fuzzy” environment where everyone sympathized – but when the grueling treatment did not cure me after two year-long attempts, that doc was unwilling to try a more intense treatment course which I had heard about. They were ready to just let me perish! So much for warm and fuzzy!!
I switched to another specialist. On the first visit, I was told sternly that the treatment would be long and difficult, and that he only wanted patients who would be 100 percent dedicated, and that he didn’t have time for those who would be non-compliant. Other patients did not like his no-nonsense manner, but I was looking for a cure, not someone who would just hold my hand.
Later I discovered this man was actually a very caring person. While he was very harried and had a crushing patient load, he lived and breathed his patients’ medical care. Many doctors, nurses and medical care workers (yes, even the file clerks) deserve our gratitude and our compassion.
Thank you for your keen observations about the impersonal, uncaring process of too many medical consultations these days. The diagnostic label becomes the focus instead of the human to whom this abstraction is attached. Several years ago there was a Michigan study of physician-consultee interactions on videotape. Everyone was aware of the ongoing documentation. The average time before the physician interruped was 18 seconds.
Betty, RN MA
To Anonymous:
Of course I do not presume to speak for everyone. So don't take my story for more than it is: an attempt at processing a frustrating experience by writing about it.
But, in my own defense, patients do put a lot of trust in their physicians, and this particular doctor did not warrant my trust, before or after his treatment.
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