I hope it doesn’t come as a surprise to most non-medical people, but doctors get together and talk about patients and the things that they do that drive us crazy. Over the years, we have all met some real characters and had experiences that will live on in our memories forever. I would like to share a few of my personal favorites, as well as some of the collective wisdom I have gotten from some of my doctor friends. Maybe if you see things from the other side, you might see why these particular things make us nuts. I don’t know if this is just a way for me to vent, or a way to actually see some change in the way that people behave when they come to a physician’s office.
One thing guaranteed to make me crazy is someone who comes really late for their appointment. I really try to be on time for appointments. You may not find this in every office, but we actually schedule adequate time for patients. If you are late for your appointment, I either have to make your appointment shorter, or run late for the rest of the day. I may even go ahead and see the people who have appointments and have arrived on time. Sometimes, when you are sitting in the reception area wondering why it is taking so long, remember that it isn’t always the doctor’s fault.
Along the same lines, some people come in with a “laundry list” of problems. They schedule an appointment for a “pap smear” or an “annual check-up.” But when they get to the office, they have a list of things that they want to have addressed. My staff or I will explain to these patients that we can do one or the other. We do not have enough time allotted to do both things. Plus, it may not be possible to do both. For example, if you have a vaginal infection, you need to wait to get your pap smear. So, you are going to have to choose what you want to get seen for. Don’t get mad at me. You need to tell the person who schedules the appointment exactly what you are coming in for. Don’t be embarrassed. The scheduling person has generally heard it all before. They are just trying to figure out how much time you will need, and if you need more than one appointment.
Some patients wait until they see the doctor to bring up the list of problems. This causes problems because the room may not be prepared. The nurse didn’t get the appropriate equipment out. It causes a delay during the appointment or a reschedule. We do work as a team, with the staff being a very important part. If they are prepared, we look like the professionals that we are. If a patient slips something in on us that we don’t expect, we may not even have the right tools to do the job.
Please don’t bring up a new problem when we are just about finished with the visit. I know that these problems tend to be the most personal problems – at least in a gynecology practice – but they also tend to be the problems that need a whole visit to themselves. It’s good that you are finally comfortable with your doctor to talk about the really difficult thing, but you are probably going to need to make another appointment to talk about it if you didn’t bring it up earlier.
By the same token, patients who ask for pain medications as an “oh, by the way” at the very end of the visit are highly annoying. If you have pain, that should be the focus of your visit. Or you should be well known to your doctor and “just be asking for refills”. If this is a new request, this is a whole visit. Most doctors will think that you are a “drug seeker”. This is one teeny tiny step away from a “drug addict” in doctor talk. We do understand that people have pain, but you need to bring this up during the office visit, not at the very end.
Another way to really tick me off is to ask me to refill medications that another doctor wrote for you. Often they are medications I don’t know very much about. Sometimes I have never heard of them. Medicine is very specialized these days. Your internist can’t keep up with current hormone therapy, and I can’t keep up with current diabetes or blood pressure treatment. If I can’t spell it or pronounce it, I probably don’t know what it is or what it is used for, and you are going to have to go back to your other doctor. Please don’t ask me to change medications that another doctor has written, especially if they are out of my area of expertise. I don’t know much more than you do about some of those drugs that you “see on TV” unless they are in my specialty.
Please don’t ask one specialist to treat a problem in another specialty. That’s another chronic irritation. There are some doctors who treat a variety of problems. They are called generalists. Like pediatricians, internists, and family practitioners. Even they will tell you that they do not feel comfortable treating certain problems. For example, adult doctors generally have no idea when kids should get their vaccinations, while pediatricians do not usually treat breast cancer. A gynecologist is great with birth control pills, but very confused about newborn rashes.
On the other hand, I have studied and worked for years to learn my specialty. So, if you come to me and pay money to ask for my advice, it would be nice if you at least tried to follow it. I really love patients who come back and tell me how they did – good or bad – after following my advice. I get really frustrated when people come back with excuses about why they couldn’t do what I advised them to do. I really try hard to make my treatments fit into the lifestyles of my patients, taking into account the type of diet, family life etc that an individual woman has. I really work hard at negotiating treatments so that they are workable within the framework of day-to-day life. Then to hear “I didn’t have time to do it” or “I never picked up my medicine” from someone who comes back to see me and isn’t any better just feels like a waste of everyone’s time and money.
I do negotiate with people. Some people have good reasons why they can’t do certain things. I am willing to work around patient’s lifestyles. But, if you have a problem that is bothersome enough for you to see a physician, I would think that you would be willing to make some effort to change things. If I have offered everything that I know to do, and you have turned me down flat, having an excuse for why “nothing will work”, sometimes I end up referring to another physician because I just can’t help you. I’m willing to work with you within reason, but you have to work with me.
Medical care has to be a partnership, in my opinion. We are no longer in the days where the doctor makes all the decisions and the patient meekly follows. Those days went out with girdles and wingtips. So let’s work together to make your health better.