Finding a good doctor is hard. I’m not even going to take into account insurance and payments for today’s discussion.
Doctors, like everyone else, have personalities. Sorry, but we do. Some more so than others but I digress. The patient-doctor relationship is interesting. It’s one of the few times where we let a stranger into our very private world, almost immediately, and we TRUST them with our lives. Did you do that with your husband or wife? How about your coworkers? Probably not. Physicians get to be a part of very intimate parts of our lives both happy (birth of a baby) and sad (death of a loved one). We inherently trust them unless they show us a reason not to trust us. We rely on their expertise to help us make decisions. What medication is best? When should I have this procedure? Some personalities click instantly and some no matter how hard you try the relationship just doesn’t’ work for some reason. Patients have fired me for various reasons, and I’ve released patients from my practice for various reasons. The relationship wasn’t beneficial to either party, and that’s not good medicine.
What happens when that relationship becomes a patient doctor patient-doctor relationship? I am no longer the expert, or at least I shouldn’t be. Finding a doctor who knows more about my disease can be a challenge. I NEED a doctor that knows more about my disease than I do. One it will keep me on my toes to continue researching my disease, and two it makes the person who needs to be the expert the expert. I want to do what I want to do. My husband loves it when I do that. There’s a great example from the movie My Big Fat Greek Wedding. The man might be the head of the family but the woman is the neck and she can make the head turn which way she wants. I can very easily go to a doctor and say this is what I want, this is the medication that I need, ok and go. And you know what, a lot of doctors when they are treating another doctor they let us do that. STOP IT RIGHT NOW. They are not the doctor at that time. I am not the doctor. I am the patient. If anyone else came in an demanding a certain treatment, I’d look at them like they had 5 heads and say … um ok? Why do you pay me again??? OH, right, to make the decision that is best for you. But what you need and what you want may not be the same thing.
I need the doctor to have answers to my questions. I didn’t bring you a question for no reason. I assuredly spent hours researching it in text books and asking every doctor friend I have because that’s what I do. And unlike the general population I have access to the same reference material you do. I am not on wiki or watching Dr. Oz. I’m reading pubmed, Up to Date, or reviewing the latest clinical trials. I ask because there is no consensus or no one I know knows the answer. You better be ready for your A game. I’m going to bring the hard questions. It’s ok to tell me you don’t know, I didn’t either.
Interviewing a patient doctor can be a challenge. I know why you ask certain questions during the interview. I know why you are ordering blood work, I know what diseases you are looking for. I’ve already come up with a differential in my head for all my ailments. I probably have a plan worked out too. I have the ability to lead you down a treatment plan maybe intential or not, becasue I gave you the right answers. Almost every new doctor I meet, once they hear that I have edema wants to check my thyroid. My thyroid is normal. It’s almost perfect normal. So you know what, I often don’t talk about the edema much, because once you hear there’s pretibial edema you are going down the rabbit hole of checking my thyroid. I’d probably do the same. Guess what? My thyroid will still be normal. Every test ever done for my edema has been normal. Despite 5+ physicians evaluating the edema, it is still there. Certain medications work and certain ones don’t. But that’s ok, because my current medications do work. You know what I don’t want you to do, mess them up. It took close to two years to get my diuretics figured out so I did not have a potassium of 2 or princess puffy feet. (And yes I was checked for hyperaldosteronism, and it was negative). I once let a cardiologist adjust my medications for a week. I gained 12 pounds of fluid and could no longer wear shoes. I waddled my princess puffy feet down to his office and said, see… this is what happens when you change the medication. But hey, I gave you the ability to see it for yourself.
I shouldn’t get special treatment in your office (I mean I’ll take it, but it shouldn’t be required). If you don’t treat me with respect why would you treat any patient I referred to you with respect? If I don’t think you are good enough to be my doctor, why would you be good enough to take care of my patients? We get referrals all the time from family members, oh you took care of my mom and she loved you so we sent our entire family to see you. Amplify that to 2000-3000 patients who need referrals. Likewise with your office staff. If I can’t get my medications refilled or a prior authorization completed I know you aren’t getting my patients completed.
The good news… you can use medical words. I’m still a peer, just a peer that is a patient at the moment. You all the medical words you want. Get out that 12th grade reading level material. I so love making fun of the patient handouts written on a 4-7th grade reading level. Geez, tell me something I don’t know. (They are good for everyone else, just not for me).
I don’t really envy any of my doctors. I have high expectations for my medical care. I’m probably considered a difficult patient. Don’t waste my time. Listen to what I have to say. This shouldn’t be any different than treating any other patient. All patients deserve to have their time valued and their thoughts listened to.
I have a new patient appointment tomorrow, I hope he’s ready.
What’s the biggest challenge you find in finding a good doctor for yourself?