We as patients have more information at our disposal than ever before. Sifting through that chaff to find some wheat is, however, sometimes the most daunting task before us.
We ALL get to be patients, unless, of course, we die in the deer stand, soon after falling asleep so we’re not discovered until rigor mortis is upon us, or in a (hopefully) sudden single-vehicle accident where no one else is hurt. Physicians who fail to remember this are out of touch with their charges and human frailty but almost always receive a clinical comeuppance when it’s THEIR ass hanging out of the hospital gown. I know of a surgeon who had his own procedure done out of town so his operating room staff would not see that his own anatomy was, in fact, well…. inadequate .
All that said, however, is how can patients manage to be informed consumers, as they should be, rather than pains in the ass? You see, there is a relative shortage of physicians in the United States.
https://www.aamc.org/news-insights/us-physician-shortage-growing
Most of us won’t miss an errant patient here and there. Everyone is pretty much busy and at capacity. Most colleagues I work with will generally take care of just about anyone, regardless of resources, because it’s their job. I’m the same way; it’s what we signed up for. Despite that, we all have patients who seem to work hard to make us wish they were seeing someone else. It’s unavoidable, but I’d rather see a nice patient for free rather than a nasty, angry, suspicious patient with guaranteed payment. The emotional reward conferred by a grateful patient far outweighs the alternative with funding.
If your physician is confident with their abilities and recommendations, they never mind second opinions, nor do they mind intelligent, thoughtful questions and inquiry. That’s the doctor you want. Certainly, there are PLENTY out there representing the flip side of that coin. We all wish they would go drive Uber (no offense to Uber drivers). If you have a well-regarded, well-trained, informative physician with whom you have built a mutually respectful relationship, and you begin to emotionally, psychologically and professionally abuse them and beat them up, you’re making a mistake. You are on your way to becoming a PITAP, or pain-in-the-ass-patient.
One way to determine this is to discover that you’ve been referred to another institution or provider for another opinion for something your physician is perfectly capable of handling on his or her own. The benefits, financial and professional, of taking care of you have been outweighed by the risks, and costs. I just did this; in fact, it prompted this post. I did it last week as well; yell at and curse my staff….you're GONE. This isn’t to say that you shouldn’t be your own best advocate; in fact, those of us confident in our clinical acumen respect and admire that. It’s when we feel that nothing we do will satisfy or placate a patient that the line has been crossed and the relationship becomes dysfunctional.
Telling my patient today that they should consider an opinion from a major internationally respected center was best for both of us. They will either appreciate what is being done for them locally or they will find a place they are happier with. Either way, we both win. To proceed without that is courting disaster by both parties.
Your relationship with your physician (or nurse practicioner, or physician assistant or any healthcare provider) is not one-dimensional. Like all human interaction, it’s mutual and cooperative. Just as you deserve the best your provider has to offer, you must contribute positively to the relationship as well, for it to be beneficial to both.
That reminds me of something our local docs often say, dealing with the Amish community, who will refuse to see a doctor up until the point that an illness has gotten so bad it is nearly terminal and then be pissed that the doctor can't magically fix the tumor in a breast that has burst from the skin.
Emotions and attitude run both ways.
At 10 I contracted spinal meningitis an was rushed to the hospital. The pediatrician missed it in the office visit 5 days before. He hovered over me more than any doctor before or since. At 22 I was the oldest and last patient he saw before he retired. The man was like a second father.
At 54 EMS was called as I was having extreme pain that had all the symptoms of a cardiac problem. 2 MRI's and 3 CAT scans (1 with coloration?) the attending team could not answer one simple question -- 'What's wrong?' After two weeks of this I asked in less than pleasant tone -- "If you cannot define the problem then get someone who can!". Bad attitude on my part? Well consider, 3 days later a vascular specialist showed up, she took one look at me, my leg and the chart and ordered Warfrin. I could tell by the facial expressions on two of the attending out in the hall that she was reading the riot act. I had DVT.
The point of these two tales is this -- It is OK to tell a patient you don't know the answer. Even better to tell a patient based on what is available what it is NOT. But to offer nothing is the worst non answer of all. But the non answer seems to be the default doctor-patient dialogue these days and it ought to stop. This maybe one man's opinion but if someone in the medical community was to take a poll of patients the observation is very common indeed.