OT - Rude Doctors Make Bad Doctors

[JDS74]

Here is a very interesting article on human interactions in the medical world.
I likely applies to Respiratory Therapists and DME's as well.

http://aeon.co/magazine/being-human/why ... d-doctors/

[chunkyfrog]

I was sent to an orthopedist who was like that. Typical arrogant frat boy.
He really wanted to replace my knee joints;
even though he should have suspected that my patellofemoral syndrome was the reason for my discomfort.
Then I read an article about him in the local paper.
He had lost an unusual number of patients to sepsis. (jerk about washing?--or drives nurses away?)
Luckily, my diagnosis was corrected in time. Due to legal concerns I will only share his name privately,
but I'm sure he would have made a wreck of my knees.

[-tim]

I disagree but I tend to deal with doctors when I must have something fixed and that means I need competence and I don't care about rudeness in that case.

When I was dealing with medical school, there were 3 reasons people wanted to be doctors:
1) Intellectual challenge -- they make good specialist
2) They want to help people -- they went into pediatrics or geriatrics.
3) They wanted the money. Only use these doctors if they are rich plastic surgeons because that is the only way they can get rich.

The nice doctors tended to end up in group 2. The very smart ones were all in group 1 and most of them had a very bad bed side manners compared to group 1. If someone is taking a knife to my heart, I want it to be one of them.

[rkuntz]

Ive noticed that since the ACA was passed that the NPs and PAs are starting to get Big Heads as well. So sad, wanted to be one myself at one time but quit the program when I realized that the educational requirements were betwixt and between and simply not sufficient to the task envisioned.

[robysue]

I disagree but I tend to deal with doctors when I must have something fixed and that means I need competence and I don't care about rudeness in that case.

When I was dealing with medical school, there were 3 reasons people wanted to be doctors:
1) Intellectual challenge -- they make good specialist
2) They want to help people -- they went into pediatrics or geriatrics.
3) They wanted the money. Only use these doctors if they are rich plastic surgeons because that is the only way they can get rich.


The nice doctors tended to end up in group 2. The very smart ones were all in group 1 and most of them had a very bad bed side manners compared to group 1. If someone is taking a knife to my heart, I want it to be one of them.

There is nothing that precludes a doctor from enjoying an intellectual challenge and at the same time treating his patients with a reasonable degree of plain old fashioned politeness that includes actually listening to what a patient is saying.

Extreme rudeness to a patient conveys to the patient the doc does not think of the patient as a real person, but rather as a collection of "symptoms" or "illnesses" to be dealt with. And if/when a patient doesn't respond as expected to the prescribed treatment, the rudeness can convey: "I'm done dealing with you since you are not getting better."

And genuine rudeness to patients can also indicate that the doc has fixiated on a pet theory about what's causing the patient's problems and the rudeness is a result of the doc's intentional discounting of everything the patient says that contradicts the doc's pet theory. And that closed-mindedness to other potential ideas that take into account what the patient is actually saying runs counter to being genuinely interested in intellectual challenges. And it leads to some pretty crappy medical care that does NOT usually lead to "curing" the patient in spite of what happens with Dr. House's patients on TV.

My former neurologist is an example: The guy is very bright, very intelligent and very knowledgeable. But he once he gets a pet theory in his head about a patient, everything that doesn't support his theory is discounted. I was first referred to this guy for chronic migraines. He tried me on topiramate, lamictal, and depakote, none of which I could tolerate, although they all knocked out the chronic migraines at very small, supposedly sub-therapeutic doses. And the lamictal triggered serious mood changes including extreme anger thoughts of suicide (I've never been clinically depressed and I'd never had any suicidal thoughts before the lamictal.) After a long and convoluted story this guy also became my official sleep doc #3 and throughout the time he was treating the migraines, he was aware of my struggles with insomnia (the insomnia increases my tendency to migraine quite a bit.)

Over the course of treating me this guy fixiated on the idea that I have a mood disorder that is somehow related to bipolarism and that it's this supposed bipolar mood disorder that is the root cause of all my sleep problems and all my headaches: He's repeatedly referred to the fact that I talk extremely fast when I get upset and that I have lost my temper with him and/or gotten visually upset with him when it is clear he has not been listening to either myself of my husband (I will NOT go to this guy without my husband around so hubby can do some or all of the talking about describing my "mental" state since the guy won't believe me when I say I'm not depressed and I'm not manic.) In November 2012 I had a follow-up appointment concerning the facts my sleep was deteriorating, my migraines were increasing, and I was once again having real problems getting to sleep comfortably with the dang cpap because the aerophagia was coming back. This guy told me to my face (for the third or fourth time) that my original sleep problem was NOT OSA---that, in fact, he believed that I do NOT have OSA. On at least two occasions, he had my sleep study (with an untreated RDI = 23.6) from Aug 2010 in his hands when he stated that I did not have OSA. And he told me (once again) that my headaches would NOT get better unless I went back on lamictal---that my real problem was a mood disorder and that until I consented to taking lamictal to fix the overactive brain, nothing would change. Hubby was with me. Hubby pointed out what happened during the lamictal trial and the guy would not budge. He said I'd not given the lamictal a long enough trial and that the adverse mood stuff would just "go away" if I kept taking the lamictal long enough and at a higher dose than I'd taken during the previous trial. (Just how long are you supposed to keep taking somthing that's making you think of killing yourself or violently harming others?) I was in tears at the end of this meeting and when the guy walked us out the door, I had to schedule a follow-up appointment just to get out of there.

As soon as we got home, hubby informed me we were firing the doc. Hubby canceled the follow-up appointment and hubby called my psychiatrist's office. (The neurologist had referred me to the psychiatrist when I could not tolerate the lamictal the first time round.) The psychiatrist had previously told me that I might have a mild mood disorder, that I don't need to be on any medication, and that if medication is ever warranted for my mood problems, it will have to be titrated very, very carefully given my adverse reactions to both the topiramate and the lamictal, both of which are used as "mood stabilizers" in bipolar patients as well as anti-seizure meds for epileptics. After hubby got in touch with the psychiatrist, he saw me on a semi-emergency appointment, supported my firing the neurologist, and expedited the paperwork to get me formally transferred a different headache doc (for the migraines) and a different sleep doc (for the insomnia and PAP-related issues) in the same large group practice. He also pulled some strings to get me "first consultations" with the new docs in a matter of a few weeks rather than several months.

It was largely the run-ins with this guy and the fact that my first sleep doc fired me as a patient because I was not getting better fast enough and wasting too much of his PA's time, that gave me the courage to not tolerate docs who cannot listen to me and address my concerns in language that makes it clear they understand I'm an intelligent grownup who is both interested in learning more about the conditions they are treating me for and that I need to understand something about the larger picture when it comes to accepting prescribed treatments.

[ironhands]

3) They wanted the money. Only use these doctors if they are rich plastic surgeons because that is the only way they can get rich.

I've never understood why people would even attempt a career in medicine solely to make money. There are easier ways to do it

As far as rude doctors, it really depends. A doctor who is simply direct, to the point, and doesn't waste time sugar-coating things can often be a great doctor. That's who I'd rather deal with, personally.

My current GP isn't exactly dude, but she doesn't listen to me. Last appointment she told me I was probably tired because my B12 was low.. despite having just completed the sleep doc referral form. Attempted to get tested for gluten issues, she cut me off as I was describing my symptoms saying "those symptoms aren't severe enough", before I'd gotten to the severe ones. After arguing for a moment she then realized that it could also explain my my B12 was so low to begin with....

I tells ya... I'll take a rude doc over one who doesn't listen any day.

[robysue]

I tells ya... I'll take a rude doc over one who doesn't listen any day.

A doctor who doesn't listen to patients IS being rude---very, very rude in my opinion. Because ignoring the other person in the conversation is the epitome of rudeness.

A doctor who is direct is NOT necessarily being rude. It all depends on whether they're being direct after really listening to what the patient is reporting or whether they're just pushing their pet theory in a direct way, but their pet theory that has no real connection to what the patient is telling them.

[chunkyfrog]

Life is too short to trust your health to someone who can't even listen.
.