My doctor's strange behavior

[mileena]

I have had two pulmonologists in the past year. The first one I fired since he never called me back after I called his office with questions about problems with my CPAP and ramp pressure, and had the bedside manner of a piece of wood. He spent very little time with me in our initial meeting after the sleep study, like two minutes. He didn't seem to care. The only time his office called again was to get me to come back in for a follow-up appointment. There was another good reason too that he was fired, but I forgot what it was. He was Middle Eastern. And the receptionist was also the nurse, which I found weird, and I was the only other one in the office.

But this post is about my next doctor. He is also Middle Eastern. The first meeting he was nice and spent time with me, so I had thought I had found a good doctor and was relieved.

Our second meeting was ok, but he asked me out of the blue when I was going to have surgery. I had no idea what he was talking about as we had never discussed that before, and after a while, sensing my confusion, he said "bariatric surgery". Weird, but ok.

But after out third meeting, I was furious:

a. I told him I had just been diagnosed with thyroid cancer and wondered how that impacted my CPAP use, since the tumor is pushing against the trachea. He acted happy and said "congratulations" since I found the tumor. This was a very bizarre reaction.

b. He was also behind schedule by an hour so I could not ask him about my low blood oxygen, why I was sleepy all the time, etc. The meeting was super rushed, like I was just a number. He said maybe the tumor was pressing against my trachea, but he did not know. He didn't care.

c. He also kept looking at his cell phone while he was reading my SD card. Do doctors need to do that to read the card? Is there an app on his phone which allows him to do that, or was he just being rude?

d. And he seemed upset I told him I was not going to have bariatric surgery when he asked again. It was like I became persona non grata all of a sudden.

f. And he forgot to send me my sleep report after my study last time like he said he would, or that he had written me a new prescription last time. So he acted all confused when I asked him to print it out for me, like he had never written one.

He then said come back in four months. LOL. Not going to happen. I found a list of 15-20 sleep medicine doctors at the prestigious university teaching hospital near me, and they are American mostly. I am not racist, but after two Middle Eastern men, I don't think they understand appropriate bedside manner or expected American behavior. You don't say congratulations after you announce you have cancer!!! All the American, Chinese, and Indian doctors I have seen were fine.

[Julie]

What does his or anyone else's nationality have to do with anything?

[jnk...]

What does his or anyone else's nationality have to do with anything?

Not race. Culture. And sometimes cultural cues for politeness and respect get lost/missed/confused. Hey, it happens. Even between regions in the same country.

bedside manner of a piece of wood

Some docs gravitate to subspecialties that take advantage of their expertise more so than their bedside manner. Some of the best docs on the technical side have little skill at connecting socially. I personally would rather have a doc that is rude and smart than have a doc that is nice but, uh, intellectually challenged. Also, many docs have been outright attacked by patients. Especially sleep-deprived hurt patients. Once a doc has had his feelings hurt, or more than that hurt, he may keep up a bit of a barrier from that day on for his own sanity.

he said "bariatric surgery". Weird, but ok.

Now considered the only evidence-based scientific approach to long-term success for weight loss, since no one in the U.S. mainstream takes extended fasting seriously. Yet.

said "congratulations" since I found the tumor.

Confusing, yes. Sincere, likely. It's easily missed. There are reasons for celebrating successful discovery. May have been doc's attempt to inject positive thinking into the issue, since patients need that when facing such matters.

The meeting was super rushed, like I was just a number.

Seems to be common with sleep docs. Most of their meaningful work is often behind the scenes doing things like looking over other people's work. They present choices to patients then bark orders at others to follow through. Remember that the model in most sleep docs' heads is that techs and machine experts interact with the patient about the success of the treatment, not them. Once you are handed over to a DME for a machine, many docs consider their diagnostic and prescription work mostly done unless you need their help getting what you need out of the DME people.

There are, of course, exceptions that prove the rule. And a patient always has the right to feel comfortable with whom the patient interacts with, since medical people are supposed to be interested in that. But many, like me, don't mind getting treated a little curt and rough as long as the doc is honest, focused, clear, and willing to adapt somewhat to our preferences to the extent that our payers will allow.

Hey, just me.

[D.H.]

I really suggest dismissing the idea of nationality, ethnicity, religion, gender, or sexual preference - at least in most cases - as a reason for choosing doctors.

Anyhow, it sounds like it's time for doctor #3.

You did not mention anything about being overweight, but I guess that it can be inferred from the suggestion of bariatric surgery.

If he really thinks that you need this surgery for urgent health reasons, he should have been a lot more delicate about it.

In any case, you need to have your tumor addressed first.

[jnk...]

I was born in a border state in which a number of the yankees considered the mountain people to be mentally slow for preferring to speak at a leisurely pace and a number of the mountain people considered the yankees untrustworthy because they all seemed to be trying to fast-talk them into something. Such culturally-based perceptions at times made for some very interesting interactions between health professionals and patients there, I reckon.

Although I ain't no medical nuthin', I would like to thank this forum (at least, those who don't have me on their foe list) for being so tolerant of MY strange behaviors here.

[chunkyfrog]

The last couple years, I have not seen my sleep doc--only his PA.
Since I am having no problems, I let the doc handle the tough patients instead.
I only need them for Medicare paperwork.
Everybody in the office is pleasant and competent. I guess I'm lucky.
I have often seen medical people of different nationalities.
Often they are extremely knowledgeable.
Most must study additional years in order to practice in this country.
Some of the highest-rated surgeons around here are minorities.

[palerider]

I would like to thank this forum (at least, those who don't have me on their foe list) for being so tolerant of MY strange behaviors here.

You mean, just because I have you on my foe list, I don't get thanks? well.. FINE!

No, seriously, you post too much good stuff (in spite of yourself) to be on my foe list.

[mileena]

What does his or anyone else's nationality have to do with anything?

Not race. Culture. And sometimes cultural cues for politeness and respect get lost/missed/confused. Hey, it happens. Even between regions in the same country.

Thank you. Nationality or ethnicity mean nothing to me. Some of my docs have been Indian, Chinese, and Middle Eastern (though not for sleep medicine). I am 0 for 2 on Middle Eastern docs for sleep medicine, and I am not going to try again, given that certain cultures gravitate towards certain professions (e.g., about 50% of hotels in the US are Indian-owned, and most often their last name is Patel--it's true; look it up). So my results with another Middle Eastern sleep doc will probably be the same.

For the same reason, if I see a counselor or psychologist, I would insist they be born in America or a similar culture, due to common cultural understanding and ability to empathize. For example, my mom was Chinese, born in Taiwan. My father was born here and Caucasian. I did not not grow up with my mom, and she never raised another child, so I had to explain to her when I re-met her as an adult what school terms like "study hall" and "detention" meant, or that private schools were considered more prestigious than public ones usually (in China, you have to go to private school only if you fail in public school, so it has a bad connotation).

bedside manner of a piece of wood

Some docs gravitate to subspecialties that take advantage of their expertise more so than their bedside manner. Some of the best docs on the technical side have little skill at connecting socially. I personally would rather have a doc that is rude and smart than have a doc that is nice but, uh, intellectually challenged. Also, many docs have been outright attacked by patients. Especially sleep-deprived hurt patients. Once a doc has had his feelings hurt, or more than that hurt, he may keep up a bit of a barrier from that day on for his own sanity.

Yep, when I was in a psychiatric ward years ago, a patient who seemed normal attacked the social worker by trying to strangle her with her hands. She did this out of nowhere and contrary to her past behavior and for no reason. I was stunned.

he said "bariatric surgery". Weird, but ok.

Now considered the only evidence-based scientific approach to long-term success for weight loss, since no one in the U.S. mainstream takes extended fasting seriously. Yet.

True. But the one person I know who had bariatric surgery regained all of the weight within a year since she kept on eating more.

said "congratulations" since I found the tumor.

Confusing, yes. Sincere, likely. It's easily missed. There are reasons for celebrating successful discovery. May have been doc's attempt to inject positive thinking into the issue, since patients need that when facing such matters.

That's a positive way to look at it.

The meeting was super rushed, like I was just a number.

Seems to be common with sleep docs. Most of their meaningful work is often behind the scenes doing things like looking over other people's work. They present choices to patients then bark orders at others to follow through. Remember that the model in most sleep docs' heads is that techs and machine experts interact with the patient about the success of the treatment, not them. Once you are handed over to a DME for a machine, many docs consider their diagnostic and prescription work mostly done unless you need their help getting what you need out of the DME people.

There are, of course, exceptions that prove the rule. And a patient always has the right to feel comfortable with whom the patient interacts with, since medical people are supposed to be interested in that. But many, like me, don't mind getting treated a little curt and rough as long as the doc is honest, focused, clear, and willing to adapt somewhat to our preferences to the extent that our payers will allow.

Hey, just me.

You are tougher than I am!

[jnk...]

I would like to thank this forum (at least, those who don't have me on their foe list) for being so tolerant of MY strange behaviors here.

You mean, just because I have you on my foe list, I don't get thanks? well.. FINE!

No, seriously, you post too much good stuff (in spite of yourself) to be on my foe list.

What I'm hearing is that I need to take my strangeness up a notch.

[mileena]

I really suggest dismissing the idea of nationality, ethnicity, religion, gender, or sexual preference - at least in most cases - as a reason for choosing doctors.

Anyhow, it sounds like it's time for doctor #3.

You did not mention anything about being overweight, but I guess that it can be inferred from the suggestion of bariatric surgery.

Guilty as charged!

Also, I make it a point not to let factors such as you mentioned not to influence my doctor selection. I use reviews (Yelp, HealthGrades, etc.), education and training, primary doctor recommendation, google searches, etc. to make a choice.

[mileena]

I was born in a border state in which a number of the yankees considered the mountain people to be mentally slow for preferring to speak at a leisurely pace and a number of the mountain people considered the yankees untrustworthy because they all seemed to be trying to fast-talk them into something. Such culturally-based perceptions at times made for some very interesting interactions between health professionals and patients there, I reckon.

Although I ain't no medical nuthin', I would like to thank this forum (at least, those who don't have me on their foe list) for being so tolerant of MY strange behaviors here.

I don't know much about you, but you seem nice.

Also, I used to coach summer youth camps throughout the country. I found people from the south very hospitable and enjoyed my experience there. I did find a lot of over racism though in places like South Carolina among young girls. They said things about black people children in other states in the north or northeast would never dare to say.

[jnk...]

So my results with another Middle Eastern sleep doc will probably be the same.

Eh. Probably not. You may have had the only two bad M.E. docs in sleep. The rest of them may be positively golden for you.

For the same reason, if I see a counselor or psychologist, I would insist they be born in America or a similar culture, due to common cultural understanding

In my experience, psychs are their own culture, no matter where they are born. And I don't consider America a culture. I consider it a collection of beautifully diverse cultures all helping one another. Except when I watch the news. Then I consider America to be a total lack of culture.

I hope you find someone you click with and who gets you for you, no matter how the doc needs to adjust to you or you to him/her. May your sleep needs get met.

My wife (Chinese/African/Jamaican) and I spent our anniversary this year in South Carolina learning about Gullah-Geechee traditions and history. We thoroughly enjoyed the experience!

[mileena]

So my results with another Middle Eastern sleep doc will probably be the same.

Eh. Probably not. You may have had the only two bad M.E. docs in sleep. The rest of them may be positively golden for you.

Ok, maybe I am too scared there is a pattern when there is none. Thank you for your perspective. I tend to be easily influenced, like letting bad Amazon or hotels.com reviews scare me away from a products that most people have liked. I want perfection with little risk, and you can't always have that in life.

[palerider]

I would like to thank this forum (at least, those who don't have me on their foe list) for being so tolerant of MY strange behaviors here.

You mean, just because I have you on my foe list, I don't get thanks? well.. FINE!

No, seriously, you post too much good stuff (in spite of yourself) to be on my foe list.

What I'm hearing is that I need to take my strangeness up a notch.

Go for it, I've got more popcorn!

[jnk...]

I want perfection with little risk,

Don't we all!