Getting fired by your doctor

Babette · Post by **Babette** » Wed Dec 26, 2007 1:37 pm

My current PCP has threatened to not see me many, many times. She threatens, she cajoles, she wheedles... She's figured out I really HATE IT when she just ignores me and prescribes a drug. Lately, she's been doing just that. I don't take them.

What's it all about? My weight. She can clearly show that my weight is the cause of 80% of my health concerns. The other 20% we'll just have to see what happens after I've lost 75 pounds. Anyway, I steadfastly refuse to follow her diets or exercise regularly.

I feel bad for her. She keeps giving me the best health care on the planet, and I keep acting like an ass. She SHOULD fire me.

I don't know why she keeps accepting my appointments. She should just tell me to get lost.

I did join a gym in November, but I've only gone about a dozen times since then. And my diet remains steadfastly Fast Food.

I think a doctor is human and within their rights to tell you to take a hike if you're not following their advice. They have other patients to see. In my case, my doc has a long, long list of patients to see - She's got a great reputation and is overbooked. And what's worse? I'm most certainly one of the few that has a CHANCE of healing myself. And I won't.

Would be kinder to us all if I just jumped off a cliff.

Food for MY thoughts, GeoDoug. I wish you very well. Keep us posted.

Hugs,
Babs

sleepycarol · Post by **sleepycarol** » Wed Dec 26, 2007 1:56 pm

Can I add my two cents Babs?

Babette Posted: Wed Dec 26, 2007 2:37 pm Post subject:

--------------------------------------------------------------------------------

Would be kinder to us all if I just jumped off a cliff.

You have helped many people on this forum and if you jumped off a cliff many of us would suffer -- you have a wit about you, can make one laugh, and express yourself in such a way that I take up and notice!!

I know I AM BETTER OFF with you being here!!

My weight is a problem and has been for the last 15 years or longer. I need to lose close to 100 pounds but it seems so overwhelming I tend to say what the heck it is a lost cause!! I need to start out with baby steps and hang in there and try -- but what I really do is take a baby step, fall on my tush and stay there!! I was going to cardio for awhile -- a really really nice doc but he had a terrible time dealing with my weight. I haven't been back to him in a year and 1/2.

My PCP is overweight herself -- probably 75 to 100 pounds as well so she tends to take the high road about my weight and doesn't nag me. It appears that many of us on the forum have issues with our weight. Yet, we are the only ones that can do something about it and for some us we are dealing with the complications of obesity.

I am hoping that the new year will see me adopt a more healthier life style.

geoDoug · Post by **geoDoug** » Wed Dec 26, 2007 2:05 pm

Thanks babs and everybody else who replied. The range of reactions to doctors reflects both the wide variety in patient/doctor relationships and the fact that both are human.

Me? I realized that I'm setting myself up for failure if I just look at it and say that I have to be using it all night every night. I've created the New Year's resolution of really tiny realistic goals to get to the bigger goal.

I've decided to take getting back on track slowly. I'm giving myself permission to use the machine for a few weeks enough so my brain isn't in a fog. (Every night for a few hours--I'm already a week into it.) This is enough to develop a habit at that level. Then after a couple/few weeks, I'll bump my routine up to actually hitting 4 hours once/week for a couple of weeks. After making that a habit, I'll shoot for 4 hours a couple of times/week. All of this is working toward eventually using it all night every night.

The reason that's my only resolution? First, it's realistic. A lot of resolutions fail because they aren't realistic. Second, it should make it a LOT easier to address many other problems in my life, since they stem directly from my low self-esteem, energy, and motivation. After all that, I'm going to reassess my goals.

Doug.

Babette · Post by **Babette** » Wed Dec 26, 2007 2:15 pm

Tiny baby steps are a very good thing indeed. Maybe we should start a Tiny Baby Steps Resolutions Thread.

Mine: Go to gym at least 3 times a week. That's it. No "Work out for an hour minimum. Or Must do Pilates for whole hour." Just GO. Do what I can. Go on nights I feel crappy and just walk the treadmill and watch the news on the TV.

I talked to my trainer about a diet. She said my biggest problem tends to be the fast-food lunch. She's sending me some lunch ideas. I said what about Breakfast, dinner, 6 meals a day? She said "Baby steps. Let's just do lunch for awhile." I like her lots. BTW, she's got me poaching eggs. Cracks me up... Yolk Yolk!

Oh, and Carol, never take my cliff-diving seriously. I'm too afraid I'd LIVE and be HURT!

Huggers,
B.

geoDoug · Post by **geoDoug** » Wed Dec 26, 2007 2:34 pm

Babette wrote:Maybe we should start a Tiny Baby Steps Resolutions Thread.

I actually considered that when I was posting.

Babette wrote:Mine: Go to gym at least 3 times a week. That's it. No "Work out for an hour minimum.

I've known people who do this. It's all a matter of changing your mindset.

Doug.

goose · Post by **goose** » Wed Dec 26, 2007 9:04 pm

Oh, and Carol, never take my cliff-diving seriously. I'm too afraid I'd LIVE and be HURT!

Happy to hear you say that Babs.....I totally agree with Carol!!!!
And baby steps are the best if that's what it takes......The secret is individually figuring out what we need and working on it -- like masks or a lot of other things -- what works for me may not work for you!!!!

One of my favorite sayings is, "You eat an elephant one bite at a time".....

Doug, you have the right idea!!!! Soon you'll be like the rest of us and won't be able to sleep without your machine......I can't imagine sleeping without it.
I fell asleep one day in my easy chair and within 30 min. awoke having an apnea -- NOW I recognize it for what it is!!!!! I went to the bedroom and put on the mask and couldn't fall back to sleep.......

As for weight -- I got down 30 by doing nothing but portion control -- then I lost control and got 10 back......So now I'm pulling the wagon again.....
My biggest problem with the weight deal is getting off my dead ass and doing some exercise -- Even if it's only walking the dog down to the cemetery and back..... (about 1/2 mile -- a historic "gold country" cemetery by the side of our access road)

Take care all!!!!!
cheers
goose

[/quote]

Babette · Post by **Babette** » Thu Dec 27, 2007 12:13 am

Don't know if this helps, but during the 4 days of misery, I kept trying to doze without the mask, because everytime I'd mask up, I'd be tearing it off to run to the bathroom. Everytime I dozed off, I'd jolt awake in 15 minutes. Really not worth it...

LOL,
Babs

writes4me · Post by **writes4me** » Fri Dec 28, 2007 12:44 am

I voted but I would say the only doctors that have given up on me were doctors who truly didn't want to work with a patient who they couldn't fix in 1 or 2 visits.

I don't want to come off as another 'crazy female' but you wouldn't believe the number of times I was told the problem was all in my head. I refused to believe that and though I tried and tried, no one would listen until I ended up 3 different times in the emergency rooms with REAL problems.

I got so angry and I have real problems trusting doctors anymore. I rank most doctors right along with scum.Even the doctor who got me to see a sleep clinic seems happy to leave me in the stage they call, "the walking and talking but not back 80% normal" stage.

I keep knocking on doors though and I don't want to give up.

Guest · Post by **Guest** » Fri Dec 28, 2007 4:27 am

Hi Norzy and All,

I was very touched by your years of not been treated well in the cpap therapy by the doctors. I was almost in the position as you were but was saved by this forum and many great people that sharing information for us to take the first step for better therapy. I was put on the straight cpap at 18.5 to 19cm but still with high AHI and every morning wake up fresh mind but with anxiety and cant focus closely on manula tasks, more like hyper mode until I decided to try the auto-cpap and found that yeild better resulst in AHI of 10s but lower pressure at 16.7cm (without anxie) instead of straight cpap at 18.5 to 19cm that was unbearable. I did debate with my doctor and reason out for better therapy auto-m aflex. Then all in the sudden but definately not by accidently for sure due to the extensive of reading and reserching in this forum knowledgeable and sharing of information with the great people in this forum. I cant imangine if I was still alone marching for an answer for all the suffering with or without cpap or straight cpap. By far, this the best place that save many lifes if not tens of thousand. I am greatly appreciate and thankful for the great people here for saving my daily challenges and make life abit more livable.

Thank you and Happy New year and May all teh great people/cpap sufferes many more wondeful years ahead.

Best Regards,
Mckooi

okcpa99 · Post by **okcpa99** » Fri Feb 14, 2014 12:25 pm

I am a Physician Assistant and this makes me very sad. Yes, I have fired patients before but not for being non-compliant. I have fired patients for yelling at my staff and for lying about narcotic use (when I have concrete evidence to confirm usage). That is it. Would never fire a patient for non-compliance. Have had way more non-compliant patients than I care to mention, however, it is my job to make sure they understand the consequences of their actions (potential for harm or death) and to encourage them to make positive changes for their own well-being. With 15 years of experience, I have found that lecturing and threatening NEVER works. It is more important to make achievable goals (weight loss for instance - will make a 5-10 pound weight goal for 1 month only, bring the patient back (to make sure they are sticking with the plan) and then set a new goal). I don't lecture patients to quit smoking... I suggest substituting a vapor cigarette or ecigarette in place of 1-2 cigarettes per day for 1 month and then set a new "achievable" goal with my patient. Yes, this type of teamwork requires more patient visits (which means more copays - however - I get paid a set salary that is not dependent on patient visits or complexity of patient's problems) but my patients seem to really appreciate the time I take with them and how I work WITH them to achieve their goals rather than just telling them what to do.

My recommendation is to find someone who is willing to be a team player with you (a coach and mentor) and will help you achieve your goal. In addition, I encourage you to set a goal for yourself - maybe a goal to use the CPAP on Sunday (to start the week off right) and maybe Thursday (to get ready for the weekend). Do that for a couple of weeks and then add in another day each week. Yes, it is no ideal, however, sometimes baby steps are much more effective than giant leaps. Your provider should ask WHY you are not using the machine as much as you should. They should view it as a challenge. I have seen pulmonolgist who lecture to patients about not smoking (and then go take a smoke break themselves). There are overweight providers that lecture to patients about losing weight. Making changes to improve your health are not always easy and encouragement and recognizing wins are the best way to help patients achieve goals. I gave a hug to a patient just yesterday for a 3 pound weight loss. Three pounds - you may say that is no big deal - but it IS!!! And I was proud of him and told him so! And I would bet money that next time he comes in, he will have lost 5 or more pounds (because I recognized his efforts and we made a new goal for him)

To be honest, there is a percentage of health care professionals that entered the profession for money. That is certainly not the majority but I have seen many that are in it for the money. To them patient visits = money and the more the better. I am thankful that I do not have to work like that and spend a minimum of 15 mintues but most often 30 minutes or more sitting in the room with the patient (my current position is certainly not the norm, although it should be). I hate to sterotype general providers but you may want to consider a mid-level provider - a physician assistant or nurse practitioner. Sometimes (but definately not always), these types of providers do have more time to sit and talk (and most importantly, listen) to patients.

I know this does not help your current situation but just know that there are other providers out there that will work with you and not put you down. You may have to shop around a bit, but they are out there.

Julie · Post by **Julie** » Fri Feb 14, 2014 1:11 pm

You are responding to a SEVEN YR old posting! No one's there any more. Start a new thread!!

Lukie · Post by **Lukie** » Fri Feb 14, 2014 1:20 pm

What is the issue that is keeping you from being compliant with your CPAP?
I had a cardiologist tell me my heart issue was totally related to untreated sleep apnea.
I suppose he could have taken a softer approach and tried to explain to you that your heart disease was
not going to be helped by anything he does until you are compliant with CPAP therapy.
Cardiologists as a rule are not the most patient people in the world. Mine is a 10 minute slam bang thank you maam
kind of guy that does not want any discussion to interfere with his precious time.

Thellra · Post by **Thellra** » Fri Feb 14, 2014 1:24 pm

okcpa99 wrote:I am a Physician Assistant and this makes me very sad. Yes, I have fired patients before but not for being non-compliant. I have fired patients for yelling at my staff and for lying about narcotic use (when I have concrete evidence to confirm usage). That is it. Would never fire a patient for non-compliance. Have had way more non-compliant patients than I care to mention, however, it is my job to make sure they understand the consequences of their actions (potential for harm or death) and to encourage them to make positive changes for their own well-being. With 15 years of experience, I have found that lecturing and threatening NEVER works. It is more important to make achievable goals (weight loss for instance - will make a 5-10 pound weight goal for 1 month only, bring the patient back (to make sure they are sticking with the plan) and then set a new goal). I don't lecture patients to quit smoking... I suggest substituting a vapor cigarette or ecigarette in place of 1-2 cigarettes per day for 1 month and then set a new "achievable" goal with my patient. Yes, this type of teamwork requires more patient visits (which means more copays - however - I get paid a set salary that is not dependent on patient visits or complexity of patient's problems) but my patients seem to really appreciate the time I take with them and how I work WITH them to achieve their goals rather than just telling them what to do.

My recommendation is to find someone who is willing to be a team player with you (a coach and mentor) and will help you achieve your goal. In addition, I encourage you to set a goal for yourself - maybe a goal to use the CPAP on Sunday (to start the week off right) and maybe Thursday (to get ready for the weekend). Do that for a couple of weeks and then add in another day each week. Yes, it is no ideal, however, sometimes baby steps are much more effective than giant leaps. Your provider should ask WHY you are not using the machine as much as you should. They should view it as a challenge. I have seen pulmonolgist who lecture to patients about not smoking (and then go take a smoke break themselves). There are overweight providers that lecture to patients about losing weight. Making changes to improve your health are not always easy and encouragement and recognizing wins are the best way to help patients achieve goals. I gave a hug to a patient just yesterday for a 3 pound weight loss. Three pounds - you may say that is no big deal - but it IS!!! And I was proud of him and told him so! And I would bet money that next time he comes in, he will have lost 5 or more pounds (because I recognized his efforts and we made a new goal for him)

To be honest, there is a percentage of health care professionals that entered the profession for money. That is certainly not the majority but I have seen many that are in it for the money. To them patient visits = money and the more the better. I am thankful that I do not have to work like that and spend a minimum of 15 mintues but most often 30 minutes or more sitting in the room with the patient (my current position is certainly not the norm, although it should be). I hate to sterotype general providers but you may want to consider a mid-level provider - a physician assistant or nurse practitioner. Sometimes (but definately not always), these types of providers do have more time to sit and talk (and most importantly, listen) to patients.

I know this does not help your current situation but just know that there are other providers out there that will work with you and not put you down. You may have to shop around a bit, but they are out there.

This is why PA's and NPs > MD's

okcpa99 · Post by **okcpa99** » Fri Feb 14, 2014 1:54 pm

sorry - the posting appeared at the top of the forum - did not look at the date.

chunkyfrog · Post by **chunkyfrog** » Fri Feb 14, 2014 2:31 pm

Lately, a prankster has been voting on ancient polls, bringing them to the front page.
It gives us a chance to revisit issues that may concern new members,
especially those too shy to start a new thread (always best--otherwise your question could get lost.)
Sadly, it has actually pushed new problems out of sight, and new threads do not receive the attention they deserve.
You are new--so it's not really your fault. Welcome to the forum.

Getting fired by your doctor

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