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Posted on 27. June 2013

Dating Doctors

By Alyssa Rosengard

Choosing a doctor always reminds me of a time when my now-married friend was searching for a mate using online dating sites. She would chat with an individual via the Internet, eventually meeting in person for coffee. My husband and I would be hopeful for her as she sorted through the candidates, but many times, the date was just “not a match.” This made me wonder: Why do we take more time and care searching for our soul mates than we do for our doctors who take care of our very lives?

As patients managing chronic illness, we swim in a sea of specialists, negotiating the rough waters of our medical system. Each physician may be right for a particular patient or diagnosis, yet completely inappropriate for another. As a person with a rare primary immune disorder (common variable immune deficiency), I’ve found it is crucial for me to be confident in my choice of oncologist, neurologist, pulmonologist, etc. Each doctor should be a good fit for my disorder and personality.

So how do we, as patients, go about finding the correct physician in our inflexible and unforgiving U.S. healthcare system? Over the past 10 years of illness, I have collected a few basic core beliefs that have helped. First and foremost, I simply keep in mind that doctors are just human beings. They are not the god-like, all-powerful beings our grandparents and even some of our parents believed them to be. Previous generations were taught not to question doctors, but to have blind faith and trust. These beliefs that have been passed down must be broken if we are to heal. A competent physician should not act like he/she knows it all. There is an enormous difference between being confident and egotistical. A good doctor does deserve respect for the years of schooling and interning, but only if the respect is mutual.

Another key way to determine if a doctor is effective is if he/she truly listens to your symptoms and concerns and accurately records them. How can you tell? The doctor will ask many questions to counterpoint your comments and make eye contact. This may seem a slight point, but do not underestimate it; it is the key to sympathetic treatment. I had a neurologist once who allowed me to suffer for a solid year with daily migraines. She would send me for grueling tests, and I repeatedly jumped through her hoops. She would not prescribe medication, but insisted I keep a journal of symptoms. She made no eye contact, rushed through the appointments and would not listen to my instinct that it was the IV medication I was receiving that was the problem. She had a lovely family. Would she have allowed that amount of pain and suffering for them? Finally, not being able to stand any more pain, I refused my necessary medication. You already know the result: my migraines lessened and almost ceased.

During the past years of horrendous illness and symptoms, I have experienced prolonged misdiagnosis, flubbed testing procedures, lack of sympathy and understanding, and a refusal to listen and notate from numerous doctors. Compiled, this has created years of needless personal, physical and emotional suffering, as well as unnecessary cost to my insurance company. The lesson is this: A person dating is not an inactive participant in the process, and in the same way, patients must learn to participate in their healthcare. Remember that a competent physician should be listening, recording and developing a course of treatment that is acceptable to both of you.

Lately, my physicians have encouraged me to make choices and help guide my own healthcare, which has left me feeling empowered and positive. My advice to anyone wishing for improved patient/doctor communication is to remember you are in an important relationship with that physician. It is a connection that requires mutual trust and respect. If your current doctor is not meeting your needs, accept that it is “not a match,” and move on.


Comments (4) -

12:21 PM on Friday, June 28, 2013

I view the relationship with my doctor and as if I am a customer, and if the doctor doesn't meet my needs as a customer, I'm gone. I do not hesitate to ditch a doctor not meeting those needs. I'm not going to continue a "relationship" just so I don't hurt their feelings. I am very fortunate that now I am working with a team of doctors who are wonderful, headed by my immunologist. I have found the need to educate the doctors other than my immunologist about what CVID and IVIG are all about, however. For example, my normal temperature runs between 95 and 96 degrees. So, I have a fever if it's any higher. I understand many with immune deficiencies have lower than normal body temps as I do. But, I still often get strange looks from nurses when they take my temperature and I point out why over 96 means I have a fever.  

Linda Rosengard
1:53 PM on Monday, July 01, 2013

I have rid myself of doctors who did not listen, seemed unconcerned, or were truly ineffective and even wrong in their diagnoses. You go girl!!!

Deborah Norris
9:19 AM on Friday, July 26, 2013

Besides having CVID, and doing my sub-q gamma globulin once a week, I also have a neurological disease that is likely related to my immune issues. It's called Complex Regional Pain Syndrome, or CRPS. It used to be referred to as RSD, or Reflex Sympathetic Dystrophy. But either way, the name doesn't say it all. It's constant burning pain in one part of your body where you have experienced a trauma. That sounds like something you could cope with, right? But it spreads in many cases, mine being one of them. I needed to find myself a good doctor, one who could understand that I wanted to continue to be an elementary school teacher, and didn't want to go around feeling drugged, but needed to be in less pain, so that I could continue to do a good job. I searched local neurologists, found an anesthesiologist who was OK, but wasn't quite happy with my pain doctor situation. Then my sister went online, and found a lead in a town about an hour away. It was a perfect fit! You see, I had read Bernie Segal's book, LOVE, MEDICINE and MIRACLES, and he indicated that if you have a serious illness, you need a doctor you would be comfortable hugging. I took that to heart. Dr. "H" turned out to be that kind of doctor. He wasn't there from the first visit. Like first dates, it was OK, but not perfect. But I came back. I kept coming back for over ten years. He didn't heal me, because this disease doesn't go away. It spread throughout most of my body. Dr. H was patient, though, determined, and definitely accessible. Because of him, I'm now taking a "cocktail" of medications that lessens my pain, yet allows me to function. Dr. H saw my husband and I together after I quit being able to drive that far. He learned when my daughter got married and was happy for us all. Years later, he celebrated the birth of our first grandchild. We celebrated his. Then about three years later, he told me he was going to retire. I felt bereft.

I didn't know where to turn. Dr H's partners didn't have the same philosophy about medicine that he did, and Dr. H warned me that they would not be a good fit for my situation. He suggested finding someone closer to home.

So, I set about finding a new pain doctor. After the first visit to my first choice, I emailed Dr. H, and let him know how disappointed I was. And like Alyssa Rosengard, his advice was to treat doctors as if they were blind dates. He said you likely won't marry your first date--or your second one.  And maybe someone you once dated, will turn out after all to be someone good. Don't treat the appointment as if it's going to be a marriage made in heaven. Treat it like a date. Interview them. Talk to them and get to know them.

I wasn't stressed the next time I "interviewed" a doctor on our first blind date. I spoke to him very candidly and let him know my expectations, instead of waiting to hear what the limitations were for his practice. He smiled, and told me I'd come to the right place. He listened, just like a good "date" would. I scheduled another date, and found him to be even more empathetic than I thought. And on that date, I had just been rear-ended the week before, and was suffering from back pain, in addition to the usual pain in my limbs. He thought about different forms of treatment, and did "trigger point injections". I left the office with very little back pain, smiling for about the first time in a week. The relationship is new, but this one could turn out to be one that lasts a lifetime! (The first doctor I "dated" was this doctor's colleague. I returned to that practice and found the wonderful man who is now my pain doctor. Dr. H taught me a valuable lesson!) And Alyssa is definitely correct in her advice!

5:35 AM on Friday, October 18, 2013

I commend your courage. How many times have I literally been turned away from doctors I have lost count. I actually do not keep a list of their names because I do not want to be reminded of all the failures to "connect" to anyone unwilling to help me. However, I have concluded that 90% of my first appointments are unsuccessful attempts to find treatment. Most of the general public do not realize how difficult it is to find adequate health care. They believe what I once did that all doctors receive the same education and experience and therefore are about on the same scale of competency. I have learned so much over the years, the most important being that we are scrutinized more than ever from the position of "what we can do" for the doctors, the community, the neighborhood, the world even, and not who we still are. So right up front we have strikes against us, before we even face the diagnosis. I am presently left with four diseases, three are rare, not counting the second tier diagnosis like osteoporosis or high blood pressure. At some point you only count the fires with the biggest blazes and just leave the smoldering embers to fizzle on their own, afraid giving them any recognition might just cause them to flare.
I also am so weary of the people who must tell you to be your own advocate, like you've never thought of that? I want to stuff a jalapeno pepper in their mouth as I'm screaming,"I'm the one who is sick, so just how effective do you think I would be?" But I know they probably don't even know what an advocate is. They just heard it somewhere and it sounded like a good come back.But of any time in history, now is probably the best time in history since it does not require one to be the best conversationalist as texting has become the common form of socialization. One doesn't even have to make sense anymore, just type in four word sentences. And act enlightened. You don't have to mean it or be authentic, as it appears irrelevant that you haven't seen another person in months, just so long as you don't bother them.
About year five I realized a pattern had developed. I found that doctors were literally hounding me on the first visit about the previous doctors diagnosis. They just ranted on and on about why I did this, or why I saw him, or why I did that treatment. It didn't seem to matter what protocol was suggested or prescribed, their focus was just to blame me for doing what the other doctors called for. I finally realized it was just their form of manipulating the first appointment so I wouldn't asked something they couldn't answer. The second appointment was usually taken up with labs. The third appointment was usually the consultation in which the doctor would inform me that there was nothing to be done for me, and dismiss me from his care.It was at this point that I would evaluate the doctor if he wasn't strong enough to do so himself. Because I would oftentimes get a letter of dismissal afterwards if they couldn't do it in person. I even had a doctor who asked me why he should invest all of his expertise when I would just go across the street and give the next doctor the credit after he had done all the work. You know how the media is describing this generation as being one of having all these expectation. We have to remember that doctors are part of this generation too.
I've seen more doctors who have spent the office visit lecturing me on their rules of not bothering them even during office hours.Doctors who have screamed at me for even showing up. Doctor have shared with me their "business practices" and confided in me how they must shed patients in order to be profitable. Once you receive a diagnosis where the prognosis is not encouraging, doctors suddenly want to share their burdens with you to find some kind of healing for themselves it seems, or acceptance, as though justifying their actions to you might serve as some kind of forgiveness for all of their compassionless actions.  So needless to say, nothing surprises me anymore, yet it all continues to break my heart.

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