I have a couple of friends and family members discuss with me their recent interactions with their physicians. I've had many patients thank me profusely for "listening more than any doctor has so far...". You've got to be kidding, right? *I'm* listening to you more than any doctor to date...in the emergency room? That's sad.
Then, a close family member told me how frustrated she was with her doctor because he wouldn't give her...basically what she wanted. And instead of making her understand why what he was doing was 'better' or 'more appropriate'...he just (in her words) flat out refused to give "this" antibiotic over "that" antibiotic. Actually, it wasn't even the antibiotic they disagreed upon, it was merely the dosage (which were both appropriate dosages in the clinical setting). How stupid. This family member is a 30 plus year RN...and has been in clinical medicine longer than that. No, she's not a physician...but she probably does know about her particular issue (and her particular body) much better than this physician. Dear Doctor, why not just listen, and if you want to get rid of the patient fast...as long as what they're asking for is reasonable...just give it to them and be done. Especially since, really, this wasn't that significant.
I've gone to the doctor, armed and ready to plead my case. I'm sure many other doctors have done the same thing themselves. I actually choose my family physicians based on, not how smart they are...but rather who will allow me access to the ancillary testing I feel is appropriate. There's nothing worse than being denied a possibly helpful diagnostic exam to allow the HMO to save money. If I have a headache, and I feel I need a head CT...I want a head CT. And unless the doctor explains to me why this may not be the best course of action...I want a head CT. Or, like the elective c-section I wanted....(and got, thanks to a listening OB who understood my concerns and agreed to my completely appropriate although 'unprotocoled' birth plan).
Because I've been blessed with really great doctors (after switching, and switching, and switching...until I find people I connect with...and who listen to me), I haven't had to argue much (knock on wood). And, yes, I've absolutely been talked out of all sorts of things "I thought I (or my kid/husband) needed." And even if things "go wrong" I feel that together we all made the very best decision possible with the information we had available to us at the time. And that decision is made by mutual understanding of expectations, explanation/education, and the overall feeling by both parties that the desired outcome is the same...which is that of health and happiness.
If what has been happening to my friends and family is the normal operating procedure of most docs...then it's no wonder we're getting sued so much. People are unhappy, and feel docs don't listen, and don't care. They don't educate, and aren't personable. This is a problem.
I understand the system is all fucked up...and this is why many (otherwise very empathetic, listening, caring) docs seem harried, unfocused, uncaring, and don't explain anything. This is why they come across short tempered, and basically rub people the wrong way. But, this is why the physicians should be the grassroots organizers for change. This is why they (I mean *we*) need a unified voice...because as it is, no one is listening.
I saw a nurse practitioner the other day. She had over 30 minutes with me. She seemed focused, and interested. She was rested...and her room was decorated with all sorts of cute pictures and informative posters and such. Her room had so much personality and I was completely absorped and put at ease. Then she came in, smiling, sat down, and looked at me. She had time to actually come in. sit down. and look at me. I felt like...I was the only patient on her schedule for an hour (and I probably was).
This is interesting since the PAs and nurse practitioners see the 'less complicated' patients, you would think that it would be they who had only 15 minutes per patient...with their easy patients and all. And the physician would be graced with over 30 minutes per patient....to decipher the nuances of the more complicated patients, and make more difficult medical decisions. Besides, there are (theoretically) more physician extenders than physicians...so it seems that the physician could busy herself with more 'doctor things' (i.e. things that require that a doctor do them) while the extenders saw the routine things which comprise the large majority.
But...this is not how it seems to be.
Physicians need a louder unified voice....lest our patients continue to think we're insensitive and uncaring, and suing us as a result. We need to be nicer. We need to listen more...and explain more. We need to change the system to encourage (or in some instances *allow*) us to be physicians...and really 'help people' and not simply stress them out and piss them off....