As I've detailed in other blogs, I've seen a lot of
different doctors over the last several years.
My experience has ranged from really good, to mediocre, to really
bad. All the doctors were nice, but a
number of them were not, in my opinion, good doctors. Along the way I switched internists; having a
good internist is, I think, important. I've gotten referrals from my new internist
for specialists when there was an issue she couldn't deal with.
After my first visit with my internist, I sent her a
detailed medical history, because I felt she wasn't getting an accurate picture
based on standard forms Ron completed with my help. I sent her a link to the MAV page on VEDA,
but when I saw her she said she'd been too busy to look at it. I noticed that my online medical history did
not include anything about my vestibular or vision disorders, so I e-mailed her
that these needed to be included. My
internist has a good "bedside manner" when I'm with her, is open about
treatment options, and asks if I have any questions, but can't spend too much
time with me. She sends me an e-mail (signed with her first name, not as Dr. so and so)
reminding me to schedule my annual
physical. I think my internist cares but is overloaded. She should get a full picture of me, but with
limits on her time, this is an impossibility.
In contrast, my allergist is wonderful about taking his
time with patients. But he runs horribly
behind because the system really isn't made for doctors like him who want to
take their time to communicate properly with their patients, and cover all the
issues. Once a consultation is over,
it's very difficult to get a doctor on the phone - it's always an assistant of
some sort. No matter how nice the
assistant is, this means more waiting on my part, and another layer to go
through which can result in miscommunication.
I was surprised and very impressed when an oral surgeon recently called
us himself and showed a great deal of patience answering questions.
I'll probably never really have the opportunity to talk
to a room full of doctors, but what if I did?
Different doctors, particularly specialists, have their areas of
expertise, but what I want really has nothing to do with a particular
specialty.
So here's what I'd say:
"Hi, my name is Tamar Schwartz and I have medical
problems that you can't see...invisible disorders. Between myself, and other family members,
we've had some really good experiences with doctors, but there have also been a
lot of problems. Dealing with doctors,
and the medical system in general is complicated and not very patient friendly.
I want to tell you some things, but first I have some questions and a comment for
you -
1) Do you remember why you became doctors? Did you want to help people?
2) Were you passionate about the sciences when you were
in school?
3) Does the human body fascinate you?
4) When you're with me discussing a problem, think about
what you would do if you were me.
To me, being a doctor is about using your medical
knowledge to care for people, helping them with personal, often important problems. The medical system seems to get more and
more complicated all the time, and I want you to always be my advocate.
I'd like to think that wanting to help people with
medical problems is still REALLY important to you. I always want to know about conservative
treatments first; having surgery is never going to be my first choice unless
not having surgery isn't an option. I also want you to be willing to
discuss/explore non-traditional treatment options; medication isn't always the
answer. If you DO recommend a med,
please be honest about it; tell me what it will do for me but also tell me
about side effects, because that matters.
Regarding non-medicinal treatment, make sure you know what you're
talking about, and if you don't have all the info, tell me how I can be fully
informed. When I have a consultation, I
need you to take your time, and I need you to listen very carefully to me. I don't want you thinking about how many
people you've already seen, or how many more you're going to see. I need you to give me time to process what you
tell me, so I can figure out what my questions are. I don't ever want my consultation to feel
rushed.
I need your medical expertise, but I also need your
compassion. Even if I'm seeing you for a
basic checkup, you have to understand that like millions of other people, my
medical history is complicated. I want
you to take a few minutes BEFORE my appointment to check my medical records, so
you are clued in when you come into the room.
You need to be aware of my medical history when you discuss things with
me, and you need to use language I can understand. Please don't talk to me as if I'm just a
medical puzzle to be solved. I'm not
just one medical problem, but I AM a whole person and I want to be treated as
such. When you discuss my medical
health, it affects my mental health and vice versus. You're the medical expert, but *I* am the
expert on ME, even if there's no research to back up what I tell you. I live with myself every day, so when I tell
you something, believe me.
I want you to admit if something comes up or is an issue that's
not your area of expertise, and then tell me who I should consult. Don't be arrogant. Don't behave as if if you don't know the
answer, there is no answer - being a doctor doesn't mean you know everything
about the human body. Nor does it mean
you understand every disease or chronic condition, and I know that. Knowing that much would be impossible, but I
expect you to do your best to help me figure things out. Don't give me info, or give me a diagnosis
unless you're sure that's what's going on.
If you're not sure, tell me more tests are needed, or that I should see
this or that specialist. Even though you
are a doctor, I know you're human, fallible just like me; you can make
mistakes. If you make a mistake, take
responsibility for it. And tell me what
to do if the mistake created a new problem.
So in a nutshell, here's what in my eyes makes you a good
doctor: your medical expertise,
acknowledging when you need to make a referral, listening well, honesty, having
my best interests at heart, being empathic and taking your time. I can honestly say in all my medical travels over
the last several years, I can think of only three doctors I would recommend."
I am well aware that there are pieces of our medical
system that I do not discuss here, that impact both patients and their
doctors. The closest I got was to
comment that the medical system has gotten more and more complex. I chose to keep my focus narrow; what I
personally would want to say to doctors. That being said, I do think we need a system
that better supports medical professionals whose purpose is to cooperate with
each other, and take care of people's physical and mental health.
