Medical Mistakes, Part 3: Failure to Communicate
Mistakes in diagnosis or treatment plans often occur when the parties involved fail to communicate. Sounds like the movie, "Cool Hand Luke".
The Patient's Role: The most critical part of any medical encounter is the history (his-story, or her-story), which is typically provided by the patient. Some patients are more verbose and specific than others, however. It is the responsibility of the medical provider to ask the appropriate, focused questions to fill in the gaps. Many times, patients will not reveal the whole story. They need to tell the whole truth and nothing but the truth, to quote the witness oath.
Recently, a medical provider friend was dealing with a patient with recurrent infections, weight loss, fatigue, and a wide array of vague, but troublesome symptoms. The history did not reveal any sort of risk that would lead the medical provider down the right pathway to a diagnosis. Why? The patient did not reveal critical aspects of his history. He was vague and secretive; a married businessman that traveled. He seemed innocent enough, but had a deep secret that may have cost him his life by delaying his eventual diagnosis.
This family man had a hidden sexual appetite; an appetite that lead him to the disease-ridden brothels of Southeast Asia. He had contracted HIV. While one can understand why he would not want to reveal this information to a medical provider (or his wife), his failure to disclose this information in a timely fashion resulted in a very undesirable outcome. By the way, his wife was HIV positive as well.
Medical providers are trained to be non-judgmental. Over the years, I have been told things that made me scream like a little girl (inside my mind, of course), like those rare (Thank God) people who admit to having sex with animals. On the outside, I am attentively listening and nodding professionally. On the inside, it is AARRGH!
The Provider's Role: Not all people realize that their hidden agendas may be medically significant, so it is the provider's role to eke out those vital facts. Unless the medical provider proper sets the stage as a compassionate, nonjudgmental, and deeply-concerned professional, patients are not going to reveal those secrets.
It can be next to impossible to establish a trusting relationship in one 15 minute encounter. Trust requires TIME. When the medical provider is hurried, or feels that they are hurried, then mistakes in communication are inevitable. Wham! Bam! Here's your prescription. This is bad medicine.
I work with many teenagers; and anyone that has ever tried to communicate with adolescents or been an adolescent themselves (all of us!), then you know how challenging communication, such as a medical interaction can be. The language a medical provider uses is critical.
For several years, my oldest teenager spoke like a Neanderthal. "How was your day?" "Uhhh", he would grunt. Adolescents often do not trust adults, especially adults in power, like parents, teachers, or in my case, medical providers. Before I can help anyone, I have to establish the ground rules of confidentiality. For sexual matters, their confidentiality is protected by law. I can't treat a runny nose in a person under 18 without parental consent, but I can treat them for gonorrhea.
If I ask a teenager (in confidence), "Are you sexually active", I will often get a, shifty-eyed, negative response (I am having sex, but not at the moment. Or, I only have sex twice a week - that is not "active") If I ask the same question, "Have you ever had sex?", I will get a different response. One young girl, perhaps trying to avoid the "sexually-active" question, once asked, "What do you mean? Do I, like, move around a lot?"
I am sure glad that I didn't have Bill Clinton as a patient when he was a teenager.
Another communication problem orchestrated by the medical profession is the failure to communicate test results or to follow up on patients who never show up at the lab. A woman has a pap smear, but somehow in route to the lab, the glass slide breaks or is lost. She never gets her results, so she just assumes the test was normal.
It is the responsibility of the lab to inform the medical provider that the specimen was lost. It is the responsibility of the medical provider to call the woman and inform that they need to have another pap smear (women love this call). And, it is the responsibility to the patient to return for another pap. There is ample opportunity for a breakdown in communication.
I have to say that over my 30-plus years in this business, I have witnessed positive lab reports getting filed in the chart without being reviewed by the provider; or worse, ignored by the provider. No one likes to do those stool tests for blood, but if two out of those three specimens are positive for occult blood, someone needs to act. First, if the patient just doesn't return those samples, we have to get after you. Second, when they do come back from the lab, you need to know those results, even if they are all negative.
Several years ago when I worked in the ER at a local military base (now closed), I heard a story (presumed to be true) of a medical records person who decided that filing lab reports in the charts took too much of his valuable time. So, in order to go home on time, he simply threw the stack of daily lab reports up into the ceiling through a missing ceiling panel. The patients and the medical providers never got those results. Tests had to be repeated, or worse, critical results never were revealed. After a year (yes, a year) of this practice, the ceiling caved in from the sheer weight of these unfiled reports and the perpetrator was eventually court-marshaled. The harm that may have resulted from this act of idiocy is unknown.
Communication requires a minimum of two people. In a medical encounter, those two people are the patient and the provider, and each should equally share the honest responsibility of full-disclosure...including mistakes. Always remember that we are in this TOGETHER.
Related Topics: Are You Too Afraid To Ask Your Doctor?, Be Your Own Health Advocate
Technorati Tags: medical mistakes, communication
The Patient's Role: The most critical part of any medical encounter is the history (his-story, or her-story), which is typically provided by the patient. Some patients are more verbose and specific than others, however. It is the responsibility of the medical provider to ask the appropriate, focused questions to fill in the gaps. Many times, patients will not reveal the whole story. They need to tell the whole truth and nothing but the truth, to quote the witness oath.
Recently, a medical provider friend was dealing with a patient with recurrent infections, weight loss, fatigue, and a wide array of vague, but troublesome symptoms. The history did not reveal any sort of risk that would lead the medical provider down the right pathway to a diagnosis. Why? The patient did not reveal critical aspects of his history. He was vague and secretive; a married businessman that traveled. He seemed innocent enough, but had a deep secret that may have cost him his life by delaying his eventual diagnosis.
This family man had a hidden sexual appetite; an appetite that lead him to the disease-ridden brothels of Southeast Asia. He had contracted HIV. While one can understand why he would not want to reveal this information to a medical provider (or his wife), his failure to disclose this information in a timely fashion resulted in a very undesirable outcome. By the way, his wife was HIV positive as well.
Medical providers are trained to be non-judgmental. Over the years, I have been told things that made me scream like a little girl (inside my mind, of course), like those rare (Thank God) people who admit to having sex with animals. On the outside, I am attentively listening and nodding professionally. On the inside, it is AARRGH!
The Provider's Role: Not all people realize that their hidden agendas may be medically significant, so it is the provider's role to eke out those vital facts. Unless the medical provider proper sets the stage as a compassionate, nonjudgmental, and deeply-concerned professional, patients are not going to reveal those secrets.
It can be next to impossible to establish a trusting relationship in one 15 minute encounter. Trust requires TIME. When the medical provider is hurried, or feels that they are hurried, then mistakes in communication are inevitable. Wham! Bam! Here's your prescription. This is bad medicine.
I work with many teenagers; and anyone that has ever tried to communicate with adolescents or been an adolescent themselves (all of us!), then you know how challenging communication, such as a medical interaction can be. The language a medical provider uses is critical.
For several years, my oldest teenager spoke like a Neanderthal. "How was your day?" "Uhhh", he would grunt. Adolescents often do not trust adults, especially adults in power, like parents, teachers, or in my case, medical providers. Before I can help anyone, I have to establish the ground rules of confidentiality. For sexual matters, their confidentiality is protected by law. I can't treat a runny nose in a person under 18 without parental consent, but I can treat them for gonorrhea.
If I ask a teenager (in confidence), "Are you sexually active", I will often get a, shifty-eyed, negative response (I am having sex, but not at the moment. Or, I only have sex twice a week - that is not "active") If I ask the same question, "Have you ever had sex?", I will get a different response. One young girl, perhaps trying to avoid the "sexually-active" question, once asked, "What do you mean? Do I, like, move around a lot?"
I am sure glad that I didn't have Bill Clinton as a patient when he was a teenager.
Another communication problem orchestrated by the medical profession is the failure to communicate test results or to follow up on patients who never show up at the lab. A woman has a pap smear, but somehow in route to the lab, the glass slide breaks or is lost. She never gets her results, so she just assumes the test was normal.
It is the responsibility of the lab to inform the medical provider that the specimen was lost. It is the responsibility of the medical provider to call the woman and inform that they need to have another pap smear (women love this call). And, it is the responsibility to the patient to return for another pap. There is ample opportunity for a breakdown in communication.
I have to say that over my 30-plus years in this business, I have witnessed positive lab reports getting filed in the chart without being reviewed by the provider; or worse, ignored by the provider. No one likes to do those stool tests for blood, but if two out of those three specimens are positive for occult blood, someone needs to act. First, if the patient just doesn't return those samples, we have to get after you. Second, when they do come back from the lab, you need to know those results, even if they are all negative.
Several years ago when I worked in the ER at a local military base (now closed), I heard a story (presumed to be true) of a medical records person who decided that filing lab reports in the charts took too much of his valuable time. So, in order to go home on time, he simply threw the stack of daily lab reports up into the ceiling through a missing ceiling panel. The patients and the medical providers never got those results. Tests had to be repeated, or worse, critical results never were revealed. After a year (yes, a year) of this practice, the ceiling caved in from the sheer weight of these unfiled reports and the perpetrator was eventually court-marshaled. The harm that may have resulted from this act of idiocy is unknown.
Communication requires a minimum of two people. In a medical encounter, those two people are the patient and the provider, and each should equally share the honest responsibility of full-disclosure...including mistakes. Always remember that we are in this TOGETHER.
Related Topics: Are You Too Afraid To Ask Your Doctor?, Be Your Own Health Advocate
Technorati Tags: medical mistakes, communication
28 Comments:
Many years ago I had a doctor who would listen and ask questions. Not any more. Instead, I receive a "I don't know", some incorrect tests, no additional suggestions/referrals. Many of my friends have the same experience.
My general experience in the past few years has been that either my doctor interrupts me while I am explaining my symptoms/history, and comes up with a diagnosis without listening to everything, or listen to it all, arrange to have a couple tests done and then tell me they don't know what's going on with me and can't help me any further. I actually have a typed up medical history because I have had a bunch of symptoms for the past few years which no one has been able to figure out but whenever I try to hand that to a doctor and go through it with them, they immediately treat me very differently (as if I am making everything up just to get attention, when really all I want is some answers). I even had one doctor who came up with a diagnosis based on something I told him repeatedly was simply not true (I guess he just didn't know what else it could be and so decided that was the story he was going with...). It's incredibly frustrating when you try to share all the information you can with a doctor but are not listened to -- it just causes you to shut down.
I went to a very highly recommended hip and knee specialist with severe hip pain. When he walked in, I tried to explain my symtoms, how long I'd had them, what seemed to trigger them, and show him the scoliosis of my spine, different leg length, etc. I barely had begun to speak when he interrupted me and said, "Lie down up there". I tried to continue explaining my problems, and again he interrupted and told me to lie down. He rotated my legs, bent my knees and said, "There is nothing wrong with your hip - you have the hips of a 20 year old." I asked why the pain in my lower left hip was so severe if nothing was wrong. He said, "It's your back - the pain is transferred to your hip. You need to see a back specialist". I went to a back specialist who, after listening to me, said, "I don't agree with Dr. ____." This doctor spent enough time listening and examining to conclude that I had bursitis in my hip, as well as arthritis in both. The hip "specialist" is rude and arrogant; and very egotistical because of his reputation with hip and knee replacements. Other family members have been misdiagnosed and had bad experiences with him as well. He could have easily made a correct diagnosis if he had taken the time to listen. I consider him to be very unprofessional and uncaring!
Thankfully, I have the pleasure of working with doctors for not only my care, but my young children's care who actually take the time to listen to what is said. I have, however, had some experience with the "other" type of providers, which has left me feeling angry and frustrated (like when my 1 year old son had a double ear infection and the nurse at the immediate care held up her hand in my face, as I was trying to give her a history of what had been going on, and told me that my responsibility was to keep my kid quiet, and she would ask the questions. Then, the doctor, looked in his ears, did not pull the ears back at all to get a better look, and said she could not see what was really going on, but thought that he had a mild infection, and then prescribed medicine for SWIMMER'S EAR! I thought my regular pediatrician was going to go through the roof when I told him about this the next day.) My OB/GYN especially has been known to take a few extra minutes with me (and with other women as well), to help answer questions and concerns. Not only do patients need to be upfront and honest with the care provider, but doctors need to be willing to prove to their patients that they are there to help them by listening to ALL of the information a patient will give.
I agree with all the statements made about Dr's not listening. I am considering changing to another internist. The odd thing is that my husband has no complaints. He says she always listens to him, which adds to my feelings, of being cheated. I usually come to her with a small list of subjects I want to discuss. My husband and I have Type II Diabetes, so we have to see her every 3 mo. She allows herself to be overbooked, thus stressed. I let her know each time that I have a sm list of questions I want to ask her, but I answer her questions first. Sometimes this gets me answers to a one or two of my questions. But before I can finish my short list, she is most often at, or out the door again. Plus, I recently experienced an extreme reaction to one of my meds, Tramadol. I take a lot of meds, 12 a day. I had been complaining about a metallic taste for over a yr. Then suddenly, it became extreme one week, about a month ago. The taste spread from my esophagus and into my chest one night. The next night, it spread more to include my throat, and the following night it invaded my mouth, as if armour had been built to fit my upper mouth, as if my tongue had a 1/4" slab of flexible metal on it, and even worse, it felt like my teeth were being etched by metal, causing me fear of looking at them in a mirror. I tried to do all I could before calling the office and scheduling a visit, on Thurs, for blood tests and to have my hips and upper thigh bones tested. These bones felt like they were turning to stone for a long period of time. From the time I stopped taking Naproxyn, and changed to Tramadol, that an Arthritis Dr prescribed for me to take, I never got relief from pain and the pain kept increasing to the point that I could hardly walk. My lower back was affecting me as well. I went in and my Doctor and nurse both asked me questions, and I tried to explain why I came, and asked them about the extreme metallic reaction and what medicine I was taking that could be causing my symptoms. Again, they both said they had no idea what was going on. My Dr said that many of her patients complain about having a metallic taste. But my symtoms had gone haywire and I thought I was being poisoned by my meds. However, I was distracted by the odd questions my Dr asked, that had nothing to do with what I came in to do. My Dr went into talking about another issue I guessed my husband had told her about. Before I knew it I was touching the door to walk out and leave. I stopped for a moment and thought about walking back to them, and re requesting some tests. I was too frustrated by then to care, and left. That night, as I took my night meds, I accidently dropped one, Tramadol. So I took the rest, then I tossed that one into my mouth, but before I could raise my glass to my mouth and take it, the med touched my tongue and went off like firecrackers!!! So I pulled the med from my mouth, sat it on the counter, and told it I would never take it again. I went to bed soon after that. I awoke with less pain than usual. Two days later, I felt so much better! Before, I felt fragile, like I was 99 yrs old, and avoided crowds, because I thought if I got bumped, I would crack and crumble to the ground. I could barely walk. I was in such great pain. But, by day 2 without the Tramadol, the tides all changed. I stopped needing a pain pill twice a day. I asked my Dr to prescribe Naproxen, because I took it for 8 yrs and had great success. She agreed. I got that prescription filled. However, I am trying to take OTC 200mg tabs of Naproxen, one at a time, up to three, to see if less mg can help as much as the prescribed 600mg tabs. Most of the time it works, and there are many days I can put up with the pain and not take a pill. This is the 2nd time I have been a victim of what a Dr has done to me. The last time was in the early 70's and I ended up with surgery that has changed my life ever since. I have to think hard about what I am going to do soon. I can find a new Dr, and decide to take her to court or not. I went to my pharmacy many times during the week I was experiencing the worst symptoms. Each day there was a new pharmacist, being trained for a new pharmacy opening closer to where I live. Anyway, I got several bits os information re Tramadol. It was to be prescribed short term only, and only 5 days or less at a time. Hum!plus i was suppose to be getting regular lipid panels taken on this med each 3 months. I knew I was getting only one panel a yr from this Dr and she was prescribing 10 meds daily.
I'm fortunate in that I have had very few bad experiences with doctors.
My current physician expects me to be an active, participating member of my health care team. Dr. S. listens carefully to what I tell her and is quite willing to discuss, in detail, any questions I have. I'm never left wondering why she prescibes a medication, or orders a test. Test results have always been gone over with me, usually by telephone the day she receives the lab report.
Dr.S. isn't perfect, but none of us are. She has misdiagnosed a couple of problems. And I've slipped up and forgotten to tell her about things that turned out to be important,such as an over-the-counter medicine I may be taking. Fortunately, niether she nor I play the blame game.
I work in Healhtcare and see "both sides of the coin" for lack of a better phrase. From my professional experience, Practioners often feels they get "1/2 truths".a patient may report to drink socially, however, they socialize quite frequently and consume a case of beer a week. Or, a patient might insist they don't eat "junk food" but forget to mention they fry their foods and eat large quatnities.On the other hand, I've seen patients concerned about a syptom/condition and tell a Practioner and tell the Practioner everything about their lifestyle and concerns and feel like their Doctor heard of what they said. Doctors are people. They have a vast variety of experiences and personalitied just like everyone else.
I believe you need to be proactive in you healthcare. Call to find out you lab results and request a copy for you to keep on file. Bring in specific questions and let the Docotor know them up front and be sure to have them answered before leaving. Shop around to find a doctor you feel comforatble with...it's not the same for everyone. My husband and I have different doctors and we each "love" them. Speak up and ask questions, it's your body an dyour well-being.
Quick Story. My 3 yr old needed surgery. We went for a consultation and the specialist walked in the room, never acknowledged our son, then, quickly examined him, said he needed surgery and that someone would come in to schedule it and, just walked out of the room. Well, I didn't take surgery on a 3-year old to be no big deal and, He didn't explain anything to us or ask if we had questions. I opned up the door and he was still in the hallway and said "excuse me, we have questions that need to be answered by YOU, Before we schedule surgery. The doctor came back in the room and did answer our questions and explained "things" to us. He was quite pleasant as well. Smetimes, we need to vocalize out needs before we coplain we didn't get the care we desired.
I've had one specific very uncomfortable annual checkup visit (thankfully, many years ago and I no longer live in his region). This was my first visit with this particular OB/GYN. He indicated that the exam was over and I could dress. I was still on the table and summoned up the courage to ask why a rectal exam had not been completed, when he asked did I "have symptoms that would warrant such a procedure?" I said I understood that it was part of an annual exam. He stated that his patients were "smart, intelligent women who would know to mention symptoms that would indicate a rectal exam". He didn't "typically" perform this procedure but since I insisted, he'd comply.
For someone who belongs to a "fringe" subculture or engages in behaviors deemed unacceptable by mainstream society, one judgmental health care provider can make it difficult or impossible to ever trust another with "the truth". I was an IV opiate user for 15 years and can confirm that it's very hard to be honest with someone who holds you in contempt for your addiction, and doesn't hesitate to convey this through their words or non-verbal communication. Whether a provider assumes you're just trying to scam prescription meds... painfully pokes your arm ten times after refusing to take your advice on where to find a vein for a blood draw... says that you shouldn't need pain meds or that you're "still actively using drugs" because you're on methadone treatment... or laughs at you while threatening to give a large & unnecessary dose of a drug that will induce intense withdrawal symptoms... the message is clear: "I believe you are a worthless human being, and I hate having to waste my time treating your probably self-caused problems". Attitudes like this only add to the cycle of alienation and stress that makes addiction so hard to break- it's hard to be motivated to re-join a society that despises you. The acceptance & compassion of one person can be that final piece you need to find the inner strength to leave an addiction behind. Health care providers please consider: you can either be that person... or the one who makes a patient lose all hope & all connection with other people. Yes, docs are human like all of us and have their own opinions and beliefs. But they should be professional enough to at least *seem* objective when interacting with patients. The results will be better patient care & outcomes, and less frustration and stress all around.
To anyone who's still struggling with their addiction, it's vital to be as honest as possible with doctors. Don't let the fear of disrespect keep you from taking care of your health. Remember that you have rights in your health care, no matter how strung out, poor, or uneducated you may be! If you are treated with disrespect at a hospital or clinic, don't hesitate to report it to administration or the local patients' rights group. If a doctor refuses to medicate or treat you because of your addiction (or for non-medical, lifestyle-related reasons), insist that s/he document the refusal and reason in your chart. Making the effort to take care of your health can help you survive long enough to beat your addiction, so don't let anything keep you from doing so. If I had paid attention to the health care providers who teated me with such contempt, I'd likely be dead today. Instead I paid attention to those few who treated me with respect & compassion, and learned to believe in my own worth... so today I'm still here to teach my Special Ed students to believe in theirs.
I have been annoyed by having many doctors asking me if I want a breast exam since I am well endowed. When I was young and stupid, I didn't get it and ok'd it. Now, I know better. Recently my doctor checked me for a hernia. Lifts up my shirt to exam my stomach and before he exams me, lifts my shirt up again and obviously checks out my chest with his eyes. Ugh. I really liked him til then. Now all I wonder is how many other patients has he hit on. He made it clear for me to see his wedding band to which I gave him this god awful face - so he knows not interested in married men. I hate people - not just doctors who use their position to take advantage of others.
I have been lucky to have good doctors for the most part--I even like my HMO (I have never had a problem getting tests or equipment I needed and have easily gotten referrals to specialists). Once, however, I did have a problem with an arrogant (and ignorant) doctor that could have had serious consequences. About twelve years ago I got a severe sunburn on my face, chest and arms. After it healed I still had a problem with a mole on my neck--it kept bleeding, scabbing and bleeding again. I went to a dermatologist who told me "it just looks irritated." A month later it still hadn't healed so I went back. She looked at it again and said, in an irritated tone of voice, "it just looks irritated." I said "Well, I don't want it. Please take it off." She wasn't happy about it but did take it off. All moles have to be biopsied and this one came back positive for squamous cell skin cancer. Fortunately it was "in situ" (just a few cells in that site). She took out a little more tissue and I was fine--no further treatment. What bothers me the most about this is that I went to her with two of the symptoms of skin cancer (changes in a mole and a wound that won't heal)--twice--and she not only didn't "get it" but she was mad at me as well. If I hadn't been knowledgable and assertive who knows where it would have gone.
In defense of Doctors, most are exceptionally hard working and caring individuals who work for about as much as a full time nurse when you break down the time that they spend with patients, and the amount of money the insurance companies are paying them. It is no wonder that many practices fail. They simply cannot afford to stay open.
I have a great doctor now. I've sure had my share of bad doctors in the past. You know knowledge is power!!! If your doctor does not listen to you go to one that will!!!! Here's an example. I saw a doctor because I was breaking out in a red rash on my hands and arms. He wasn't sure what it was so he prescribes some kind of cream. Well that didn't work. So I saw a different doctor. He gets on his high horse and says "oh that has to be scabies". He never took a skin sample or analyzed it or anything. I had to apply that nasty lotion from head to toe to "kill the scabies". Well tried that and still had the rash. I changed clinics totally (not just because of this but due to other factors) and saw a doctor that referred me to a physician's assistant in dermatology. What sucked is I had to wait forever for the appointment. Once I got in he told me it did not look like scabies but just eczema (from stress or who knows what). He asked if my husband was itching too and I said no. He said if it was scabies my husband would have it by now. He put me on oral meds and prescribed cream. The rash healed up quickly without the cream. The moral of this story? Don't let your doctor do the "I'm God" trip on you. If your doctor won't listen and will not refer you to anyone else, change doctors. I'm glad I did!!!!
well, I don't know about the rest of you, but I would say about 85% of all doctors out there ( and I have met alot of them) really don't care and just want to make a buck.
The answer? nurse practitioners. they are more sensitive, just as well trained and really do care about YOU, not your insurance card.
No, I don't tell doctors everything, sometimes I have lied about things such as my age or personal life, but I know what I am getting into and so I know I am in control.
sorry, but I get so tired of being told what tests I need just because I am whatever age..
I too have many stories of Dr.'s just not listening. Mine started when I was really young and unfortunately I really liked the Dr. so I never sought a second opinion. Then my parents insurance changed and we were forced to see a new Dr. They quickly caught the mistake and we thought finally a great Dr. Only to find out that they too don't listen. I have had endometriosis since I was 12, I told the Dr. this. He said well you don't know that you have, you don't even know what a period is supposed to be like. I said well that may be true, but I do know that my aunt has it and she describes the pain just as I do. I also know that my mother doesn't have it and has little to know cramping with her periods, so that tells me that I most likely have it. And since I know that it can lead to infertility and I want children I want to be tested, and if it comes back positively I want it removed so I am not in pain.
They did nothing, absolutely nothing. When I became sexually active I thought well maybe they couldn't do the tests before, but they certainly can now. That didn't happen either. When I was 21 I received my first abnormal pap when doing a b/c study. They thought it was merely an STD, but I knew better and saw a GYN. He confirmed my suspicions. He did the Laparoscopy and unfortunately it didn't work, but at least he tried.
I have several other issues I'd like to resolve, but no that I don't have insurance I can't get a Dr. to give me the time of day. It is extremely frustrating. I want answers just like the rest of America, but because they aren't going to get lots of money by me paying cash it seems they don't want to take the time.
I wanted answers so much so that I became an MA and all that did was open me up to what could really be going on. Not even the Dr. I work for who will spend an hour or more with new patients, because he likes to be thorough will answer my questions. His response is that he doesn't have my records. When I offered to have them sent here he said it would be unethical to treat an employee.
I don't neccesarily agree with that, but at least I can see his point of view.
Dr.'s so far have done nothing but drive me crazy. Then they wonder how people get anxiety and depression. Well I say this, how would they like it if they were asked their professional opinion at a medical conference and were told that they would be speaking to people they looked up to and respected only to have these same individuals constantly interrupt them and tell them they were wrong; despite their expertise? I know for a fact they wouldn't stand for it. So why is that they treat their patients that way?
I know for a fact that Dr. that I work for has his patients come back because he spends time with them and answers their questions. If he doesn't know he freely admits it, but then he hops online and researches it. When he is better informed he calls the patient and gives them the information.
SO to all the Dr.'s who think in out and on your way is better. I say no it's worse. Slow down and take the time to hear your patients. You will get more patients that way, and they will be more likely to listen to your advice.
My wife and I have been to 34 doctors across 4 states without a diagnosis or treatment.
She has been in terrible pain for three years and cannot walk or stand. We went through the games of "its your Hip. Its your Back , it's neurological...etc"
Many MRIs and thousands of dollars in insurance bills later she came to a well known doctor in tears begging for help.
He was nasty, arrogant, and abusive.
He was recently sued for killing a famous broadcaster.
Doctors are Gods paid and owned by pharmacutical Companies and Insurance companies, and we are subject to be milked and never cured.
Sept.30/06
I'm a nurse of 35years. I have seen so many changes over the years...perhaps the worse change is the manner in which the providers handle their patients. The docs ARE on a time limit with each pt. b/c the powers that be are on their backs to get as many pts. in during office hours,as possible! $..$..$!!!!!! In fact, the Dr.s office I worked in...any of the docs that took the time with a pt. they deemed neccessary...were routinely given a stern reprimand re: this. Hurray for them...theses few MD's continue to be thorough and caring with each pt, they see...they tell me they just can't practice medicine the way the finicial big-wigs demand they do! So,kudos to them!!
Briefly..I had a bad event with an ortho doc I saw for full-thickness torn rotator cuff.....Physical Therapy was way more painful than should have been that far out from the 1st surgery. I asked him 3 different times to PLEASE order an MRI..I thought (and so did the P.T. gal...)this was too much pain. That surgeon was so mad at me. Nevertheless I had him do it again..(a 2nd MRI showed another full thickness tear..)because my feeling was HE'D been the one to know what was going on in there...it should be easy for him to fix.Well....4 rotator cuff repairs later and 4 months of my life on hold....one more to go..oh,by the way, that first doc packed his little bag and left town..rather quickly I might add....but the Ortho'surgeon I have now is the best!!
Lesson is...be very comfortable with the doc you have thru ALL phases of your relationship with him/her. If there is any hint that things have gone awry between you GET OUT....there WILL be someone you can "connect" with..have faith. And remember to ALWAYS speak up for yourself!!Noone else will...
What do you do when your Dr. is foreign born and can hardly speak your language? Very hard to understand him and make yourself understood. I cannot change Doctors as it is with the VA.
It is so frustrating that we are charged hundreds of dollars and We hardly have five minutes. Five years ago, I took my daughter to an orthepedic doctor due to swelling in her leg, he was rude and very condesending. After her being casted for 3 weeks, the swelling was still there. I had mentioned to the doctor if he thought it could be arthritis. His intern at the same time had mentioned the same thing. The doctors response was "You are learning and I am diagnosing" then told me basically that I was out of my mind and that it was not arthritis and it would take a couple of weeks for the swelling to go down. Two weeks later for the followup and she was still swollen and had no mobility in her leg. I walked out frustrated and finally found the best pediatric orthepedic doctor in all of IL. God bless them, they discovered the real problem my daughter had rhematoid arthritis. After some anti-inflamatory medication and proper psyhical therapy my daughter is back to normal.
I think the doctors these days are more worried about getting you in and out then actually taking the time to care about there jobs!
I am had a triple hernia operation in the stomach area. I had to have the one repaired near the wraist line because the mesh and the colon was getting mingled together. That was my second surgery and now I have to have another surgery for the same thing. I do not understand why they can not get the problem solved.
I agree about dr.s, I don't think they are all paople make them out to be. My daughter is mixed (black and white) and after she was born we took her in for her checkup and the dr. said she was so jaundice that we may need to admit her. We took her in for all of the tests and they came back normal! NO jaundice at all, it was just her coloring. I'm no genius but even I thought that was wrong.
After reading all of the posted comments I am very fortunate to say that my physician is very wonderful. He listens to my compliants and answers all my questions and never seems short with me or bothered. He talks in layman terms and explains things until he is positive that you understand them. I can call his office ans leave a message for the nurse and always get a return call the same day. i trust my physician and I am very open with him as well. He treats my children and husband and knows us all by name. He has a great memmory for all of the patients he sees. I only hope that everyone is as fortunate as my family has been when it comes to having such a professional yet down to earth doctor. Keep searching because there are caring docs out there!
When I was pregnant with my first son, I found the OB of my dreams. He took the time to listen to everything I had to say, answered all my questions, and when a complication arised (I developed Gestational Diabetes) he gave me every course of action medically possible to manage the condition.
We chose to bring in an extra doctor. Since my OB's offices wasn't accessable 24 for diabetic related care, I would see a specialist just to get medication.
This doctor was very different. He put me on pills to manage my blood sugar. My pharmasist expressed concern saying they were not ment for pregnant women. I tried them and for 2 days it made my sugars worse. I called the doc and he told me to take more. I called my OB and he was like, "He put you on WHAT!?!?" My OB wrote me a script for the proper medication.
When I went back to the specialist, he was not happy. I told him after having difficulty with the medication, and looking into the medication, talking to my pharmasist and my OB, we all decided that this was not the write course of action. He, in not so many words, said "I'm the doctor here. Just do what I tell you."
I switched specialists. It's my body, and I don't care if you know more than me when it comes to books smarts about the human body, it's MY body and I know when something isn't right.
I wish all doctors could be as wonderful as my OB!
I am trying to find Information on patients with a tear in the esophagus and results of repair surgery. Recently a family member had this to happen. While still hospitalized, a second procedure was done and a stint? was placed in the esophagus. It was then moved approximately 3-4 times. The patient eventually died while still in the hospital. The doctor gave the cause of death as hemmorrage due to the drainage tube from the first surgery eroding into the aorta. Should this not have been detected in the almost daily chesh x-rays? Would something like this be a common thing?
I have a verey rare condtion (1 of 5 ) in oregon I have had my share of good and bad doctors . then I found a good nurse practioner they listen they can do any thing a doctor can do including write prescriptions for class 2 medications best of all they really seem use my honesty to help me!
I have had the experience (since moving to Arizona) of going to doctors who don't see the patient. They heavily rely on NP's and PA's. I get a different person each time I go in, and have to recap everything thats been going on. Each one has had a different opinion on whats going on and keeps ordering a variety of tests and refer me to different specialists, or tell me to hold off on the one another person from the office told me to go to. Its really frustration and I don't know if I am really getting the help I need.
i mainly rely on the va for healthcare, due to financial reasons. it's really a problem for me, as i have a multitude of chronic illnesses.
after i finally develop a rapport with the physician,they always get transferred and i get the displeasure of breaking in a new one. it always seems to be that i finally had to 'read them the riot act' before get them to listen to me, then they actually listen to me and stop trying to treat me like a textbook case.
i've survived certain death 15 times, sometimes by ignoring well respected doctors in my community.
i've lived with my body for 55 years, and i know it's idiosyncrocies better than anyone. anytime i see a new drug introduced, i'm afraid to take it, if prescribed, because its side effects are a symptom i already have! mostly i just learn to live with the pain or symptom for fear of dying even while under a dr's care.
the last time survived death, i was admitted wth a blood pressure of 66/33 and a left ear draining pus. fortunately i had been rushed over from the va clinic with a list of the medications i was currently taking, so i was treated correctly and seriously. i was in the hospital 10 days until they were satisfied with the test results and they discharged, although i'm following up with with daily iv infusions of antibiotics for my still infected ear.
all in all, it's really tough to find a caregiver that is willing to listen, take you seriously, and act on it, but like said, sometimes you need to stop and 'shake' them to make them listen!
I am an example of the worst of patient-doctor communications.
At a point about two years ago, I just felt strange. Very strange - like there was pressure all over my body. I also felt as though I were going to die. Now, I'm not a medical alarmist or hypochondriac, and I had never experienced anything like that before.
So, I called my doctor. He was always a bit brusque and never seemed very concerned or sympathetic, but his reaction this time was beyond belief. When I told him my symptoms, he said:
" You're dreaming this. There's nothing wrong and you're not going to die. I'm not going to waste my time having an office visit for nothing".
I still thought I was dying. It took me six miserable, scary weeks to find a replacement doctor. She was wonderful - concerned with the whole patient, and really listening to my concerns.
Well, she took my blood pressure and pinpointed the problem immediately. My BP had spiked, suddenly to 220/180. As I understand it, that's stroke territory. Had my original physician just asked me to come in, he would have taken the BP and identified the problem immediately.
Today, with just Lasix, my BP is once again normal.
Everything I've read stated that high BP is a "silent" killer, with no symptoms. I don't know about anyone else, but I definitely did have symptoms - undifferentiated, but real nonetheless.
Doctors should listen. My current physician does.
AAK
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