Thursday, September 22, 2016

Doctors Are Part Of The Problem, But They Can Also Be Part Of The Solution

“Are you a good witch or a bad witch?
Who, me?  Why I’m not a witch at all.”

There are good doctors and there are bad doctors.  I’m not a doctor – well not that kind, anyway – but recent experience suggests that maybe I should become one.

On Saturday, I had a follow up visit with my primary care doctor.  To put it mildly, it went terribly.  He asked me one question, I answered truthfully, and he freaked out.  He basically told me that if I coped better with life, I wouldn’t be sick. 

Well isn’t that rich?  Is that your many-years-of-medical-school-medically-informed-opinion doctor?  Because if it is, you need to go back to school.  And if it’s not, you need to stop.  Just stop. 

You know, when he learns what it’s like to become chronically ill in his early 20s and lose his dad on his 29th birthday in a very traumatic way, then judge me.  But until then, don’t – and oh wait, he can’t because he’s already way past that.  All things considered, I think I’m doing pretty well.  And I am not perfect my any means, but I don’t deserve to have some doctor’s petty resentments projected onto me.  That’s not right and it’s not fair.    

I barely held it together in the appointment.  I should have stood up for myself.  Or I should have just walked out.  But I didn’t.  I sat there, trying not to cry.  Trying not to scream “You have no idea what you’re talking about!”  But I clammed up, I closed off, and I didn’t know what to say.  I don’t think I’ll ever go back to him again. 

This situation reminds me why I sometimes hate doctors, and why I sometimes go through phases where it all just gets to be too overwhelming and I have to take a break for a while. 

Whenever that happens, I get delinquent about doing the preventative things I’m supposed to.  And then things happen, and I’m rocked back into reality and the fact that I have a crappy immune system and all that comes with it. 

And maybe that’s because I’ve had a lot of bad doctor/medical professional experiences, not just the one I just described.    

Here is a case in point:

Not long after I got sick, I had a yeast infection. It was really bad.  I’ve never had one like that before or since.  My only choice was to go to the walk in clinic at student health.  I saw this nurse practitioner who was asking me questions and basically told me that since I had lupus and RA, why was I even thinking about having sex?  Like sick people can’t have sex?  I was so shocked, I didn’t really react or fight back. 

Honestly, I’m still traumatized by that one.

But then I have experiences like today, that renew my faith in the medical profession, and make me realize that there are good doctors out there, and that we need to work together to improve healthcare. 

I finally went to the gynecologist, after too long of not going (read several years).  And I had to see a man, which I wasn’t thrilled about.  But it went very well.  The doctor was very thorough in taking my medical history.  And he really understood the complexity that is my chronic illnesses.  He was very non-judgmental.  And his office staff was very professional.  I was very impressed.  I left feeling very good about the appointment, which you can’t generally say about the gynecologist.  And thought, why can’t he be my primary care doctor?  

I’ve learned that the office staff at a doctor’s office says a lot about the doctor.  So this doesn’t bode well for my primary care doctor. 

Aside from the situation I described, I received a notice that my new insurance had been billed for an appointment when I didn’t have that insurance, so of course they rejected it.  I’d called my old insurance, and they stated they had never even received the claim.  Getting anyone from my primary care doctor’s office to deal with it has been a huge problem, so in retrospect, I shouldn’t have been so surprised about Saturday because I suspect that some of what went on was a result of having to basically fire his entire office staff.    

But regardless, if I’m having a bad day, I cannot treat my clients the way my doctor treated me.  So even if, as I strongly suspect, the behavior wasn’t actually directed at me specifically, it doesn’t make it okay.  It’s unacceptable. 

And if the billing issues that I experienced are such a widespread problem for this doctor, then I believe the doctor should have sent a letter out to all patients, explaining the situation and that they are trying to rectify it.  But rather than act responsibly, he decided to take it out on me. 

I’ve spent a long time feeling like improving healthcare falls squarely on the shoulders of patients.  But I think that doctors can help with this, too.  And they should.  Rather than taking anger and frustration out on an individual patient, talk to Congress.  Explain that while a practice manager used to be a master at insurance, the system is too fractured now and confusing, that it’s impossible to stay on top of it.  And not only does it make it difficult for the doctor and his staff, it also makes it difficult for his patients. 

For patients like me, who had to make seven calls to his office, only to find out that he fired his old biller, which seemed to be the standard line.  Five messages went unanswered, a call to a person told me that they would reach out to their outside biller and she would get back to me.  Weeks went by with nothing.  So despite my disappointment on Saturday, I mentioned it on my way out of the office.   I was told I had to speak with someone on Monday.  I spoke with someone yesterday, and I have been assured that the situation will be rectified.     

But this isn’t how it should be.  This shouldn’t be what patients come to expect as normal.  Every visit shouldn’t become a fight.  Every appointment shouldn’t be approached with trepidation because of how much it might cost or how difficult it will be to make sure that the right amount gets billed to the right insurance. 

I shouldn’t avoid obtaining necessary healthcare because I’m worried about how a doctor will react to me.  Or if they won’t be understanding or compassionate toward my illnesses. 

I’m sick, but I did nothing wrong. 

Doctors spend years in medical school, studying and learning.  But clearly there are still things that aren’t being taught well.  Clearly the non-medical aspects of being a doctor don’t rub off on everyone. 

Next time, I will be strong.  I will fight back.  I will throw down.  And I will stand up for myself.  Because I didn’t ask to be sick, and I’m doing the best I can to live with it, but the fact that I’m sick, on its own, does not give anyone, including a doctor, a right to mistreat and disrespect me. 

It bothers me that despite the fact that I don’t have any years of medical school behind me, my eight plus years of experience as a patient still isn’t seen as being worthy of praise or esteem.  For some doctors, it doesn’t even grant me a seat at the table or even a voice in the exam room.  

I will continue to be outspoken when I find the courage to use my voice.  But doctors cannot remain silent.  They are 50% of the doctor-patient equation.  They must stand up for themselves and they must stand up for their patients.  Getting consumed in the greed and the bureaucracy diminishes us all.  It makes doctors focus more on the bottom line and less on healing and minimizing suffering.  And it cheapens the patient experience.  It makes us bitterer, angrier, and less compassionate, both for our doctors and for ourselves.     


  1. Hi Leslie, I've been quietly reading your blog off and on for some time now but this is the first time I've been moved to post. I'm beginning to think there is something in the air the last couple weeks. I'm very sorry you went through that with your GP. Our GP's should be the dr we can all lean on when there is stuff from all the different specialists we have to see that we don't understand and to help us maintain the rest of our health, not belittle us. They should be our anchor points.

    Last week I was supposed to see my GP then my Neurologist the following day. They are in two different counties and 1 1/2 hour drive from each other. Suffice it to say I would never schedule both on the same day. I get a call from the Neurologists office two days before the appointment to confirm which I did. I was anxious fir this appointment because my symptoms have become much worse and there are new and as I understand it serious ones. I've been trying for weeks to get the appointment but the office staff there has a habit of not returning calls (red flag) A half hour after confirming the appointment that I waited 3 weeks for I get another call, this time I'm told the doctor will be at the hospital for an emergency meeting and can't make my appointment after all (second red flag) They want to schedule me for several weeks further when I've already waited more then 8 weeks including phone calls not returned. I beg for a sooner appointment telling the staff member my symptoms are worse but they never once ask about my health, not once. Then the staff tries to offer me an appointment the following day, two hours after my GP appointment in another county. I explain that it's not physically possible to make both appointments and it's too late to cancel the GP because it's the next day and confirmed. I'm then offered an appointment two hours later on the same day as my original appointment. I'm thrilled, I say thank you so much and tell them I'm changing my calendar as we speak. I will absolutely be there. We hang up, all seems fine.

    Fast forward, I go to my GP appointment and am exhausted and hurting from the drive. I know I have another appointment the next day with my Neurologist. I don't feel well enough to drive so I take an Uber. I give myself extra time so I'm not late and arrive 1/2 hour early. I apologize to to the only staff member for my early arrival at the office, he tells me they won't be back for 1/2 hour and to please have a seat. I wait. When the two women arrive my world just collapses. Immediately I'm berated for being a no show to an appointment the previous day, except I never agreed to an appointment the previous day I agreed to an appointment on the day I was there. Explaining why just got the other female staffer jumping in saying I heard the whole thing. What could I say? I did say and maybe I shouldn't have "you heard 1/2 of a conversation, you never heard how I responded. Why on earth would I agree to an appointment 2 hours after an appointment that takes a minimum of 1 1/2 driving time on a good day?" I'd never make it. At this point they were just yelling at me and I was in tears and I'm the first to admit I used a single curse word at one of them for spewing such hate at me standing there with tears streaming down my cheeks. I needed to see the doctor. When I saw him at first I was falling, tremors, weakness. I even fell at the hospital when I went for scans, into the wheelchair I went. Now my neck and back pain is excruciating, I'm falling more often, can barely sign my name and most embarrassing but also scaring me is the fecal incontinsnce. This staff though doesn't know any off that and didn't ask. I'm just praying I haven't developed another bone spur that damages my spinal cord before I can get in to see the next neuro and start all over. In the meantime I'm just scared.

  2. Not nearly enough time is spent on educating doctors on the importance of communicating with their patients in an effective and compassionate manner. I’d suggest that when you fire your GP, send him a letter telling him why. If you feel emotionally up to it, of course. And maybe include a copy of this post.

  3. I would send a letter to the doctor explaining how you were physically. I would then send a letter the the director of the place with a copy of the letter to the doctor. Ask them to please help you, you are in need. It worked for me recently....the director contacted me by email. Try it. :) LInda