01 March 2013 ~ 12 Comments

How To Be a Good Doctor – 10 Patient Tips

You might wonder who on earth I am to have the gall to give tips to doctors. Well, I’ll tell you. I’m a very well informed chronically ill patient who has gone through doctor after doctor after doctor and sadly at times has suffered greatly as a result. I’m not saying there aren’t good doctors or healers because there most certainly are (Dr Schaudig, our doctor in Germany, Inna Topiler, our kind and knowledgeable nutritionist, and many of the healers I have met through my patient advocacy) but sometimes you have to look long and hard to find such people.

I’ve been bullied by doctors,  I’ve been dismissed, I’ve been shouted at as they called me “fat” at the top of their voices and I’ve been insulted. Little wonder then that I suffer from what might be defined as a form of iatrophobia or fear of doctors. My white coat syndrome seems to be related to this too as does my excessive nervousness about seeing a new doctor – once bitten, twice shy. Well, sadly, I and many others have been bitten repeatedly!

Yesterday, I was talking to my personal trainer Walt about this very conundrum. He too was able to relate to the condescending attitude that many doctors have towards their patients and we both commented on how funny it is that doctors have their own guidelines and expectations for you, but when it comes to affording you the same courtesy, you are all too often expected to put up and shut up. Can anyone tell me why doctors expect us to respect their time by arriving punctually to appointments, but sometimes make us wait for over an hour or at times several hours? One time I arrived 10 minutes late to a gyno I used to see only to be snapped at very nastily. This lady routinely made me wait an hour even if I had an appointment … double standards much? I’m also curious about how some doctors can demand respect from their patients when they don’t always respect them back. And what about the 48-hour cancellation policy although some doctors won’t hesitate to cancel your appointment in the blink of an eye if you are a mere 10 minutes late due to traffic. Seriously? Yes. This and many other things have happened to my husband and me.

So here are my tips to doctors who have problems with their doctor-patient relations. All of these are based on true experiences, either from me or my friends and family. One integrative doctor commented that I am “preaching to the choir” here. Well, that’s not my intention as I realize that some of these tips are matter-of-course for good doctors who respect their patients. I am not pulling any punches here, but speaking very matter-of-factly.

  1. Listen to your patient. Yes, REALLY listen to what they are saying, without already thinking about the next thing you are going to say or interrupting them mid-sentence. Don’t start harping on about your next fishing holiday either and end up having to rudely cut the patient’s appointment short because you were too busy going on about yourself. Chatty is nice, but chattiness eating into the time I’m paying dearly for to consult with you is not so cool!
  2. Think of yourself as a medical Sherlock Holmes. The patient is your client who is coming to you with clues that you shouldn’t ignore, although it seems many doctors do ignore these clues as they gloss over what the patient is saying or jump to the wrong conclusion. This also goes back to listening!
  3. Don’t be so desperate that you feel you have to try and think up imaginary diagnoses that the patient obviously doesn’t have simply to scare them into continuing regular treatment with you.
  4. Don’t plug your supplements and push the patient to buy excessive amounts of them so that you can hear the ching-ching of your cash register. We go to some healers for supplements, but some of them seem intent on excessively selling overpriced ones simply to augment their income.
  5. Don’t make rude assumptions. Case in point: If a female patient comes to you and tells you she is bloated from her period, don’t proceed to harp on about her visceral (abdominal) fat. She told you she was bloated, so give her a break and understand that she is not looking or feeling like herself. Furthermore, it is NEVER acceptable in polite society to comment on somebody’s weight and so it’s certainly not acceptable to do it as a doctor either. Again, this is all about respect – and not just the patient respecting you. It works both ways.
  6. Don’t lecture your patients as if you are the school master/mistress and they are your pupil. First off, it’s rude to assume they don’t know as much as you as there is a new generation of patients becoming increasing self-educated due to sheer necessity. Don’t talk down to them or “tut tut” about what you think (or assume!) is their less than healthy diet. Yes, some healers are there to give dietary advice, but as the Germans say “the notes make the music”, so bring up these suggestions and recommendations with respect and maintain your patient’s dignity without judging them.
  7. If you are in the healing profession, be in it for the right reason – i.e. because you actually care about helping people. Take the story of a friend of mine whose chiropractor asked her “How are you?” and she responded “I feel like I’ve been run over by a bus!” His response? “Oh, that’s nice”. Well, Mr. chiro was promptly fired and rightly so! We patients are not stupid and we can tell if a doctor doesn’t really care about us. They might not be a member of your family or your close friend, but in my opinion if you take pride in your profession you do care about getting your patients genuinely well and listening to and fulfilling their needs.
  8. Never insinuate that your patient is lying. Case in point: If you are seeing your patient for the first time and you notice she has a curvy figure, don’t assume that this must mean she is unhealthy and unfit. And when she tells you that her blood lipids (cholesterol and triglycerides) have been perfect for years, take her word for it even if these tests weren’t included on the latest labs as they were not considered a problem. Don’t feel the need to double-check just to make sure she’s not telling fibs!
  9. Never underestimate the power of a patient’s intuition or their knowledge of their own body. After, all they’ve lived in it for many years! Time and again, I have suspected that something was going on with my body only to be dismissed by doctor after doctor and when I finally got the correct diagnosis (the one I had originally suspected all along!), my suffering had progressed so my healing took longer. In my case, this was true (among other things) for both gluten intolerance and adrenal fatigue. Don’t you wonder if there are statistics showing the time between the point patients suspect a diagnosis and the point they get a doctor to actually listen to them?! Medical professionals vow to do no harm, but by refusing to listen they are harming their patients time and time again.
  10. If a patient asks you to adjust their dose of medication because they might feel better on more, don’t categorically reject this proposal because you feel that the blood numbers are in line because – as we all (at least all patients!) know – the blood tests rarely tell the whole story and whilst some blood tests might indicate healthy levels, that might not necessarily be the case. Consider doing further testing or giving the patient a trial adjustment of their dosage before fobbing the patient off. As I said above, we patients know our bodies and it is vital for a good physician to work WITH their patient rather than against them.
    On the topic of blood tests, when evaluating the patient’s blood tests, don’t sit behind your desk, telling them that certain test results are too low or too high. This is extremely patronizing. Go through the blood numbers TOGETHER with the patient, showing them WHY certain levels are too low or too high. If they’re on your computer, turn the monitor around or, alternatively, share the lab printout with them or even get a second copy printed out for them. An informed patient wants to know where their blood levels are in the range and – shock horror! – might actually disagree with your assessment due to their individual “feel-good range” or because – shock horror again! – you are not always right! After all, you – like your patients – are just a human being. It is the doctors who realize this that are often the good ones.

This list makes no claims to completeness. I could talk the hind leg off a donkey when it comes to this topic and I’ve also written various other articles on doctor-patient relationships on my blog Butterflies & Phoenixes. I’d like to finish by saying that no matter how many of these bad experiences you go through, try not to focus just on the bad and never give up hope because there are competent and understanding doctors out there and you owe it to yourself to carry on looking. Here at ThyroidChange we have various resources to help you find a good doctor and our columnist Dana Trentini has also written an excellent article on this which you can read here.

I’d love to hear your thoughts and experience on this. What do you feel constitutes a good doctor? What do you wish some doctors would do differently?

What do you as a doctor think constitutes a good patient? I’d love to feature the other side of the coin because I know that it takes two to form a good doctor-patient working relationship.

Yours in healing,

Sarah

12 Responses to “How To Be a Good Doctor – 10 Patient Tips”

  1. Susan Reinhard 1 March 2013 at 3:03 pm Permalink

    This morning, I told Dr. Flores about some things I had seen in the drug store that were covering specifically for burns, which I was having trouble bandaging as it’s on my back. He dug through his drawer and found a large patch that stays on 3 or 4 days and is like artificial skin. We agreed to try it. I suggested it. So, he’s a pretty good doctor.

    • Sarah Downing 1 March 2013 at 3:07 pm Permalink

      That’s great to hear a positive doctor story, Susan:-). Thanks for sharing.

      Love,

      Sarah

  2. Cindy 1 March 2013 at 5:38 pm Permalink

    I really enjoyed reading this, I have had awful experiences with doctors just not listening or in to much of a hurry just to get on to the next overbooked patient. I finally found 2 wonderful, caring, professional , open minded and well educated doctors. Once a patient finds the perfect fit, don’t let go, these doctors are a rare find.

    • Sarah Downing 1 March 2013 at 5:42 pm Permalink

      Thank you, Cindy. I’m very sorry you’ve had some awful experiences. It can be very tough and it makes you want to give up, but it’s always good to hear that there are some nice ones out there. It always astounds me how often we have been treated this way and makes me appreciate the good healers even more:-).

  3. Lori 1 March 2013 at 5:38 pm Permalink

    Excellent points and all very important! We certainly do deserve respect. On more than a few occasions I wish I had said out loud “you are fired”, instead of quietly leaving and never returning. However, I now will not hesitate doing so in the future.

    • Sarah Downing 1 March 2013 at 5:43 pm Permalink

      Thank you, Lori! I am also crap at telling someone they are fired. At that point, I am usually so stressed and upset that I just want to get out of there. I don’t like confrontations either, which is why I don’t usually tell them out loud, but I know some people do and sometimes they need to hear it!

      Love,

      Sarah

  4. Dana Trentini 2 March 2013 at 11:30 am Permalink

    Great article Sarah! Thank you for including a link to Hypothyroid Mom. Much appreciated. It is wonderful to be a guest writer at ThyroidChange, especially with you as editor.

    • Sarah Downing 2 March 2013 at 11:34 am Permalink

      *Blush*. You are too sweet, Dana! We are so glad to have you contributing your brilliant articles on TC. I love your writing and this article of yours was very relevant and seemed to have some great resources:-).

      Take care and have a great weekend!

      Sarah

  5. Karen 20 March 2013 at 2:04 pm Permalink

    Sarah,

    Most times I don’t think doctors are as great as they think they are. Especially when they refuse to try natural alternatives to common aliments.

    Until my sister searched for natural solutions she was never able to get her hypothyroidism under control, I’m just glad she decided to look beyond doctors.

    • Sarah Downing 28 March 2013 at 12:56 pm Permalink

      Yes, I definitely agree with you there, Karen. Like people in general, some doctors appear to have overinflated egos. I’ve seen doctors of mine in the past pat themselves on the back when I improved due to things I did, but not thanks to anything they helped me with and I have seen doctors who are very dogmatic that they know what is what and have a big problem listening to the patient.

      I too have come to the point where I prefer natural treatment to all those synthetic and potentially damaging pharmaceuticals.

      Cheers,

      Sarah

  6. Cat 28 March 2013 at 12:43 pm Permalink

    I’ve had some Dr’s good and bad over my 50+ years. Most recently things were going well with my current situation, until one of the Dr’s got a job elsewhere and the health care clinic changed hours of operation and then went from walk-in to appointment only. I work quite a distance from where I reside and if I get sick the night before I’m pretty much out of luck. It’s not like I have a crystal ball and know when I’ll get sick. Anyways, this situation forced me to switch to another care facility and I think I just met “Dr Wrong for me”.

    He said he’s studied this and knows all about it. He questioned all my other doctors before him (many over course of my life, in part due to moving). I guess they were all wrong in diagnosing/treating my hypothyroidism. How do I go back and question my baby doc (wherever he is) and get answers from my Mom who would know (since deceased)? I had never been questioned like this going back that far, as if I can remember everything he had said?

    The only thing this new doctor would share with me were the numbers. Then, he pushed everything “synthetic” . He would not listen to how I said I felt much better using Nature Throid as opposed to Synthroid. I had spent many years using both Synthroid and it’s generic,Levothyroxin. Shouldn’t I know how I feel? Scoffing at the thought of it all, he prescribed Levoxyl and also wants me to take Premarin (hrt). I mentioned something along the lines of hearing about all those lawsuits related to breast cancer. He said that there was no basis for the claims that were made against that drug. After only the 2nd day of taking the Levoxyl, I’m having terrible headache and shakiness. I don’t know if I can hold out for 6-8 weeks for it to adjust. Ah, but the numbers are the only thing that counts and this doctor could care less about my symptoms or side effects. I had some major shakiness using Synthroid too and it reminded me why I’d rather not take anything. I’d rather have people think I give a shit (by not taking Synthroid because of the shaking), than to think that whatever they’re saying (because my shaking), appears I’m nervous/scared of them which seems to give them the upper-hand and increase their sense of ego. Where are all these willing to listen and work with their patients type of doctors? Shouldn’t there be more of them and less of the other kind?

    • Sarah Downing 28 March 2013 at 12:52 pm Permalink

      Hi Cat,

      Thanks for commenting. I’m very sorry that you are having to deal with Dr. Wrong. That is precisely why I mentioned the importance of listening to the patient in this article. We know our bodies best and I hate that he didn’t listen to you and instead forced you to take a T4-only drug that is obviously not working for you. Is there any chance you could switch to a more open-minded doctor?

      I too have had doctors criticize my healthcare practitioners before them like it is some kind of stupid competition. I find that both annoying and rude and don’t want to have to stick up for people who aren’t even there to hear it.

      Where are you based and do you have insurance? Maybe there is some way I can help you find a new and better doctor.

      Cheers,

      Sarah


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