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

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