"Dear Doctor": what would you tell your doctor?

This thread was inspired by the individual who started a thread in "Psychotherapy" on what they would like to say to their therapist.

Here's a similar thread I want to start.

I am fed up with health care providers' baloney and at best, their inability to figure out what's wrong with me.

Here's my first post:

Dear Dentist: Why did you excuse me from your practice just because you could not figure out what's wrong with my teeth?

Why can't you be honest with me and say, "Ms. ___________, I don't want to see you anymore because you will not pay $145. for cleanings."

Why do you have to milk my money? While I'm in so much pain?

Dear Doctors:

Instead of throwing your hands up in the air because my Dilantin does not help me, why don't you refer me to a neurologist? and why did you only give me 3 weeks supply instead of a month's supply of meds, when you know that I cannot go off them suddenly?

Why do you think like a robot and not like a human being?

And you order only 3 shots for my allergies when you are supposed to order 9? (1 a week)? and then the nurse yells at me because I did not make another appt. for one?

Why do I get the brunt of things?

Why are you not responsible for your mistakes?

This is an angry letter and I do not intend to send it anywhere.

This can be a venting thread or just a thread to get it out so that you can process your issues in a safe forum before you actually talk to your provider.

You can even process your good feelings about your provider if you want to.

Billi

Spend more time with me as a PERSON, not just a body or body parts. Also, I'm on time for my appointments so be reasonably on time for yours. If you get hung up, have your stupid, *****nurses inform the patients that are just waiting and waiting and waiting. Also, try to get them to hire some nurses with better people skills and compassion, even though you are not directly involved in the hiring process.

Spend a decent amount of time with me. What is a 45 min wait for if I only get 5 min with you? What is the blasted co-payment FOR, and worse, what is the full cost of a visit with you FOR? Because you're an MD???? The only people I ever got decent time with were physical therapists. I got 30 minutes.

If we have to wait so long, how about waiting rooms that are not artic like in temps? The exam rooms are even worse, with you sitting around in that flimsy stupid gown. In the waiting/exam room, they could have some soothing music or colors, prettier pictures on the wall of things such as nature scenes instead of the generic ugly things they put up.

I am thinking of changing one of my doctors next year, but it's all trial and error, except if you get a referral.

I like my dentist. She talks to me awhile before poking around in my mouth. I found out we both suffer from allergies and like the same kind of books/movies. We both have Kaiser (they suck), and we happen to share the same primary doctor. She referred me to a couple of specialists I might want to consider when I want to change doctors. She too, like me, expects a decent amount of time for the "doctor's visit."

Now that I've vented on that, I feel better.

Thanks for starting this thread.

"Just because I'm on psychiatric medications doesn't mean you can assume I'm depressed, and that all my issues are because of that. In fact, I'm not depressed at all. I'm on psych meds for mania, OCD, and ADHD, NOT for depression!"

"Just because I'm a med student doesn't mean I'm stressed out. Not everything is because of stress, okay? In fact, I've never been less stressed in my life. I was stressed BEFORE med school -- because I was worried that I wouldn't get in. Now that I'm in med school, all that stress is gone!"

"Just because I come to you with problems and research my health doesn't mean I'm a hypochondriac or have 'medical students' disease'. There is a reason I am on top of my health -- a lot of rare medical **** runs in my family. There has been a lot of illness in my family that was blown off and misdiagnosed. I had gallstones and pancreatitis for years and noone took me seriously. My brother has a rare brain tumor and he almost died because of a very rare reaction to general anesthetic. My brother, dad, and I have a very rare heart condition."

"Just because something is RARE doesn't mean it CAN'T HAPPEN. You still need to test for it and rule it out!! Plenty of rare **** has happened to my family, okay?! So don't just say 'oh, I'm sure it's not that, it's too rare to happen to you.' NOTHING IS TOO RARE TO HAPPEN TO ME."

Yeah......I HATE DOCTORS. ARGGHHHH.

I like this thread! I completely repeat myself here, because I have a rant about doctors I put earlier in the "Chronic pain" forum. But the gist of it is:

"Dear doctors:

I know I have been diagnosed with fibromyalgia. I've had it for years, and its symptoms come and go. Therefore, I KNOW what fibro pain feels like. So, I DO NOT appreciate it when you see my fibro history in my chart, do a cursory exam, and then say, 'Well, it must be your fibromyalgia. Are you on Lyrica?'

Don't you realize that people with fibro can also have other ailments? That not every medical issue they have should just be blown off as that because you are too lazy or unmotivated to keep working at the diagnosis or at least refer me to someone else who might be willing to try some other possibilities?

Fibro is a diagnosis that's iffy, anyway. Historically, it has been given when nothing else can be found. But something else might still be the cause! And then it could actually be treated!

Sometimes I wish I could go see Dr. House. At least he doesn't say, "Well, it must be your fibro!" when the first three possibilities don't pan out!

Sincerely,

Your ex disgruntled patient"

thanks everyone.

I look forward to seeing more.

good to know I am not alone.

I wish I could send a printout of this to the American Medical Association (or similar organizations in other nations)

We're living beings and we feel pain and we need to be treated like we are!

Billi

Dear Dr,

You charge me a half week's salary to see you. It's obscene.

You rush in, rush through, rush out. I know you are an Internist but I am more than my lab results. Which, by the way, cost me a full week's salary.

I need to lose weight and exercise. I don't need to see you and give you all my money anymore to hear that.

So, adios.

Dear Dr #1.
Giving me the diagnosis over the phone of my chronic illness was reprehensible. While it is controlled by diet, there are significant secondary medical implications for the disorder especially since i have probably had it since childhood. Two minutes on the phone telling me the results of the tests and asking if I have any questions before I even have time to process what you said is not enough. If you are going to refer me to a nutritionist, you should refer me to one who knows what they are talking about. One who knows less than I have been able to figure out on the internet is not helpful.

Dear Dr #2,

When you run out of the room after I disclose my sexual assault history when you keep pushing me to get a pap-smear it doesn't really help. (especially as this was documented in my intake paperwork which obviously you never read). It was apparent that you could not escape fast enough. Being that it is a women's clinic it seems like you would have a number of patients in this position. I don't understand how that is supposed to help me feel comfortable discussing medical issues with you. As you are in your residency I hope you go into research and not continue working with patients.

Sincerely,
Your patient.

I am very grateful I live in Canada and don't need to pay to see the doctor or have tests done!

aww...googley, I'm sorry about the resident. I guess he or she just freaked out. Hopefully s/he learned from the experience and won't be so flighty the next time. Probably what happened is s/he didn't know what to say and was afraid to say the wrong thing and offend you. But you're right, there's no excuse for that. Even I could handle the situation better, and I'm not even a resident yet. A resident should really be able to handle it.

What chronic condition do you have? Diabetes? See, this is why giving results over the phone is a bad idea, even though patients sometimes push their doctors to do it (and I'm guilty of pushing my doctors to give me results over the phones as well).

I have a bias against socialized medicine, Bipolarmedstudent. Remember that you are paying for your treatment, but by paying your taxes! I won't get started about how I feel about Obamacare. That's another issue....

Thanks so much for starting this thread!

"Dear Doctor:

Please remember to tell your nurses to look over the test results carefully before calling me to report on them. I received a call telling me my Vitamin D was still too low, so I needed to take more, and that my Vitamin B12 was way too high, so I needed to cut down on that. So, I went out and bought the appropriate bottles with less or more of these vitamins.

The next day your office calls me again and says, 'All your results were normal.' What? Come to find out, my Vitamin D hadn't even been tested, but the sheet (which I later got a copy of) happened to have the previous report results on the bottom of the first page. And the B12, I found out, is not an issue to be concerned about!

Also, I had an appointment to talk to you directly about the results of my additional mammogram work. But first thing that morning the nurse calls and says, without any introductionary remarks, "We have you scheduled for a biopsy. You have a breast mass."

I later discovered that the biopsy was to be done on the breast without the mass, because it showed increasing calcifications. The mass had already been determined to be a benign cyst, which I found out was even stated on the report! But your nurse didn't tell me that important bit of information!

And, doc, when I did see you directly, you sort of blew me off, saying regardless, the findings wouldn't be anything to worry about. You just in passing said something about calcifications and maybe cancer that had not spread. You didn't even tell me about the results of the breast mass. The mass was what I was worried about all along, since I had felt it before the mammogram was done! I didn't even know anything about any calcifications, since they only showed up in the testing! As a result, you had me more worried then ever!!

Maybe from now on you should just mail me my reports and let me read them for myself! Thank you!

Sincerely,

Your annoyed patient"

why the h do they have to be so unkind about this issue?

Did they skip the chapter on psychology?

Did they?

I was told I was "noncompliant" once by a doctor for not having a p smear.



thanks for this,

Billi

Dear Doctor:

Dear Dentist:

anyone concerned!

If I act weird or act "flirty" or inappropriate, don't you DARE get angry at me or put me down.

I am an IC survivor and it's not my gd fault! My behavior is symtomatic/indicative of being an IC survivor. Can you be professional and set boundaries or just ignore it instead of taking it personally, taking advantage of me, or thinking I am some kind of w***e?! I am not! I do not mean to be this way and I am not "being this way". I am trying really hard to act normal. I get little crushes on nice people and I am trying to break free of that.

I am working HARD on these issues!

Have you worked on yours?!

Billi

I have celiac disease. (you probably wont learn much about it in med school). It means I can't eat wheat, rye, or barley. Even microscopic amounts make me sick.

Glad more replies came in Billi. Seems none had come in at the time I first viewed it, but many had viewed.

I must say that although I sympathize with everyone and am not glad it has happened to you all, I am comforted or consoled that I am not alone. It's not my "imagination" or I'm not being too sensitive or picky that I expect a doctor to spend a reasonable amount of time with me.

Respect MY time too, as it takes so much time to even make it to the doctor. Traffic, parking, checking in at reception, having your vitals taken.

BTW, I HATE HAVING my BP taken!!! Squeezing the **** out of my arm! It f****** HURTS OKAY??!!! So how am I supposed to "RELAX" with all that pain???!!!!! Of course it's going to go up when they take it cause it hurts! Then, they act annoyed that it's high, like it's an inconvenience to them since they have to wait a few minutes for it to hopefully drop.

I've heard a disturbing trend about how not enough medical students are becoming primary or family pratice doctors. That's where preventive care is, and that can go a long way for a healthy population. So, there's a shortage of them.

Guess why more are choosing to become specialists? There is more money in it, MUCH more. I often wonder if a lot of them do it for money, not cause they care about people or treating them.

Billi, I agree with your comment about compassion. I don't think that's taught---or maybe it cannot be taught. It's innate or inborn. PEOPLE SKILLS. Just as important as medical knowledge. Only nice people I encounter are the receptionists, but I have little contact with them, unfortunately. There is little "care" in health care, in my opinion.

Yes of course we learn about celiac disease! It's the BROW foods. You can't eat Oats either, right?

Did you have an endoscopy and tissue biopy to confirm the celiac disease?

The diet restriction must be really tough. I would die without my rye bread.

Oats would be all right but they're usually grown in the same fields and/or processed on the same machines that process the others, so there might be contamination, just like with the peanut/tree nut warning on some other foods :-)

My doctor is okay; the whole system is kind of messed up I think so how we're treated is part of a larger problem. My doctor tests and throws meds at problems and it's a 3+ hour wait in the ER, no matter what the problem.

I have a dentist I trust so don't have any problems there but that costs $$$ out-of-pocket.

I have chronic illnesses that doctors don't really know anything about the causes of and can't "cure"; asthma, hypothyroid, etc. and the whole milieu is such that we expect cures and fixes for everything these days, even though you can't fix old age or normal wear and tear on bodies, etc. But I keep forgetting that what I eat and whether I exercise, how well I work on sleeping, etc. impacts what hurts but I want my cake and to eat it too (not feel bad the next day and have higher blood pressure when I've had too much to drink the night before, for example).

Speaking as a med student...

Yes, I want to become a specialist. I don't want to be a primary/family practice doctor. Why? Four things: 1. It's boring (intellectually) 2. There is little research in it 3. Once I choose to become a family doctor I'm stuck. I can't specialize later. 4. I'm very ambitious.

There are a few trends that are really important.
1. It used to be that EVERYONE would first do a year of residency (called the 'rotating internship') so all doctors could be GPs. If you stopped training after that year of rotating internship, all you could be was a GP unless you went back and specialized. But even specialists could moonlight as GPs. But they got rid of the rotating internship year, and now family practice is a separate 2-year residency. That forces you to decided earlier (during med school) whether you want to do family practice, and once you go down that route you are stuck. You can't later specialize. Also, the specialists can't moonlight as GPs anymore. Getting rid of the rotating internship was a HUGE mistake, imo, and is a big cause for the shortage of family care physicians now.

2. The cost of medical school tuition is astronomical now. Decades ago, students would graduate with no debt. Now students regularly graduate with $200,000 of debt, which they need to quickly pay off, at the same time that they need to establish a practice and start a family.

3. The process for getting into med school has become SO competitive. The only people who get into med school now are extremely ambitious, bright students who have done a lot of research during university. Such people are used to being overachievers, and 'settling' for something 'boring' and 'easy' like family practice is just NOT in our blood. We can't imagine doing it. Med school now selects for students who NEED to be challenged, and NEED positions that are intellectually stimulating and involve research. One way to fix this is to expand the research programs in family medicine, which is being done.

What do I want to be? I want to do either psychiatry or oncology. Neither are particularly high-paying specialties, so for me it has NOTHING to do with money. It's about the challenge, the intellectual stimulation, etc.

If you have any other questions, feel free to ask!

Oh god, don't even get me started on my ex-dentist. Crackpot. Getting my wisdom teeth out was the worst experience of my LIFE. God, I wanted to sue him so bad. I should have.

Well, if you learn a lot about celiac disease, you must go to a especially sensitive med school. Yes I had a biopsy to confirm the disorder. However, there is debate about whether that is necessary if there is a positive blood test.

Perna was right about the issue around oats. Most oats are cross contaminated in growing, transporting, or processing. There are some brands that are certified gluten free because they control for these things and then test to make sure there is no gluten contamination. The problem is that some people react to oats because the protein in oats is similar enough to the ones in the others. The other thing is that the certified gluten free oats (along with other specialty gluten free food) is very expensive. A box of gluten free rice pasta is $4-5. The hardest thing is the cost of being gluten free. I avoid traveling and eating out because of the risk of cross contamination.

You would NOT die if you had to stop eating rye bread. It is comments like this that are very insensitive. You would adjust.

I think being a PCP is the greatest thing in the world. I feel like all of my patients come to me for the way I take care of them and expect me to be up to date on every aspect of their care. They want everything done in one stop and I am happy to do that until it reaches a point where they need a specialist and they are happy to go. They appreciate not having to go to different places to have things done. and specialists copays on managed care plans can be high. Mine personally is $60.

If a woman doesn't want a Pap because of her past history- no problem, just let me document the reason for liability purposes. Thats all.

When my nurse calls back results she can only read what I have written. I am worried someone can screw up the Vitamin levels. Back office issues. It's always something. I think it stings more in healthcare than at KMart though. Good help is hard to find. I communicate well with my patients so I call most my own results, if normal I will send a card. The patients know that. If it is
bad news I contact them myself. I have even made house calls to speak with them if they have been long time patients ( I have been at this for a little over
20 years... And I do have boundaries if any eyebrows are going up...but I am in therapy..hmmm mm)


If you don't want your blood pressure checked- no problem, BUT can I please just tell you that if you are using your insurance I will need to have 3 vital signs documented and we love blood pressures. Same goes for weight. When the insurance audits the chart and we are doing "our" job ( which they are dictating) then we don' t get the NEGOGIATED rate for the office visit. Which, by the way, is what you will see on your explanation of benefits. Not the superbill. When I went to see my neurologist the copayment was $60, when the EOB came in he was paid $12 . Plus my $60. Almost makes you wonder about the purpose of insurance. Now I just have my partner treat me. The Medical Board watches everything too. The days of writing a prescription for a sick family member or neighbor are done. There has to be an established relationship. I keep " new patient" forms in my car and at home in case someone needs something. WTF? Marcus Welby would be turning over in his grave ( I hope someone knows who that is)

Sorry to rant. It is hard to be a PCP. The economy is so bad, healthcare is so expensive and people want a lot from us. That's fine. It's what we do. And
sadly insurance is what is it and with the low re- imbursement some providers schedule a patient approx. every 8 minutes. Screw that. I did it when I was
younger. I up to one every 15 minutes. Seems to work out fine if you know
what you are doing.

And to my cyber friend Bipolar med student: SPECIALIZE . Sadly that is what I tell the students today. Primary Care is difficult. In the states the kids can't make enough money to pay back their loans . But GOOD Primary Care will be the most important job ever. Just look at the person, listen, accept them, be kind, and give them peace of mind. Do the right thing. It isn't hard. ( but you already know that)