Wednesday, May 24, 2006

Thought for the day - May 24th

I was in the doctor's office the other day to get a physical. I think about doctors differently now that I have two sons that are going to be doctors with a possible third one in the form of Addie.

As the doctor came in and sat down and started asking me questions I had a epiphony pertaining to docs. He was on the computer and looked up my file from when I was in a year ago (I hadn't seen him since) He was confiming a bunch of stuff like the meds I'm on (Norvasc and TriCor), my latest blood test, did I have a colonoscopy and the like. It just struck me that this man doesn't know me from Adam (no pun intended Addie) I'm just a body to him. No relationship with me as a person. It was obvious that he hadn't even looked at my file before he came in.

I have nothing against this Doc nor do I think he was in anyway a bad doctor. When I only see him once a year, I can't expect him to know me from the hundreds of others he is seeing.

It is just the thought occurred to me that I want a relationship with my doctor that is beyond just a body he is seeing. It just gives me a funny feeling that he really doesn't know me, has little interest in me as a person and is just treating me as a kind a generic patient.

In a large practice it can be no other way, I suppose, but it just hit me that I hope Mark and Jeff and Addie really have the opportunity in their medical lives to get to know their patients and really be a part of improving their lives in a personal and professional way.

I also suggest that when you see a patient after the first time, that before you go into the patient you review the records briefly, try jogging your memory as to why and when you saw him the last time so that when you open that door you are approaching him or her like you are personally interested and informed about their issues. It makes the patient feel more than just a body. Don't know how you do that, but I sure think it would help. My doctor takes a picture the first time you see him so he can kind of remember what you look like and that may jog his memory. Seems like notes in the file to help you the next time would be a good idea as well as names the patient goes my. You should take a few moments to review that before you open that door. I'm sure that in the rush sometimes that happens and other times maybe not. The first thing he said to me was "Hi Michael." I knew right away he didn't have a clue about anything we had talked about before and didn't remember me at all. How hard would it be to make a note in the file to say this patient goes by "Mickey." A little thing and perhaps a bit artificial but it sure gives the patient the impression you know who he is.

Dad

7 comments:

Wendi said...

Yeah, I know what you mean about the whole "bedside manner" thing; many docs can be rather impersonal, but I'm sure that both Mark and Jeff will make very warm and compassionate physicians.

Oh, one thing -- Mickey, can you please email me your and Margaret's cell phone numbers? I need to get in touch with you re: your ride to and from the airport this weekend. :-)

Tyler said...

You're paying the doc good money, well at least part of the good money (ABB takes care of the rest) he is pulling down. The least he can do is treat you like the consumer of his services that you are and give you the good customer service you deserve.

I have had the same experience with doctors. I don't think they are bad doctors, I realize that they have a lot of patients who have a lot worse problems than me, but it seems to me that a really great family doc should go beyond the chart a little bit. I guess I should be glad I've never had a close relationship with any doctor because I haven't had to see any very often. However, I feel like I am a much more complex person (my health included) than a 15 second chart scan can reveal (some may disagree with my assessment of my complexity).

I think that as a small town doc in Worland over the course of years, Mark will be able to develop the kind of relationship with his patients (even the healthy, occasional health care consumers like myself and the Mick) that will make them feel like they are more than a specimen (in my case, a fine specimen).

A sincere thank you to all the hard-working, self-sacrificing, "human-touch" sort of doctors out there. You are appreciated!

Tyler said...
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Jeff said...

As a future Doc, I'd like to say to you insignificant whiners out there(patients), "Come in, sit down and shut up, you piece of meat. Only speak when spoken to. Some of us are trying to get some work done!"

Mark said...

No doubt that every patient deserves to be treated as a whole human being. Who can argue with that? In all humility, I am the Master of the Bedside Manner, and I think my patients (largely) enjoy our visits and feel like they've seen a doc who cares for them and for who they really are.

However, speaking from real-world experience, I would hate to be judged by whatever criteria has been proposed above.

First off, your doctor is a trained professional and a busy man. You were probably one of 30 patients he saw that day, many of whom were much sicker than you. It sounds like, from your experience, he treated you kindly and professionally. However, he didn't know your nickname, and he didn't remember any details from your last visit, and that appears to be the beef.

All I can say is, Cut the guy some slack! Would you remember any personal details when you saw a person once a year, out of 5000 other patients the doctor has seen in that time? Can you blame a man for calling you by your given name, when that's what is listed on your chart?

You are not paying him to be your buddy-buddy. You're paying him to access his high level of education and his wealth of experience to keep your ticker tickin'. If he doesn't know your details off-hand, it's not because he doesn't care about you. It just means that he doesn't see you very often because you're not that sick, which, somewhat paradoxically, means he's doing well the job you're paying him for.

As far as not remembering the specifics of your last encounter until he looked at your chart: that's what the chart is for, so that he doesn't have to rely on his own memory.

Besides, a certain level of detachment and objectivity is essential for a doctor to be able to do his job well.

The biggest fool-doctor I've even met (Scotty Stinkin' Steingard) was Mr. Chummy Chum with all his patients. They left his office feeling like they'd just seen Mr. Charisma himself. But the job they were paying him for was incompletely and incompetently rendered.

Who would you rather have when your life was on the line?

Now, some doctors will treat you like a piece of meat (see Jeff's comment above). I don't subscribe to that theory. I do allow my patients to speak, if only in direct response to my questions and in under three seconds at a time. If they pass the three second threshhold, I gently hold my finger to my lips and strongly whisper, "Shussh, now!" If they violate this rule again, I push a button and send an electric shock through the exam table into their exposed fannies. A third violation results in me kicking their sorry cans out on the street.

But that's just my style.

In summary, you should expect quality healthcare from your physician. You should also expect professionalism and courtesy commensurate with his level of education and experience. Many doctors will give you more than this and will come to know exquisite details of your personal life. But if this isn't the case, count yourself fortunate and give the man his due for doing well the job you're paying him for.

Angie said...

You know who is the other king of bedside manner besides Mark? My OBGYN, Dr. McKernan.

When I became pregnant with Cal, Jeff and I got a recommendation to go see Dr. Paul McKernan. I didn't realize it at the time, but this doctor is a common household name among not just the baby-making ladies in our ward, but our entire stake and neighboring stakes. Everyone seems to go to him--not only is he a member of the church but he's known for being very friendly.

When he walked in to our first appointment, he looked at the charts, looked at Jeff, and instantly recognized him as Mark's brother (he saw Mark and Liz when they were down here, and delivered Joy). He asked how Mark and Liz were doing and we had a great appointment. We walked out feeling very important and well taken care of, which is so important especially in a first pregnancy.

During subsequent appointments I could tell he was always in a hurry and it became clear to me that I was just another one of the many faces he saw day after day. I was impressed that he still maintained the illusion that he knew a lot about me and remembered all the details about my pregnancy from appointment to appointment. But I knew that that's all it was--an illusion.

I think as the patient you just have to chuckle and realize how impossible it would be for your doctor to remember everything about you, but speaking to doctors and future doctors everywhere, your attempts at personability are greatly appreciated!

Tyler said...

Doc Fos #1,

Just chill out a bit...so defensive of your profession although I think that is a good thing to be admired.

The Mick was not denegrating all doctor's everywhere. He was just making an appeal to those doctors among us still in their formative years of medical practice to realize how personal each visit is to that individual patient. As I see it, you have chosen a profession which requires extreme intimate contact with many people the likes of which you would most likely not choose to have much relation with under different circumstances, which I think is a very noble choice.

Knowing your personality, I'm sure you are "the Master of Bedside Manner," even though I've heard you say before, paraphrasing someone else, "I went into medicine to work with people and found out that people aren't all they are cracked up to be."

As Angie pointed out, I'm sure a lot of your good-naturedness is "an illusion," but your patients don't have to know that.

Keep up the good work!