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Doctors Doing Damage


When my friend B. went to see a specialist last Thursday, she watched a representative from a drug company sail into the waiting room carrying six cups of coffee and a bag of pastries for the office. In the meantime she sat and waited. And waited. And waited. She had an 8:30 a.m. appointment but wasn’t seen until 9:15. “It’s just wrong,” she wrote in an email to some friends.


We haven’t been to the doctor in almost three years and I have been struggling with camp forms lately, wondering who to list as our primary care physician. Do we even have one? But I remember four years ago when I took one of the kids to the doctor and was told to take a seat.


After twenty minutes I asked if the doctor was running late.


The receptionist answered with a surprised smile, “Oh, no. He’s on time. Have a seat. We’ll call you.”


It took an hour and fifteen minutes to be seen.


In what other profession can a sales representative who flits in without an appointment be seen ahead of a paying customer? In what other profession could you stay in business and constantly be so late?


If you show up an hour and fifteen minutes after class starts … you miss the class.


If you’re a pilot and you come an hour and fifteen minutes late for a flight … you get fired.


We weren’t even given an apology, or an acknowledgement that we’d been waiting for so long.


Not only were these doctors running inexcusably behind schedule, they seemed to feel no accountability for their actions.


But there are much bigger problems in today’s medical system than just an astonishing lack of punctuality.


Instead of treating us like active participants in keeping up the health of our bodies and our children’s bodies, doctors often act like we’re obtuse.


This power dynamic usually starts from the first interaction. A doctor introduces himself by his last name and title, expecting to be called Dr. X, but inevitably calls you by your first name (or just “Mom” if you’re in the hospital having a baby, which is even more insulting), establishing that he is (presumably) more educated, more knowledgeable, and more worthy of respect than you are.


He acts hurried in your presence (he is, of course, because he’s running an hour and fifteen minutes behind schedule) and treats your questions like petty annoyances.


Even when you have a good, genuine, equal relationship with your health care provider, your relationship can change in a shorter time than it takes to snap your fingers if you refuse a recommendation.


Pregnant with my first child, I declined a pregnancy-induced diabetes test. I was aversely affected by sugar and I knew the test would make me sick for the rest of the day, if not the week.


Since I couldn’t eat sugar, I was on an ultra healthy no-sugar diet. A typical dinner was raw broccoli, green beans, a glass of milk, and a half a cup of plain yogurt. I wasn’t eating that way to be virtuous. Small quantities of healthy high protein food and vegetables alleviated the overwhelming nausea I had. I exercised every day and lost weight in the first trimester.


So when a hospital nurse midwife ordered this routine test, I asked for more information. She got annoyed. I explained that I was severely affected by sugar and was eating none, and barely any fruit (except pineapple, which I sometimes craved). She told me the cure for pregnancy-induced diabetes was to go on a low-sugar diet, the diet I was already on.


“You’re going to buy yourself a C-section,” the nurse midwife said angrily, scaring me with a detailed list of the myriad problems that would result because of my refusal. My baby would be enormous and possibly malformed. I could die in labor. Because I refused a simple glucose test? It seems silly now but I left her office, sat in the car in the parking lot, and sobbed.


Eight months later the doctor (I switched practices) ordered an emergency sonogram. “For inter-uterine growth retardation,” she said offhandedly. “You’re measuring too small.”


After six and a half months of nausea, I felt so good I had started biking long distances every day, fast.


“Could I be measuring small because I’ve been exercising?” I suggested.


“Not a chance,” she said, hurrying away to “help” another patient.


We all have the same goal: good health. It’s time for doctors to slow down, talk reasonably instead of using scare tactics, and not be so hurried and so prejudiced by their own preconceptions that they do not listen. It’s time for them to put the needs of the patients first and the needs of the drug companies last.


It’s also time for people seeking medical attention to insist on being treated respectfully and not assume that the doctors know what’s right for them.


Those providers have forgotten me—not one could remember my name. But their words, their insensitivity, their hurriedness, and their arrogance have had a lasting effect.


A version of this post first appeared in a print issue of the Ashland Daily Tidings.


Do you spend a lot of time at the doctor’s office? Are you happy with the way you and your children are being treated by your health care provider or do you feel your doctors are doing you a disservice?




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Tags: bad doctor behavior, drug company representatives, exercise as a reason for measuring small, hospital midwives, lack of punctuality among doctors, measuring small, not taking children to the doctor, nurse midwives, pregnancy, pregnancy and nausea, pregnancy induced diabetes, sugar and pregnancy, taking children to the doctor, weight gain during pregnancy



 

Comments (22)

I don't spend a lot of time waiting at the doctor's office. It varies, but it's typically less than half an hour. It's one thing I like about my current doctor. I will admit that I have a tendency not to engage my doctor in debate. Thankfully, the midwives that I saw during my pregnancies were fabulous, and really took the time to listen. They informed me and respected my choices. So far with my doctor I haven't really run into any conflict areas. I hope I don't. I did with my last doctor, and I just left his practice. I realized that we weren't going to see eye-to-eye and so rather than debate it, I just moved on. .-= Amber´s last blog ..Mr Salesguy =-.
Wow, that is really wrong to see a drug rep sail into the doctor's office while patients are being kept waiting. What is really sad about this and the other problems you identify in your piece, is that my husband is one of the rare doctors who listens, treats people respectfully, enlists patients as partners in their health care, and left private practice because he couldn't be the kind of doctor he wanted to be and also make a living. I guess what I'm saying is that I don't blame the doctors - I blame the system in which they're working. .-= Katherine´s last blog ..Family Road Trips on July Fourth and Beyond =-.
I've seen some doctors' and dentists' offices make marked improvement in their service - when they started losing patients and suffering bad publicity to online reviews. Doctors are providing a service and should treat customers with respect just like any other service provider. .-= Melanie Haiken´s last blog ..Surfing - in Montreal =-.
I've had some terrible experiences w/ doctors (similar to what you describe above), and also some very good ones, fortunately. But it definitely takes searching. We used to go to a family practitioner who treated us with respect and conferred w/ us on everything, and are now at another practice where the doctor sees us promptly and again, treats me like an equal. So I'm pretty happy about that. But again, it took searching to find someone who was on the same page; I asked around and/or interviewed others and knew who to screen out. .-= Christine´s last blog ..Summer sewing =-.
A universal problem, observed in may clinics: The pestering medical salesman (usually called a Med Rep) who just breezes in when ever he feels like it. There are some good Drs who don't allow it, but they are few and far inbetween. .-= Joe´s last blog ..The Barber =-.
Fortunately our local health clinic is cleaning up its act. Not easy to dispense medical care in a crumbling building, to a community that goes from 3000 to 25000 for two months of the summer! My worst experience was when two doctors there missed my Lyme Disease. Fast forward five months. A Lyme specialist off-Cape told me I was cured, but I knew my immune system was shot. So, I sought out an alternative medicine doc who has been treating me ever since. He is WONDERFUL! I also have discovered community acupuncture. I had a great doctor in France, where I lived for 25 years, who was always respectful of his patients, did not have an attitude, and was trained in acupuncture and homeopathy as well as regular medicine. .-= Alexandra´s last blog ..View from the Hammock =-.
I just read an article about a concierge doctor in our area. You pay $1500 a year and become one of his select group of patients. If you call him, you get to talk to him or be seen the same day. He does an "executive physical" and manages your care when you see specialists. Isn't this what all doctors are supposed to do? I'm really tired of the medical system. It seems to me that many tests are ordered just to prevent malpractice instead of actually listening to the patient and working through possibilities.
I agree with many of your points, Jennifer. However, I think the healthcare system is partially responsible for these problems. Doctors get paid based on how many patients they see, thus the need to cram in as many appointments as they can. That's why they're forever running late. And the system has forced a lot of well-intentioned doctors to rush and become desensitized to patient's real needs. When I get treated poorly, I move on and search for a doctor who breaks this mold. So far, I've been lucky. When my internist is running late, I know it's because he is taking his time to talk to his patient before me - because that's what he does when I come in. We sit and chat and he doesn't rush me. He's rare, but there are others like him out there. This certainly does NOT excuse rude or insensitive behavior from many other physicians, though. .-= Sheryl´s last blog ..What Your Urine Can Tell You About Your Health =-.
My uncle was my family doctor until he died in the 80s. He is still remembered in my home town for being a man who would take you in no matter if it was 3 o'clock in the afternoon or 3 o'clock in the morning. He even operated on my grandmother's dog and treated my brother's brain hematoma in the office (no, I'm not kidding.) he was caring and took his time and if he didn't know the answer, he sent you to someone who did. My family hasn't been so well cared for since. PS - I must admit even we, his family members, had to wait forever to see him, but it was because he took his time with each and every patient and took walk-ins no matter whether they had insurance or not. I think doctors need to go back to this model. My uncle made plenty of money, but that isn't what drove him. .-= Almost Slowfood´s last blog ..Tasty Side- Potato- Bacon and Garlic Scape Hash =-.
With our latest medical scares, doctors continue to say "That's a good question" ... when I ask something. I'm tempted to say, "Thanks. I ASK questions for a living," but a friend whose brother is a doctor told me that saying "That's a good question" is like saying "Shut the @#$@ up and let me do my job." :o( .-= Roxanne´s last blog ..What Dog Fears Look Like =-.
Great post, Jennifer. I'm hoping new med school curricula are teaching doctors how to act like decent human beings -- but it can't happen quickly enough. .-= Ruth Pennebaker´s last blog ..Can’t Get Past my First Love =-.
I have always marveled at how when we take our dog to the vet there is rarely a wait, the schedule is on time, the fees are explained up front, our questions are answered as we ask them, the docs (vets) return phone calls, the staff are always happy to see us...the list goes on. We have been fortunate to have several "people" doctors who are very responsive, too, but sadly, many of the larger practices are too big, the staff/docs rushed etc. .-= Meredith´s last blog ..The 5-Question Literary Agent Interview- Anita Bartholomew =-.
My sister works for a large pharma company. I used to help her file papers on weekends and will admit to glancing at what some of the 'med reps' were (laughably) allowed to expense. I will say in the last 10 years there has been some sweeping reforms in that arena, but really it's not enough. It become more and more clear to me that Big Business/Pharma is truly what runs the country. Not citizens, or really even the government. .-= Colleen´s last blog ..Why do we fall =-.
So true. I think a lot of this comes down to people skills. Some docs have them. A lot don't. I finally--after a long search -- found an internist with good people skills. We have great talks. He's usually on time. And he sometimes doesn't make me come in. Like I can email and say "I have all the classic symptoms of a UTI: burning, urgency, etc" and they will call in a prescription for me. But he's a rare breed. I've told him that he should teach other docs how to be him. I really wish he would. I had a midwife when I was pregnant who was the same way. She left the profession, tho. I loved her. Just loved her. .-= Alisa Bowman´s last blog ..The Antidote to Pride =-.
I think part of it is doctors get paid for ordering tests, but not for talking with patients. I've had similar experiences, but thankfully, I haven't had this experience with my new doctor (she says, with fingers crossed). .-= Lisa Mann´s last blog ..Petaluma’s Art -amp Garden Festival =-.
Oh my god girl I have spent way too much time in doctors' offices over the last few months. Here's what I've learned: You have to be assertive and when you're seriously ill or incapacitated you need to have an advocate. As a journalist, I'm very much in reporter mode when I meet with these folks. I know they're pressed for time. I know I may have spent two hours on public transit for what will be a 10 minute visit. I have my list of questions and I make sure they get answered. If they keep me waiting -- for hours in some cases -- then I come equipped with laptop, smart phone, pen & paper and work while I wait. I'm polite but I'm also very clear that I'm a working professional and my time is important too. If I'm late for an appointment (at this point I pretty much know who runs over) I apologize. I always ask if the doctor is running on time when I check in at the desk (it helps me figure out how to fill the time I'm waiting). If, as happened last week, I'm sent to the wrong office -- had the confirmation letter to prove it with me -- I make very clear that it's not my error, I fully expect to be seen, and the office staff needs to advise me the quickest way to get there and to let the doctor know I'm on my way, delayed by an administrative error. I'm polite but stand my ground. I look around doctors' waiting rooms and see so much passivity it makes me want to scream. And one of the things on my list when I finally do see the doctor: Express gratitude and say thank you. Only, of course, if it's warranted. But when it's genuine -- and you are truly grateful that you're no longer in pain or danger -- I find it sets the tone for the whole tenor of the discussion that follows. .-= sarah henry´s last blog ..Ten Teens Rocking the Food Revolution Scene =-.
Wow, Jennifer, it sounds like you've had nightmare experiences with doctors, especially with pregnancies. I can't believe how you were treated. Wait, yes, I can. What I can't believe is that it was considered "acceptable." I recently found a doctor who started his own integrative medicine practice. He doesn't have a staff; he does it all himself by having patients schedule appointments online and keeping medical records on computer. My first appointment with him was an hour long. He's amazing -- and the only way he could make this work was to leave "the system." Thanks for sharing your experience. .-= Jesaka Long´s last blog ..Blogging for Writing Discipline =-.
My family doesn't have insurance, so we are pay-as-you-go when we do go to doctors. This provides us with the freedom that we demand without an insurance company telling us what to do. My kids see a local N.D. who has been helpful for conditions both chronic and acute. We also see an M.D. who is not at all conventional. She has a lovely little office and spends loads of time with her clients and never makes us wait. But, she works by herself and isn't trying to pay off enormous med school loans, so she has the flexibility to be humane and reasonable. I wish we could find "insurance" that enabled us to make the decisions and that we could actually afford. I won't hold my breath. I don't know what my family would do if any of us needed ongoing care. But we just can't afford health insurance. What we really need is health care, not health insurance! Can't we just cut the insurance companies out and pay our doctors directly at affordable rates?? Or sign up for plans with them directly?
Funny thing is, when you ask people for a recommendation for a doctor, the response is usually, "I take my kids to dr. X. She/he's really nice." As if NICE is really all you need in a doctor. And even this "nice" doctor probably makes you wait at least half an hour in the waiting room, is often wrong on the diagnosis, prescribes antibiotics when they are not needed, and is less informed than you are about everything from the right shoes for your toddler to what exactly is in those vaccines. My thinking is that the vast majority of doctors do more harm than good in all but the most extreme medical situations, which is why I avoid going to the doctor or taking my kids to one unless there is a serious illness (think bacterial pneumonia, malaria (we live in Africa), typhoid...) that requires medical treatment.
Maybe it's because I'm from a family of doctors, but I haven't had these kinds of nightmarish experiences. Sure, I sometimes have to spend a lot of time in the waiting room, but it's an excuse to catch up on reading (I'm sure I'd feel differently if I had fidgety kids in tow.) My frustration is that it can take a LONG time to simply get an appointment and by that time, whatever ailment I had has passed, so I usually hit up my relatives for free medical advice. I've been known to email them photos of eye infections or what I suspect was bed bug bites to see if it's worth making an appointment or if it should clear up on its own.
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