What’s up, Doc?

For starters, lest I upset or disrespect anyone reading this, I must say, doctors, you have the ability to help save people’s lives and enhance their quality of life. And for that, I love and respect you. Please have that in mind as you read this column.

At the same time, please also draw from this column some input that may positively affect the manner in which you treat your patients. The following is about some doctors — not all doctors.

My gripes about doctor-patient communication — or, rather, its deterioration — bubble to the surface from time to time, but I often let my frustration simmer down after a little while. By a “little while” I mean it can be days or it can be weeks. Usually, it doesn’t hit the one month mark, but I can’t say for sure as I have probably blocked out those experiences out of necessity. Anger and frustration are no good for the soul.

To be clear, again, I think that anyone who has dedicated themselves to the medical field has chosen a noble profession. That goes for doctors, nurses, and medical professionals of all stripes. An enormous amount of time, effort, sleepless nights, and keeping up to date with the newest treatments and technology are requirements within the medical field and all its specialties and subspecialties.

Now that you’ve heard my disclaimer, I will tell you my ultimate pet peeve: a horrible bedside manner. This manifests in multiple ways.

First: when a doctor comes into the exam room with a holier-than-thou, condescending manner, all his (or her, of course) experience and expertise under his belt, and treats a patient like a mere “case” to plow through and — ”Next!” — get out the door for the sake of expediency.

Second: when a doctor steps into the exam room, and after hearing three sentences or less from the patient, stops the patient in her (or his, of course) tracks and starts talking over the patient.

Third: when a doctor, in addition to talking over the patient, is dismissive and doesn’t allow the patient time to explain his or her symptoms and possibly related medical history.

Fourth: when a doctor, while talking with a patient, is looking at a computer screen for most, if not all, of the session.

Fifth: when a doctor takes one look at a patient’s psychiatric diagnosis, and with the smell of preconceived notions in the air, thinks he has the patient pegged and chalks up the issue at hand to something like “anxiety.” (Of course, no, this never happened to me.)

Sixth: when a doctor looks up a patient’s medication that he knows virtually nothing about, reads the possible side effects, and says, “Oh, look, I see here that this medication may cause dizziness,weight gain, weight loss, depression [insert here any other reaction that might be listed so that if it does occur, the pharmaceutical company won’t get sued]. That’s probably the root of your problem.”

Seventh: when a doctor speaks “doctoreez” to a patient who doesn’t know the language and then, in an impatient, condescending manner, translates the issue into “patienteez,” making the patient feel like an idiot for not — duh! — knowing what the doctor originally meant.

Eighth: when a doctor states, “I’ve seen hundreds of cases like yours before; you must have this condition,” without thoroughly evaluating the patient and listening to her own personal observations before coming to his conclusion.

Or, as my friend, who is in the medical field herself, says: “That’s great that you went to Harvard Medical School — but my body didn’t read your textbook.”

Ninth: I’m not sure I have a ninth, but I bet you do.

The bulk of doctors, I would hope, are nothing like this. The bulk of doctors have patience with their patients and listen and ask clarifying questions and work with their patients to understand what’s going on. But in addition to experiencing all of the above, I have, indeed, heard the stories of many others who have had similar experiences at their appointments and consultations.

I’m certainly okay with a doctor not knowing something. Pass me along to another specialist, sure thing. But don’t pretend that you do know until you come to the point toward the end of the appointment when you realize that you don’t know and then just shrug and walk out.

And please, all the while, show some semblance of respect during my appointment.

“I’ll let you in on a little secret,” says a doctor friend who I’ve known all my life. “Doctors don’t know everything. Some may act as though they do, but oftentimes they’re shooting in the dark and learning as they go.”

Honesty. Practicality. Let’s say it like it is.

To sum up, doctors need to listen to their patients better, exhibit a more welcoming and reassuring bedside manner, treat patients as people, don’t talk over patients, ask relevant questions for clarification, don’t act pompous and all-knowing as if they automatically know the patient’s body more than the patient, and recognize their own limitations.

At the same time, patients often need to learn how to hold their own. They need to come prepared with a list of specific questions as well as a list of specific symptoms. They need to ask as many questions as necessary in order to understand what the doctor is telling them about their condition and other matters of concern — and, if need be, write down what the doctor says. They also need to be their own advocates and not let the kinds of doctors mentioned above intimidate; remember that the doctor is working for the patient, not the other way around. They also should not be afraid to call out the doctor if the patient doesn’t think he or she is being heard.

A week or two after a recent appointment, I received an email from the medical practice requesting feedback. The email said:

“Thank you for choosing [our practice] for your recent health care services. To provide the best possible care for our patients, we hope to learn more about what patients experience and how we can improve the quality of our care. Below is a link to a survey asking about your experiences. Your participation in this survey will be very helpful to us and to future patients.”

I’m sorry (not sorry), Dr. X, for completely bashing your professional performance as it relates to items one through eight listed above. You may or may not have a wealth of knowledge “up there,” but down in the exam room, your doctor-patient communication skills leave much to be desired.

And again, hopefully, all matters listed here don’t apply to most of you doctors reading this. Still, I hope I’ve offered a little food for thought. And please, don’t take offense; some of my dearest friends are doctors.

It’s just that sometimes, you know, your patients, who are already struggling with whatever condition at hand, leave your office feeling even more frustrated, wondering:

“Hey, what’s up with that doc?”

About the Author
Dena Croog is a writer and editor in Teaneck, New Jersey, whose work has focused primarily on psychiatry, mental health, and the book publishing industry. She is the founder of Refa’enu, a nonprofit organization dedicated to mood disorder awareness and support. More information about the organization and its support groups can be found at www.refaenu.org. You also can email dena@refaenu.org with any questions or comments.
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