Obnoxious Patient:

A Response to CNN's Health Feature "Are You an Obnoxious Patient?"

Do You Put Up with an "Obnoxious" Doctor?

by Josh Day

On January 24, 2008, CNN published an article on their website entitled Are You an Obnoxious Patient? Highly biased, the piece offered five guidelines to make your doctor's limited time with you easier on the doctor. Forget about yourself as the patient who's shelling out hundreds of dollars for this appointment, it's the doctor who must be appeased and made comfortable!

I've come up with five of my own guidelines for dealing with MD's. I'll present them as I counter each one of CNN's points.

CNN point #1: Don't Demand Medication over the Phone

CNN states:

This issue rankles doctors like none other. Doctors don't like prescribing medicine without first seeing the patient, period. [Emphasis mine]

"When my staff asks them to come in, they say they're too busy and they know what's wrong with them. It's a very common thing," says Dr. Jeff Hurwitz, an internist in Hagerstown, Maryland. "But health care isn't just saying, 'These are my symptoms. I know what's wrong with me.' Medicine is an art. You need to go see your doctor."

If your doctor sounds anything like that guy, it's time to fire him and find a new one. You know why this "issue" really rankles so many doctors? Did you take a look at your last bill before it was sent on to your insurance company?

Doctors aren't exactly working for competitive prices. And every time a prescription is called in without a visit that's money out of their practice. To be fair, wouldn't you be a little steamed if this happened often enough to your business?

Now to my counterpoint. If there is a drug you feel you absolutely need, DO ask for it over the phone, especially if you've paid the doctor for various visits over the years.

Don't demand anything -- ask nicely instead and explain your situation (finances, lack of insurance, you don't want your well baby exposed to sick children in the office, etc). Be reasonable and state your case. If your doctor still demands a visit for a simple prescription that obviously wouldn't require an examination and consultation, cuts you off, or belittles you, consider dumping her and finding someone you can work with.

Be sure to let everyone know about your experience too. Tell your friends, family, coworkers. And visit RateMDs.com and give a tell-all. If you feel like your doctor's great and he listens, spread the word! Likewise, when you have a jerk on your hands and you feel like you've been mistreated, disseminate that information too.

CNN Point #2: Don't Come in Loaded with Internet Printouts

CNN:

Trisha Torrey, the moderator of about.com's Patient Empowerment section, recommends making bullet points after reading information on the Internet. "Don't bother printing copies of your research for [your doctor.] She doesn't have time to read them," she says.

Another piece of advice: Be careful how you bring up Internet information. Sounding like you know more than the doctor does could result in alienating your doctor and getting less than optimal care.

That's horrible and ridiculous advice. If that's what passes for "patient empowerment" these days, it's sick and obscene. Your doctor doesn't have the "time" to read the information you brought in? Who's paying whom here?

Many doctors seem to forget that they're highly paid service providers (ones who -- unlike most auto mechanics -- don't even guarantee their work).

If a doctor won't look at information you've researched and consider important or threatens to drop you as a patient, consider walking out and making an appointment with another doctor or going to a new practice.

If you come in with some reading material, do try to keep it to one or two pages. Offer a summary of the points. If the subject is about side effects, do not let the doctor brush you off. If he tries to intimidate you in some way, turn it around and let him know you can just as easily write to the AMA about your experience at his office.

Again, remember RateMDs.com.

CNN Point #3: Arrive Organized

CNN:

"... Before each appointment, she fills out three index cards: one with any new problems she needs to tell her doctor about, one describing her current symptoms, and a third with specific questions for the doctor.

... "My doctor is busy, and I have to respect that he has 40 patients in one day," she says. "If I don't go in with all my questions written down, I'd be rambling all over the place."

Mostly this is pretty good advice, especially the point about index cards.

However, if you feel your doctor is treating you like a side project or you feel like you're a head of cattle in a pen, dump her, and once again, let everyone know why you had to look elsewhere for medical service.

CNN Point #4: Need a Lot of Time? Ask First

CNN writes, "Doctors often schedule appointments in 15-minute increments. Sometimes you'll need much more than that."

How much are you paying for your doctor's time?

If you're seeing a specialist about an unknown problem, do you really think 15 minutes of consultation and examination is enough to determine much of anything?

So before you set up your first appointment, quiz the receptionist about average visit times. Also, find out how long you have to wait before you actually get in to see the physician.

If you don't like what you're hearing, keep looking for doctors.

CNN Point #5: Exercise Basic Human Kindness

CNN:

Remember, your doctor is a human being, and we all respond better when we're treated well.

"Show human courtesy and respect who they are. I'm talking basic human interaction 101," Haig says.

Miserandino says she doesn't shy away from asking tough questions -- on the contrary, she asks lots of them and sometimes questions her doctor's recommendations -- but she always does it politely. Plus, she fosters a relationship with her doctor because she knows that to a great extent, her health depends on him.

While I certainly have no issues with exercising basic human kindness, I'm nonetheless disturbed by the implications in the above paragraph. So it's okay to question your doctor, but you have to preface it with an apology?

I always thought my health and the responsibility of staying healthy belongs with me. After all, who else would care about my health as much as me?

Doctors deserve respect--as do all people. Like CNN said above, they're human, no different than the rest of us. If you get the impression that a doctor will demand more respect than you would give to anyone else, consider firing him. First impressions are always important, and if your instincts tell you you're in the company of an egomaniac, how well do you think this guy will listen to you and really care for?