March 5, 2016

Doctors and Patients

When we are sick we are vulnerable and when we seek medical care we want comfort and strength being exuded from the people treating us. We want our doctors and nurses to be competent, efficient and make disease and problems go away. When we see a doctor, we do not want that doctor to be insecure but we want him or her to take charge, inform us and then decide what to do. Some patients want to be very included in the decision process and have accumulated much information prior to the visit and place demands on the doctor to show that he or she knows more. Other patients like the doctor to make decisions without much involvement from the patient. In all cases, there is a power dynamic between the two players, doctor and patient that must not be abused.

I have gone through much medical care during my 43 years on Earth. Between having type 1 diabetes since I was 16, having two transplants, requiring a pacemaker and having two spinal fusion procedures, I have seen many doctors, surgeons and nurses.  I am myself an MD and a PhD, specialized in diabetes and have spent a career analyzing innovative products in a number of other therapeutic areas, so I am very educated in medicine and also more critical than the average person since I do not want to waste my time on a doctor who is ill-prepared, poorly educated, weak or as importantly rude.

I am one of those patients who study the academic backgrounds and CVs of my potential doctors and when I meet them, I make sure they are aware of the newest developments in the space. I normally check references and Google their publications and research interests before I visit. This work is a prerequisite for me to even make an appointment and then in the first appointment, I interview them as much as they interview me about my medical history. Of course this thorough preparation can only be completed when one has time, and doesn’t work in acute situations nor do they work in hospital, when we are faced with the doctor on call. The point is that our health is the primary objective for all of us and we need to be even more discriminative with our doctors than we are with our finances, houses, our cars or schools for our children. We would not just buy a house without legal and other diligence, and we would not place our children in a school without knowing details about its teachers, facilities etc.

Because of the power situation we are facing each time we are sick or seeking help because of fear for our bodies, many of us do not place enough importance on how doctors treat us as human beings. A medical doctor has studied many years and a specialist has practiced his or her craft even longer, perfecting the practical aspects of medicine and the thinking required to diagnose, treat and in some cases cure. However, listening to the patient, and treating them with respect is often not part of the equation.

It stuns me that doctors are not treating their patients more like clients or customers. In no other field would we accept hours of waiting, derogatory comments, exam rooms with insufficient heating and meeting a person for the first time in your underwear!

One recent example of this happened today, when I went to see a new dermatologist, recommended by a dear friend and colleague. I did my usual diligence, but didn’t go as deep due to the area, dermatology, which to me is a combination of esthetics and medical, and I wanted to see for myself how this woman would deal with my situation of being on immune suppressants and thus making sure I do not have cancer. It would be a bonus if she also improved my skin tone and quality, and I placed lots of trust in my colleague who recommended her. I also got impressed with her address, and the fact that she is a relatively young woman who seems to have succeeded in the tough NYC market, where derms are a dime a dozen.

My appointment was for 1pm on a Friday and I rushed there from a meeting downtown, without having lunch. After 48 minutes of waiting, she finally showed up to see me – while I was sitting in the exam room, in my underwear and a paper robe. She smiled and said “ Hi Karin I am Dr H”. Why is she Dr H and I am Karin? As in Austin Powers: “Dr. Evil: It’s Dr. Evil, I didn’t spend six years in Evil Medical School to be called “mister,” thank you very much.”

My point to her was that I had been sitting for close to an hour with no message from her, in my paper robe, in a freezing room, waiting for her to come and see me. Why is it that she could not send a nurse or an assistant to let me know what was going on? Why did I have to undress before she knew that she was going to see me within minutes? Who actually meets a person for the first time with them in their underwear and they themselves fully dressed? Being a former diabetic and still vulnerable to low blood sugars, it is also hard for me skipping lunch, so this made it worse and for people seeing their doctor during working hours, it is frustrating to miss more time due to the doctor being late.

It all comes down to respecting the human being who is vulnerable and seeking help. In addition, medicine is a service industry, and in any business, one should treat the customer right.

It is no longer enough to be smart, confident and well-read, doctors need to start being polite, timely and good to their patients – not only out of decency, but low and behold, they may actually learn something from a happy patient – only the patient knows what their symptoms are and only patients can ensure compliance. Putting the patient in the center and providing services to them, including them in the process will improve the overall medical care and outcomes for medical doctors and of course, make it a little more pleasant to go for a visit!