Why Your Doctor Comes Across As An Asshole

This article from The Lancet is a must-read for anyone who has a doctor.

And if that doesn’t apply to you, well, see previous thoughts on that topic, then get a doctor, and THEN read this article.

Every third sentence, I seriously had to keep myself from standing up and shouting, EXACTLY! (In my empty apartment.) You should hear my internal monologue when I’m talking to my patients.

I’d like to add: I’m getting a little sick of people talking about how doctors never have enough time for them because they’re evil money-grubbers who are more worried about the bottom line than the human being sitting in front of them; they push through as many patients as possible so they can fill their Olympic-sized backyard swimming pools with as much money as possible. Yes, some doctors are like that. But no matter how much you hear about them, my experience is that they’re the exception, rather than the rule, especially these days.

There are enormous pressures on a physician’s practice these days, and a lot of them are financial. The clinic where I did my Family Medicine rotation had to do Botox injections on the side, just to balance the books financially so they could keep taking Medicare patients without going bankrupt. And their schedule was PACKED. We saw patients every fifteen minutes. Which SUCKED, both for us AND (especially) the patients. But the only other option would be to close the clinic to Medicare patients. It was the only holdout in town; if we stopped taking low-reimbursement patients or went bankrupt, the Medicare patients in the area would have been SOL. (That stands for “surely out of luck,” Mom. πŸ˜€ )

I read comments on blogs and newspaper articles about health-related stuff a lot, and so far my favorite comment to illustrate this point was as follows: “I get reimbursed fourteen dollars for a physical. How much do you pay for a haircut?”

There’s not much awareness about where exactly medical dollars go. Yes, we’re pouring money into the medical system right now. Niagra-Falls-style. But I’ll tell you one thing: it sure ain’t going to the doctors on the front lines. It used to be that going into medicine was a sure first-class ticket on the gravy train. But that’s not always the case anymore, yet the perception survives the current reality. (Your typical medical resident starts out at least a quarter of a million dollars in debt, due to the absurd cost of a medical education. And no one ever bats an eye when doctors’ salaries are eroded.)

On a personal level, my patients often accuse me of being greedy and heartless when they’re upset with me for whatever reason. I get it; it’s what you say to your evil doctor when they’re being evil at you. Or you threaten to sue them. Whatever.

But it’s kind of hard not to take the prevailing cultural attitude personally. I did well enough in med school and on my Step exams that I could easily have gone into one of those super-cushy specialties that would pretty much set me for life. But you know what? I’m doing underserved internal medicine, in one of the most messed-up hospital systems in the country. I am not there for my health, or my pocketbook. Certainly not.

It was my first-choice program.

And you know what? I still have a see-x-number-of-patients-in-a-day schedule. Because there are a LOT of sick people. It sure doesn’t do my bank account any good.

But hey. Evil doctors are evil, and they evil the evil with their evil evilness of evil.

I get it. I swear I do. People who are scared and in pain lash out, and it’s often hard to remember not to attack your allies. (It’s understandable; it’s always safer to attack people who are on your side; they’re less likely to hurt you back.) But I can’t help getting irritated and ranty when I read stuff on the interwebzes.

Hoo.

I’ll end by saying, if I had the luxury of spending an hour with every one of my patients, I’d be the greatest doctor IN THE UNIVERSE. Not to mention the happiest. And so would your doctor.

But try finding someone that will pay us a living wage for that. Especially in this day and age.

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Published in: on July 26, 2011 at 5:17 am  Comments (8)  

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8 CommentsLeave a comment

  1. The Lancet article was very good. I actually suffer from a lot of thought derailment in the parenting day — which just one reason is why my novel is so slow out of the gate. But reading your posts, and now the article, is revising the way I treat my doctors.

    Thanks!

    p.s.
    I am hoping that the change is for the better!

  2. I read your post and the article with some interest, but really, it seemed obvious to me. Maybe because I’m like the patient mentioned in the article, and I have a few health problems. I don’t expect my doctor to remember everything every time I see him. But he does a darn good job at remembering a lot of it. Does he use the new computer system a lot? Yep, and I can tell it helps him to remember things he wants to talk about, and I’m all for that.

    He always starts an appointment by asking me how I’m doing and what I want to talk about today. It gives me a chance to tell him of anything new and/or worrying, and we can discuss that. Then he glances at the computer for a reminder as to anything else we might want to talk about. I rarely leave an appointment thinking we missed talking about something.

    My doctor is very busy, and it can be hard to get in to see him. That’s a big problem here, where doctors prefer living in the bigger centres, and would rather work in the US than in the Canadian healthcare system. People complain about how doctors are trying to squeeze as many patients in as possible in a day to get more money. Around here, there are so many people who don’t have a regular doctor anymore because there aren’t enough, that I’m so thankful he can squeeze me in when he can.

    I love my doctor. I’ll be in real trouble if he ever retires. I thought this needed to be said.

  3. Or, maybe the doctor’s just an asshole.

    And that Lancet article? Finger-pointing customer-is-always-wrong victim-mentality.

    If you can’t handle the variables, don’t go for that career.

    At least you didn’t choose computer programming, whiner.

  4. No one feed the troll, okay? Thanks.

  5. Mmm, I think doctors should advice sex like prescribe and so forth it’s time we drop this taboo… people need it as well as love, there are those out here like myself that believe in that. A pan-sexuality if you will but more I don’t assign myself with any of them. I love all equally and I don’t discriminate against anyone.. and it’s more then fine if you do that is who you are and that is great πŸ™‚ I just feel you and I should be able to have the choice to get into what we would like and what we need. I feel that it is time for a different kind of doctor to emerge… a sort of charak doctor πŸ™‚ A doctor for everything.

  6. I just left the Latham location and the doctor i saw one one of the most arrogant, rude, opinionated assholes I’ve ever had to deal with in my entire life. if i could not pay them i would. I am absolutely shocked and offended at how aggressive, mean and combative he was. One of the nurses on staff call me a hypochondriac. he told me to take Advil to cure a chest pain i was having and when i told him that would only mask the pain not cure the cause he said “oh really… read about it” and walked out on me. i never wanted to beat the fucking shit out of anyone so badly in my entire life.

  7. I get it. And to be honest I’m so tired of walking into a Doctors office and being treated by your admistrative staff like I’m a pain in their ass. Can you imagine how I feel when I encounter you. Apparently you are not the only one who’s over worked and under paid.

    By the way 3 years of doctors just like you and I still don’t have a diagnosis. Here’s the difference between us: I’m the one who’s sick and my bitching ain’t solving the problem. So do the best you can with what you have and shut up. You have patients who need the best of what you have to offer or get out of the business of health provider. Or better yet join your patients in the fight to get better care. I’m so weak most of the time I can’t even fight. So if not you…WHO??

  8. blah fucking blah.. you guys are all money hungry assholes who think your above your patients.. I’ve decided i would rather suffer then waste time trying to get help from any one of you men or women.. i’ll live longer without you…hahaha


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