Monday, August 31, 2009

My Doctor Felt Used? What the Heck Does That Mean?

I had an odd experience at my doctor’s office on Thursday. First I have to give some background story so you can understand the context of both my mindset and, perhaps, why I found his reaction so strange. I’m putting this out there on the Web, so that if this odd doctor reaction happens to anyone else, they’ll know they aren’t alone if they do a search to see if it’s happened before. I’d also like to hear peoples’ thoughts on my Doctor’s behavior.

Last May, my dental hygienist was concerned about how much my gums bled when she jabbed them with sharp metal pointy tools. I may have “perfect teeth” in the words of my dentist, but my gums suffer from some gingivitis despite my good brushing and flossing habits. She suggested I talk to my doctor about it at a general physical exam, since it could indicate some potentially serious health problems — some which should not go untreated for months.

I phoned Doctor A, the doctor I see most frequently, and who I consider my “family doctor”. I was told that they were booking physicals in November, 6 months away! I couldn’t believe it — actually I believed it, but I wasn’t going to settle for it, so I booked that appointment and figured I’d check with other doctors in the city to see if I could get checked sooner. I phoned the office of Doctor B, who I’d seen a few times before, and they had an appointment for July. Still, July was 2 months away, but I figured I’d made my best effort to thwart the health system’s attempt at euthanizing me by putting me in a long waiting line, and left it at that.

I saw Doctor B, and the check up was pretty normal. I got some drugs for my mouth (which didn’t seem to help, I thought), and some standard blood work, etc. I got a phone call a week or so later asking me to pick up a form to get more blood drawn because they wanted to verify some tests on liver enzymes were correct. I got the blood drawn for that and phoned Doctor B back a week later asking if there was anything wrong on the test, and the office said there must not be, because the lab report “was filed”.

Fast forward to October, when I get a phone call from Doctor B’s office, asking for an appointment with me to discuss a problem on the blood test. “What the heck?” I’m thinking, because they told me before there was nothing the matter. I asked for them to fax me the blood tests, and they did. There were obviously high numbers for a few enzymes, highlighted by “up arrows” and boldface print. “It wasn’t nice of them to miss that two months ago,” I thought out loud to myself. I assumed whatever it was couldn’t be too serious, because the appointment they wanted to set was about a month later, on November 21, 2006!

My physical exam with Dr. A that hadn’t taken place yet was scheduled for November 16, and it was going to happen before I got the [bad] results explained to me by Doctor B – two months late. I reasoned if there was something wrong with my liver, I couldn’t get too many physical exams and blood work done, or too soon, so I didn’t cancel my appointment with Doctor A and figured I’d take him the July and August blood test results so he could explain to me what my liver was doing wrong.

It’s all about the smile.

I put the test results on the desk in Doctor A’s office while I waited, and, when he got there, he looked at them and I told him that they were from that summer and I had an appointment later to have the results explained to me, but that I’d like his opinion on the results. Big mistake on my part, apparently.


He got this strange look on his face and asked if I’d seen Doctor B because it was an emergency and Dr. A wasn’t available. I had a feeling that answering “no” was the wrong answer, but I told the truth anyway, and said, “no, not really.” Then he looked at me with a pained expression on his face and said he wasn’t feeling comfortable with what I was doing. He said, “Perhaps I shouldn’t tell you this because maybe it will just chase you back to Doctor B, but I’m proud of my work, and won’t allow myself to be used. I work until 8 in the evening some days, not until just 5 like some places, and appointments are given quickly. You have to understand, it’s not right to use me just when you think I’m good enough. I am nobody’s ‘doormat’.”

I sat there stunned for a moment, not really able to speak because I don’t have a steady voice after just being scolded. But I squeaked out that I wasn’t trying to misuse either Doctor A or the health system, and maybe that he felt that way because I did something not really typical, but it wasn’t my intention to abuse anyone. I was trying to get an appointment sooner than November, and that seeing Dr. B wasn’t personal, and I had confidence in Dr. A’s abilities. I asked if he thought we shouldn’t proceed with the exam, but he said we could, just that I should keep in mind what he said about him not letting people walk on him.

He didn’t seem to completely get the point that I had no real clue as to what he found insulting, but he calmed down some, and tried to get the appointment back on track. I decided to go ahead with the appointment too, since I was already in a hospital gown at that point, and even though I was questioning the mental stability of my doctor, I still trusted his physical capacity to examine me properly.

He left the room for a couple minutes, came back and conducted the exam, and left again for a bit to compile some information before returning to give the results. He explained them, and identified and explained the common liver disorder I apparently have (Gilbert’s Syndrome – which is so minor they don’t even bother treating it). There was the other standard stuff, with more follow-up and drugs to come.

After the prescriptions had been written, and the appointment was over, I made a point to try and bury the hatchet, and explain my intentions once again. I explained my actions from my perspective. “In May, my dentist told me I had potentially serious medical issues that needed to be detected and diagnosed through a ‘physical exam’,” and when I was told by Dr. A’s office that November was the soonest time available for one, I thought that wasn’t soon enough. I hadn’t considered then that they could make room to see me for a shorter exam, or considered that anything other than a “complete physical exam” would be able to find the issues suggested by my dentist. I said I was sorry if I made him feel used. He half-heartedly accepted my apology, because he still brought up that he would not be used inappropriately, and something or other about “loyalty”.

I just can’t get my mind around his reaction to me seeing another doctor four months ago, when his office would have had me wait four months longer. Are patients really supposed to remain so patient as to wait half a year for a particular doctor to look at them? Is it “disloyal” or just proactive healthcare for a patient to seek a waiting time that’s 66 percent shorter than their regular doctor’s line? I guess I was deluded to think that he’d take the blood tests I’d thought enough to provide him with – tests from the same lab he’d order results from normally – and interpret them without a lecture on doctor-patient loyalty. I can understand some people get sucked into brand name loyalty, but hasn’t he ever heard of getting a second medical opinion?

I can’t know if it’s because Dr. A hates Dr. B, or is desperate for fees collected by seeing more patients, but I remain a little weirded out by the encounter and have to decide if I should be chased back to Dr. B, or grin and bear Dr. A since he’s otherwise competent. In this tiny city, in this small province where a town is lucky to keep General Practitioners or get new ones to take new patients, can I really afford to alienate one of the five or so doctors available to treat me?


Check out Saskboy's blog, Abandoned Stuff by Saskboy.


Saskboy said...

Thanks for posting this.

rww said...

My guess is the problem started with you asking for a physical and the doctor assumed you just wanted a routine check up. I expect if you had told him there was something specific you wanted checked out you would have got an appointment much sooner.