Dr. Jon LaPook

Dr. Jon LaPook

Posted: July 2, 2009 04:25 PM

Breaking It Off With Your Doc

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Being with the wrong doctor can have grave consequences -- literally. As a practicing physician, I'm the first to admit that no doctor is perfect, especially me. I'm in a field that is eternally humbling, with my next mistake potentially hiding just around the corner. The stakes are enormous and the number of tasks I must juggle often daunting. From my point of view, I'm trying my best. But from the patient's point of view, that may not be enough. So how do you know when it's time to call it quits with your doctor? Here are ten reasons to make you think twice about continuing with the status quo:

1) You feel your doctor isn't listening to you.
Listening isn't waiting to speak. One of my favorite and most beloved teachers, Dr. Alfred Markowitz, once told me, "If you let patients talk long enough, they'll actually tell you what's the matter." Studies show that, on average, doctors let patients talk for 18-23 seconds before interrupting. Patients are allowed to finish their opening statement of concerns about 25 percent of the time.

You want a physician who not only is willing to hear what you're saying but who's intrigued by interpreting nuances of words and body language, who notices when you hesitate a millisecond before answering a question that's hit a hidden sore spot. Don't be shy about confronting a doctor who isn't listening. And leave if your concerns aren't addressed.

2) Your doctor can't communicate effectively with you.
Your doctor not only needs to be a great listener but has to be able to explain things to you in a way that you can understand. You'll know it when you don't hear it.

3) The doctor isn't taking you seriously.
This is a deal breaker. It may happen if your doctor jumps to a conclusion about the cause of your symptoms before considering other possibilities. Even if you're a hypochondriac, your hypochondria needs to be seriously addressed. And even hypochondriacs get real illnesses.

4) You have a problem with the office staff.
Office personnel represent the doctor. If they're unfriendly or unkind then you're starting off on the wrong foot. And it gets worse if they're inefficient. Messages must be given to the doctor, insurance forms filed, tests properly scheduled and results reported. Last week, a survey of primary care practices found that patients were not told of abnormal results an average of 7 percent of the time.

5) You're kept waiting too long.
Doctors can be delayed by unpredictable medical emergencies. But if it happens consistently then the doctor is probably scheduling inefficiently. A clue you've been in the waiting room too long: if you pass completely through menopause while waiting to discuss your hot flashes.

6) It takes too long to get an appointment.
Routine annual visits can be scheduled months in advance but new problems and ongoing medical complaints need to be addressed in a timely fashion.

7) The doctor's too busy.
This may develop over time, as the practice grows. If messages are going unreturned, insist on talking to the doctor. If the problem continues or the doctor always seems to be in a hurry then you may need to find somebody else.

8) Your doctor gets annoyed by questions.
This may be a reflection of other problems listed above such as the doctor being too busy or not taking you seriously. Whatever the cause, it's unacceptable. Not only are patients entitled to careful consideration of questions, those questions may provide doctors with important clues. "Why do I get a stomach ache every time I eat a slice of toast?" may lead to the diagnosis of celiac disease, a condition in which gluten -- a component of wheat, rye, and barley -- is toxic to the body. If a doctor doesn't immediately know the answer, a perfectly good response is, "I don't know but I'll research it and get back to you."

9) Your doctor is too arrogant.
God save us from the brilliant doctors. You probably need to be a B+ student to be smart enough to learn everything you need to be a great doctor. But you also need to be A+ in empathy, listening, carefulness, keeping an open mind, logic, and common sense. Doctors who think they are brilliant scare the heck out of me. I've seen them make huge mistakes as they take short cuts or rely on their instincts without seeking help from others or adequately listening to their patients.

10) It just doesn't feel right.
As with any relationship, sometimes you can't put it into words but you just know it's wrong. Don't fight your instincts.

For this week's episode of CBS Doc Dot Com, I visit the Mount Sinai School of Medicine in New York City and speak to Erica Friedman, the director of the Morchand Center, where budding doctors are schooled on bedside manner by treating actors pretending to be patients.



Watch CBS Videos Online

 
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Thanks for this. Now, I'm gonna leave my OB-GYN. Why? Last visit, she stood so far across the room from me, if she could have stood in the sink, she would have. Is it me? Nope, just a shallow good looking Doctor, who fears patients.

    Favorite    Flag as abusive Posted 09:04 PM on 07/02/2009
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If your doc DOES NOT ask the folowing two basic questions- fire him/her and move on.

- How are things at home?
- How are things at work? (or school)

Dr. Rick Lippin
Southampton,Pa
http://medicalcrises.blogspot.com

    Favorite    Flag as abusive Posted 08:30 PM on 07/02/2009
- JuliaRain I'm a Fan of JuliaRain 69 fans permalink

Thank you, doctor.

    Favorite    Flag as abusive Posted 10:20 PM on 07/02/2009
- Pammy1151 I'm a Fan of Pammy1151 8 fans permalink
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Does anyone remember the old days when your doctor actually came out to your house if you were too sick to make it to the office??? Yes, believe it or not mine did. We are "very" lucky if the doctors today are even in the office when WE get there. It is a whole new world out there these days.

    Favorite    Flag as abusive Posted 07:18 PM on 07/02/2009

You must have a very good memory.

    Favorite    Flag as abusive Posted 09:41 PM on 07/02/2009

What about when the drug dealers show up and they get to see the doctor before you?
I stay away from doctors with offices that are decorated with big pharma ads, have a closet full of free drugs (not really free ya know, we end up paying for it!) and when the office assistants and nurses are talking about the vacations they've been on courtesy of the pharma reps. I've also seen the drug dealers bring lunch platters and other "treats" to the doctors offices. Free drugs, free vacations, free trays of "treats"..­.. Wonder why drugs cost so much?

    Favorite    Flag as abusive Posted 07:05 PM on 07/02/2009
- hark I'm a Fan of hark 110 fans permalink

I like the part about the doctor interrupting you in 18-23 seconds. My record is about 9 seconds before I got interrupted. What's the secret for getting so much time to talk?

I also like the part about timely appointments. Is three weeks timely?

You forgot the one about when the doctor is always reading something if he's not interrupting you.

And the one about when he looks up and wonders why you are still there.

What about the one where you don't sit in the waiting room for very long, but then you are taken to the examination room and sit there for an hour twiddling your thumbs. Does that count? And that's only the nurse. Then you have to wait again for the doctor.

God, I'd hate to have to go to a doctor in Canada. I understand that it's terrible there.

    Favorite    Flag as abusive Posted 06:54 PM on 07/02/2009

Hark, are you being sarcastic with your last comment? I have no idea. But it doesn't make any sense in the context of the article. The Canadian one payer system isn't even mentioned, much less compared to the current American system.

Until you understand the system you may be critiquing, it would be better not to comment.

    Favorite    Flag as abusive Posted 08:31 PM on 07/02/2009
- JuliaRain I'm a Fan of JuliaRain 69 fans permalink

These are L ! E S.

    Favorite    Flag as abusive Posted 09:26 PM on 07/02/2009
- JuliaRain I'm a Fan of JuliaRain 69 fans permalink

Another attempt to vil ify SP and Canada. These are L iEs.

"I understand that it's terrible there."

Have you even been there? Spoke to a Canadian? How much more can you be offensive?

    Favorite    Flag as abusive Posted 09:29 PM on 07/02/2009
- Rogan I'm a Fan of Rogan 30 fans permalink

I think the part about Canada, was a joke. (You should read slower and more carefully.­.. especially before posting angered responses!) (I've learned my lesson... having made similar errors myself, and regretted them...)

    Favorite    Flag as abusive Posted 07:01 AM on 07/03/2009

All well and good but I've never - NEVER - been to a doctor or even a dentist who didn't keep me waiting at least 15 minutes after arriving for a scheduled appointment. Don't tell me there are ones who actually see patients on time?!

I'm curious to know if anyone here has found any like that.

    Favorite    Flag as abusive Posted 06:12 PM on 07/02/2009

My dentist usually sees me within a very few minutes of my appointment time (

    Favorite    Flag as abusive Posted 06:46 PM on 07/02/2009
- OpalSky42 I'm a Fan of OpalSky42 15 fans permalink

"On time" usually seems to mean 'no more than 15 minutes late.'

    Favorite    Flag as abusive Posted 06:50 PM on 07/02/2009
- JuliaRain I'm a Fan of JuliaRain 69 fans permalink

Excellent advice. Thank you.

    Favorite    Flag as abusive Posted 05:49 PM on 07/02/2009
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