Advice For Patients
Today’s physicians have a predicament. The world of yore has changed. No longer do physicians commonly make house calls or meet you in the office and sip a cup of bourbon with you while you discuss medicine. Nope, the world has changed. I have 15 minutes to see you, refill your medications, address your concerns, answer your questions, perform a physical exam, review your labs/xrays/MRIs/CTs, and make sure you are caught up on your preventative care. It’s not enough time. It sucks. I know it. I’m not happy about it either, but it’s a product of the current system of medicine. It’s a broken system and we can discuss that in another post. For now, let’s talk about how you can make your visit better for you and your doctor so that you can get everything accomplished that you need.
Come prepared. Make a list of items you want to talk to your doctor about. My time is yours when you are with me. But please respect that time and the other patients. I know you have a lot to discuss. You have fears and concerns and questions. Share those with me. But if you find yourself telling me a story about your Great Aunt Mildred and her cats, that’s just not nice. Stop it. I will listen if I have time, but know that you are being rude to the other 20+ people I have to see. Also, I get that your erectile dysfunction is embarrassing or your heavy periods are awkward to talk about, but please don’t go the entire 14 minutes and 57 seconds talking about other concerns and then give me 3 seconds to deal with this once we have started walking out the door. If you can’t bring yourself to bring it up, write it down on your list of discussion points and show me the list. I can bring it up for you. I’m nice that way.
Physicians don’t work at Burger King. You can bring in your requests and have special orders but I am going to use my clinical judgement to make decisions. I know you did your research and the only thing that will cure your cough is a new medication that costs $15,000. But maybe, just maybe, my 11 years of training and research after high school and my years of practical experience might count for something. Also, I get that you NEEEEEEEED this medication and have to have it. Give me a chance to help you though. Feel free to request tests and medicines and referrals. But, I’m not going to do something that hurts you just because you ordered me to. You want it, go get your own medical license.
Do research. I love when patients tell me they have done some research first. Try and use reputable sites and not just the first search listing you come across on google. Sites like the cleveland clinic, medscape, and the Wall Street Journal are great. Sites like mommyvaccinehaters.blogspot.aol.madeupnonsense might not be as reputable. Please do not quote Dr. Oz to me. Please do not tell me that you saw this on Grey’s Anatomy or Chicago Med and it totally fixed everything. Those aren’t real physicians. Do not get medical advice from them. I don’t get my medical advice from Doc McStuffins.
Don’t decline an exam because you haven’t groomed. Leg hair, pubic hair, dirt, blood, french fries, I’ve seen it all. If I believe that you need a rectal exam or a groin exam, it’s because it is medically necessary. I honestly would rather not being doing that particular exam. Believe me. It is not the highlight of my day. Please don’t make me beg you to do a medically necessary exam. With that being said, good hygiene goes a long way in life in general. Clean your body with soap before coming in. Check your pannus (i.e. fat rolls) for french fries (true story) or the tv remote (also a true story) and try and leave those items at home or in the car. Menstrual blood, wound blood, rectal blood, vomiting blood, and more, I’ve seen it before. It doesn’t bother me. I know you think it’s gross, but let me do my job and don’t apologize for bleeding. I’ll take care of you no matter how much blood there is. And ladies, leg hair is very common, please don’t apologize for it. My male patients don’t apologize for their hairy legs (or backs), you certainly don’t need to worry about the hair on your legs.
Don’t ask about other patients. You are in the office to see me about your medications and just as we are finishing up, you stop me for one more question. Your son has a rash and you want to know what to do about it? Make an appointment for him so I can focus my time on him. Even though it seems like a simple little thing, and it may be, it could also be much more complicated than you think. Give me the opportunity to perform good medicine for you and for your son too.
Use the pain scale responsibly. Everyone experiences pain differently. I get that. But if you tell me that your pain is 10 out of 10 while you are sitting comfortably on the exam table sipping a starbucks latte, I’m probably not going to believe you. Also, the scale only goes to 10. Your pain cannot be a 13 out of 10. Picture a 10 story building. You cannot be on the 13th floor. It’s impossible. If your pain is 13 out 10, you are wrong. Also, people who are in 10/10 pain don’t have to tell me - they are curled up in the fetal position because of the pain and it hurts so much they can’t answer questions. Stop it. You are not 10 out of 10.
Don’t answer your phone in the office. This is a huge pet peeve of mine, so if I sound harsh, it’s because it is a big deal to me. You are in my office because you want my medical advice. Please put down your phone long enough to look me in the eye and listen to me. Don’t sit on the exam table and play Angry Birds while I’m examining you or discussing your case with you. I will walk out if you do this. I will get to you when I have free time later in the day. If you can’t respect me as a human, then my time is better spent with other patients.
On the flip side, use your phone responsibly. You have a rash? Take a picture of it. You had some weird poop? Take a picture. You had a coughing attack that sounded like someone was choking a dying seal who smoked 5 packs a day for years? Get a friend to record a video. Your child is making funny movements with his hands but only occasionally, take a video. A picture/video is worth a thousand words. Take multiple picture from different angles and try and get some good lighting. I would much rather you take a picture of that nasty stuff you coughed up rather than you bringing it in to give to me in a ziplock baggie.
Take your medicines or come back in. This happens every. Single. Day. I prescribe a patient some medicine for their condition and schedule them to come back in a month to see how the medicine is working for them. They come back in a month and tell me they took the medicine twice, got an upset stomach and then stopped taking it. And then they have been doing nothing about their condition for the last month! Gahhhhhhh! That’s not helpful. I didn’t schedule the appointment out a month because I wanted you to take a “tincture of time” or because I needed you to go away and a month was the earliest I could tolerate you again. I wanted to see if the medicine would work for you. Some medicines take time to work. If you don’t take it or you know it doesn’t work because it is hurting you, then come in right away so we can try something else. Please, please, please don’t do nothing for a month and wonder why you aren’t getting better. That’s stupid. Stop it.
Don’t lie. We both know you are lying. It doesn’t help you get better and it makes me frustrated. I know you are embarrassed about how that object got up your rectum. I know that you wish you were better at exercising or dieting. I know that it’s awkward telling someone you did meth yesterday. I get that. But just tell me the truth so I can help you. I don’t report your cocaine use to the police, but if I know you are using, it can affect the meds I prescribe as there are potential interactions. I won’t love you less as a human being, and I won’t treat you differently, but it does affect my medical judgement. So please help me help you and tell me the truth. Even if you don’t think I can handle it.
Take responsibility for yourself. Keep a record of medical procedures and the year they were done and write down the medications you take and how often. You had your gallbladder removed in 2008? Write it down. You take 15 pills? Write them down. I know medical records are supposed to be electronic and do amazing things. Let me let you in on the dirty little secret of electronic medical records: They suck. They are unwieldy and often tough to navigate. Information gets entered incorrectly or doesn’t get updated. They are a tool to keep insurances happy and as an afterthought, they are used to do medicine. Also, I know your previous physician kept meticulous records and if I could just get those, I would know everything about you. But let me tell you another dirty little secret of medicine: those records often take a long time to get to me if they ever do and they are usually not as comprehensive as you were led to believe. (See the previous dirty little secret).
Sometimes, you need some help. The great philosopher, Paul McCartney, once said, “I get by with a little help from my friends.” That guy was wise. If you are worried that you will be overwhelmed or that you will get bad news, bring some support. Bring a family member or close friend or a pastor or mentor or someone who loves you, and let them help you.
And finally, if you need to bring your kids with you to your appointment, do it. That’s ok. It’s hard to be a parent sometimes and bringing kids with you isn’t always ideal but take care of yourself so you can take care of them. Bring them with you to the physician if you need to so you can get the care you need. Don’t miss an appointment just because you can’t find someone to watch the kids. I love having kids in my office and most of the time it brightens my day to have some tiny humans around.
That wraps up my baker’s dozen of tips to being a good patient. A lot are common sense, but unfortunately common sense is becoming rarer and rarer. Some of there are issues that you wouldn’t think of unless you were told and now I’m telling you, so no more excuses. Now go forth and impress your physician with your newfound knowledge.
We talk about these and more on Episode 4 of the Doc Doc Goose Podcast. If your interest in this topic has gotten you this far, you might as well go listen to the episode.
-Dr. Ben Ihms, DO