By Kathy Hubbard
When out and about, I’m often asked which local doctor I would recommend. Instead of naming a name, I’ll usually go into my spiel on how to choose a healthcare professional. I’ll talk about the difference between a medical doctor, doctor of osteopathy and nurse practitioner.
I’ll advise the person to think about what they would consider a good healthcare teammate. And, to make a list of the things that are important to them such as same-day appointments, the medico’s age and personality style, office location and hours, and, of course, if he or she will accept their insurance.
What I always stress is that changing doctors, if you don’t happen to like the one you’re seeing, is your decision, your privilege and your prerogative.
So, when I came across this article that was published in the New York Times a couple of weeks ago, it made me smile. It’s too long to print in its entirety, so I’ve excerpted it.
It’s written by Dr. Mikkael Sekeres, a director of the leukemia program at the Cleveland Clinic, and it gives a doctor’s-eye view about doctor/patient relationships.
“I had already been given a head’s up about my next patient by one of our schedulers. The notes next to her name in the electronic medical record read, ‘New consult, switching care, patient preference.’
“Second opinions are a normal part of my line of work. I specialize in rare diseases affecting the bone marrow, and feel privileged both to practice at a hospital where I can focus on these esoteric illnesses, and to be considered competent enough at what I do that people seek my input on their diagnoses and therapies. At the same time, I never discourage my own patients from seeking the opinions of others, as their conditions are unusual and serious, and frequently deserve advice from more than one doctor. It’s what I would ask for if one of my own family members became sick.
“But that wasn’t exactly why this woman was seeing me. She had arranged this appointment because she didn’t like her other doctor, and wanted to see if she liked me better.
“These kinds of clinic visits have also become a normal part of my practice.
“Decades ago, when physicians worked within a much more paternalistic system, such ‘doctor shopping’ would have been considered inappropriate. Your doctor’s medical opinions were considered authoritative, incontrovertible and often final. Patients who challenged them were labeled ‘difficult,’ and worried about developing a reputation that would influence their care, both with their own doctor and with others – as in the 1996 ‘Seinfeld’ episode called ‘The Package,’ in which Elaine is blackballed from being seen in medical offices and tries to steal her own medical records to erase her ‘difficult patient’ status.
“In recent years, patients have become more empowered to demand both good care, and a good attitude. Given some of the stories I have heard, I can’t say that I blame them.
“One patient recounted how, when she mentioned to her primary oncologist that she wanted to seek my opinion, he told her to take her medical records with her because if she did see me, he would refuse to ever treat her again.
“Patients feel their doctors may be overly confident, or not confident enough; excessively nurturing, or too aloof. Alternatively, they simply may not ‘click.’”
Dr. Sekeres points out that it is a two-way street, and that he doesn’t always like his patients. His philosophy, however, is that he needs to put his emotion aside and care for his patients “without judgment and to the best of my abilities, because it is both my job, and my duty.”
“In their moments of need, we should disregard any feelings of indignation if our patients seek the opinion of another, or our disappointment that they don’t immediately accept our advice. We should support them as they make decisions about their own health – even if those decisions don’t include us.”
He wrote that he didn’t want his patient to be uncomfortable about the reason she was there, “Because this was about her medical care, and not about anyone’s pride.” Amen, Dr. Sekeris. Amen.
Kathy Hubbard is member of Bonner General Health Foundation Advisory Council. She can be reached at 264-4029 or email@example.com