Doctor patient relationships

Posted by Merry, Volunteer Mentor @merpreb, Apr 10, 2019

I was recently writing back and forth with @jenniferhunter and we got to talking about doctor patient relationships. And this got me thinking about the many complaints that people have, especially that some doctors really don't listen or acknowledge that you know your own body, or listen to suggestions or read articles that you suggest.
When is was much younger l had a huge need to be loved and accepted, someone with a huge amount of sympathy for me. But that didn't really do me much good medically.
Now validation, trust, respect and empathy are what is most important to me next to knowledge and qualifications. I've learned that my doctors don't have to love me but they damn better listen to me, offer me sound, truthful medical advice, options and enough information that I am comfortable knowing that I can go to my computer and know what I am searching for.
I don't think that's too much to ask for do you?
For the doctors who see me regularly it would be difficult not to establish a close relationship. And in this example that's what I want and what I have. For doctors who I see occasionally I do have a friendly relationship because I am very personable. I feel that if I hold back they can't do their jobs.
As Jennifer Hunter stated doctors have a tough job and if cooperating means a better doctor than I'm all for it. Doctors work under an incredible amount of stress but they also have an ethical code of behavior that they must abide by. I was once molested by a doctor and after that it took a very long time for me to trust another. I was lucky as it only happened once.
I certainly don't want to know my doctor's health or mental problems. The focus of an appointment need to be me me me.
I also expect my doctors to reply to emails and phone calls within a rational amount of time and let me know immediately about important tests and scans.
So is that too much to ask? l don't think so because doctors have a huge responsibility to their patients.You should never feel intimidated nor put down in any manner whatsoever.
One time a new doctor, who I had never met walked into my room and without an acknowledgment said to me, "you are an interesting case." I can tell you that I was and am but not one of hers.
What do you expect from your doctor both personally and medically? What do you find is fair treatment and what do you think that a doctor should expect of you?

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@merpreb This is an interesting question. At the time I was seeking help and needed spine surgery, I read a book called, "Back in Control" by David Handsom, MD who is an orthopedic spine surgeon, and who also became a spine surgery patient. His book pointed out the stress of being a spine surgeon and that he had personally known spine surgeons who chose to end their lives during the time that they had been treating patients. It hadn't occurred to me that treating me as a patient could be very stressful, and it wasn't just because of me, but also because of everything else that might be happening in their professional and personal life. A mistake during spine surgery could have serious consequences. I wanted to know that any surgeon I chose would not be distracted and would be able to fully focus on the procedure that I needed. I also knew that I as a patient could make a difference and that if I let my physician know that I was grateful and valued their advice, that I could assure a good relationship which could help me get better care. At least I would find out if a doctor was receptive to my positive energy, and if not, maybe someone else would be better. I found a variety of personalities in the specialists I consulted, and different degrees of their willingness to listen to me, answer my questions, and to try to make me comfortable as a patient. One wouldn't answer questions at all, yet was pushy about wanting to do surgery and he started some extreme anxiety that took a long time for me to overcome. I kept looking. My symptoms were different than what was expected for my condition, and 5 surgeons missed that completely. The one who didn't miss the diagnosis and who answered my questions, and fully explained the procedure got the job, and he was by far the most compassionate of all of them, and intuition told me I could trust him. I knew a lot about spine surgery already because I had been watching neurosurgery conference presentations online and I had a background in biology, so I knew what all the others had missed. I also asked questions to try to figure out if he was happy in his life and had a good work/life balance, and I would ask others that question who worked with him. I paid attention to body language and interactions with the doctor and his staff.

I made sure my surgeon knew how much I appreciated his help. When I got the hospital survey that came in the mail, I answered it, but felt that the multiple choice answers didn't fully represent my gratitude, so I wrote a personal letter about my experience to the CEO from the cover letter, and I was pretty excited when I got a personal letter back from Dr. Noseworthy, the CEO at Mayo at the time. I gave my surgeon a copy of my letter and the response which made him very happy. Everyone likes to be appreciated for a job well done, and my surgery changed my life. As a patient, I want a doctor who is kind, but I need to return kindness to him in return. It helps both of us, and having a great relationship with a doctor will help me a lot on the future if I am in need of further treatment. I can focus on good things instead of worrying about the procedure. It builds trust and that is so important to me.

I don't want to be treated like a condition or a disease, but a person. I see my doctor as a person and expect the same in return and I expect that my doctors will engage in two way conversation about my medical issues with advice, and anything fun that isn't about medicine is a bonus. I always want to know why they chose their career, and I want doctors who love their jobs. If they talk about that with excitement and passion, you know you found a good one. When I was little, I didn't have a choice if I felt intimidated by a doctor, but I have that choice now. If I feel like I'm being dismissed, I won't go back as long as I can get help elsewhere. I have to be able to trust them as a person first in order to be able to trust their medical advice. There are some top notch surgeons who are arrogant, and I had enough to worry about as a nervous patient while making choices and that kind of personality interfered with good communication and affected my ability to make an informed decision about my treatment. I like a doctor who appreciates having an informed patient who might arrive with a lot of understanding about their own issues. A doctor should also be able to trust you as a patient. You are a team making a decision together, and the doctor should be able to trust the patient to follow the advice that was mutually discussed. A patient should raise questions during that discussion if they are not comfortable with a decision or need more information about it.

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@jenniferhunter

@merpreb This is an interesting question. At the time I was seeking help and needed spine surgery, I read a book called, "Back in Control" by David Handsom, MD who is an orthopedic spine surgeon, and who also became a spine surgery patient. His book pointed out the stress of being a spine surgeon and that he had personally known spine surgeons who chose to end their lives during the time that they had been treating patients. It hadn't occurred to me that treating me as a patient could be very stressful, and it wasn't just because of me, but also because of everything else that might be happening in their professional and personal life. A mistake during spine surgery could have serious consequences. I wanted to know that any surgeon I chose would not be distracted and would be able to fully focus on the procedure that I needed. I also knew that I as a patient could make a difference and that if I let my physician know that I was grateful and valued their advice, that I could assure a good relationship which could help me get better care. At least I would find out if a doctor was receptive to my positive energy, and if not, maybe someone else would be better. I found a variety of personalities in the specialists I consulted, and different degrees of their willingness to listen to me, answer my questions, and to try to make me comfortable as a patient. One wouldn't answer questions at all, yet was pushy about wanting to do surgery and he started some extreme anxiety that took a long time for me to overcome. I kept looking. My symptoms were different than what was expected for my condition, and 5 surgeons missed that completely. The one who didn't miss the diagnosis and who answered my questions, and fully explained the procedure got the job, and he was by far the most compassionate of all of them, and intuition told me I could trust him. I knew a lot about spine surgery already because I had been watching neurosurgery conference presentations online and I had a background in biology, so I knew what all the others had missed. I also asked questions to try to figure out if he was happy in his life and had a good work/life balance, and I would ask others that question who worked with him. I paid attention to body language and interactions with the doctor and his staff.

I made sure my surgeon knew how much I appreciated his help. When I got the hospital survey that came in the mail, I answered it, but felt that the multiple choice answers didn't fully represent my gratitude, so I wrote a personal letter about my experience to the CEO from the cover letter, and I was pretty excited when I got a personal letter back from Dr. Noseworthy, the CEO at Mayo at the time. I gave my surgeon a copy of my letter and the response which made him very happy. Everyone likes to be appreciated for a job well done, and my surgery changed my life. As a patient, I want a doctor who is kind, but I need to return kindness to him in return. It helps both of us, and having a great relationship with a doctor will help me a lot on the future if I am in need of further treatment. I can focus on good things instead of worrying about the procedure. It builds trust and that is so important to me.

I don't want to be treated like a condition or a disease, but a person. I see my doctor as a person and expect the same in return and I expect that my doctors will engage in two way conversation about my medical issues with advice, and anything fun that isn't about medicine is a bonus. I always want to know why they chose their career, and I want doctors who love their jobs. If they talk about that with excitement and passion, you know you found a good one. When I was little, I didn't have a choice if I felt intimidated by a doctor, but I have that choice now. If I feel like I'm being dismissed, I won't go back as long as I can get help elsewhere. I have to be able to trust them as a person first in order to be able to trust their medical advice. There are some top notch surgeons who are arrogant, and I had enough to worry about as a nervous patient while making choices and that kind of personality interfered with good communication and affected my ability to make an informed decision about my treatment. I like a doctor who appreciates having an informed patient who might arrive with a lot of understanding about their own issues. A doctor should also be able to trust you as a patient. You are a team making a decision together, and the doctor should be able to trust the patient to follow the advice that was mutually discussed. A patient should raise questions during that discussion if they are not comfortable with a decision or need more information about it.

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@jenniferhunter How interesting your post is! It makes sense. I know that recently all of my team of physicians have been good listeners and I felt like they understood my perspective and answered questions. That was a relief prior to, during, and after surgery. I think most surgeons an other doctors have it trained heavily into them to blot out during treatment, personal problems they carry. However, the worry of something going wrong with surgery is an interesting thing to ponder. Thank you for addressing a truly eye-opening concept.

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Interesting topic. I am finding that some doctors listen to a point, but when my issues don't fit into a neat little box they tune me out. A patient is not suffering from panic or anxiety attack when other physicians comment on quantifiable evidence. But what I find even more frustrating is when you find a doctor who will listen, but you can't get past the nursing staff or appointment desk. My pulmonologist seems to be in my corner, but the appointment desks waits 3 to 4 weeks to schedule emergency room follow ups and the nursing staff seemingly fails to follow through with treatment or tests the doctor said would be coming, meaning I have to wait weeks or months to discuss it with him again.

Son what is a patient to do? Put up with poor staffing to see a doctor who seems to listen? Or presume the doctor is communicating one thing to you the patient and another to his staff about you? Is the action of the staff a reflection of the doctor? I am on the fence about that one.

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Advocate Advocate Advocate for yourself. I do not know where you are. But, If you are a Mayo Clinic patient, take the first appointment they will give you and then show up as a checker at 7:00 am or 1:00 pm and wait for them to call you in to see the doctor. If you are desperately ill go to St Mary's ER. It has helped save lives. Now go Advocate. I do know that the teams that work with Mayo Physicians really are some of the most caring in the world!

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@llwortman LInda, you are so right! I agree. I had never experienced truly compassionate and expert care until I came to Mayo. I was impressed that my Mayo doctor received a phone call during my first appointment with test results and an evaluation that had been completed just an hour before from a different specialty. That extra effort in timely communication only happened at Mayo, and didn't happen at all with doctors I saw before I came to Mayo. I came to appointments where they should have had test results and communications, but they knew nothing and then they didn't find or look for results that had been sent to the wrong office, and the computer network didn't allow global sharing of the information between departments. It just wasted time. If you haven't experienced how good and efficient health care can be, you don't know what you are missing. It's so easy for doctors to miss things, and patients can give up because their doctors have. This is why patients need to educate themselves and advocate for themselves and family members. Once you become an empowered patient it changes the way you interact with your physicians.

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