Tuesday, January 4, 2011

Patient Empowerment Blog: A Call to Physicians

Patient Empowerment Blog
A Call to Physicians: It's Time For You to Weed Out Those Rotten Apples

By Trisha Torrey
Monday January 3, 2011

Today's blog post is written for doctors, not patients. I don't often
address doctors directly, but you'll see in a moment why that's
important for this post.

I have a great relationship with most of the doctors I've met. We have
a mutual respect and great conversations. And there are many
conversations -- I spend a lot of time talking to doctors. I meet them
in person at conferences - or parties. I see and exchange information
with doctors at Twitter and Facebook and other online venues. I
interview them or ask them to help me understand something medical --
or sometimes we just chat.
And here's what I have found. The doctors who are willing to talk
about patients and empowerment are usually quite open and forthcoming
about their own experiences, good and bad. But few (if any) are
willing to discuss their colleagues who don't treat patients well, who
are disrespectful, or arrogant, or who just aren't doing their jobs.

When the point is raised, they either deny those bad doctors exist,
they brush aside the conversation, or they make sure to mention the
"few bad apples" and move on.
But guess what, doctors.... your numbers of bad apples have begun to
rot the rest of your barrel.

Why do I bring this up today? My About.com colleague, Adrienne Dellwo,
who writes about chronic fatigue syndrome and fibromyalgia, posted a
few days ago about an experience with a disrespectful doctor - and the
numbers of comments to her post show that such disrespect,
dismissiveness and arrogance is much more far-reaching than those
doctors I talk to would like to think it is.  They are compounded by
the comments about arrogant doctors made by readers right here at the
patient empowerment site.

Yes, I do understand why the problem is growing and getting out of
hand. As fair reimbursements are tougher to come by, doctors are
becoming choosier about the patients they will care for.  Once a
patient needs treatment that will take any more effort than the doctor
assesses the reimbursement will cover, these rotten apples take steps
to be sure that patient won't return.
Unfortunately, that behavior has begun to affect you all, doctors.
You see, the result of your denial, of refusing to acknowledge or talk
about it, or DO anything about it, is that your patients are beginning
to treat you based on the bad treatment they've received from your
colleagues.  It's a vicious cycle.

99.9% of us patients begin with respect for our doctors. We maintain
that respect until it is violated in some way. Then we begin to
distrust all doctors, or at least it puts us on our guards.
Then, when we come to see you, doctor, you find a patient who is
guarded, and is unwilling just to accept what you tell us.  We may
come across to you angry or belligerent - not necessarily because YOU
did anything wrong; rather, because your colleague did not treat us
well or fairly. You won't listen to us or acknowledge the problems
we've had - so we have no platform on which to trust you.  Then,
because we learn we can't trust you either - we don't trust the next
doctor we see... and so the vicious cycle continues.

How can we stop it?  How can we correct the course and reestablish
trust between patients and doctors?

This post is a call-to-action. Doctors - it's time you take a stand
and begin talking to your colleagues about their behavior. If a
patient complains to you, then acknowledge (and clarify) the patient's
complaint, and  share that complaint with your colleague. Don't allow
your colleague to brush it off.  Support CMEs and coursework that
improve respectful communications. Ask your local medical society to
begin training. See if the AMA will address the problems your
colleagues are causing for you.

The days of accepting arrogance, disrespect, poor behavior, and even
worse - injury - from our physicians is gone, as far as we patients
are concerned. We'll do what it takes to work with you to improve the
situation - but we request (perhaps demand!) that you stop merely
putting a lid on that barrel of apples.

Because the rotten ones are creating such a stench that it is
affecting your career, and patients' lives.

* * *
More than 3/4 of CFS patients report a bad encounter with a doctor, and Dr. Klimas notes that she has some patients who went to a doctor with CFS and came out with PTSD due to the doctor's attitude toward them. 
Unfortunately, my state's Medical Board (and apparently others as well) have such limited funding that they only investigate the most extreme cases of malpractice.  I was told that since I hadn't died nor had the wrong limb amputated, they weren't going to do anything.  Never mind that "life as I knew it" was permanently changed and I'd never work full-time again.

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