A large part of our work here at the Society for Participatory Medicine is about changing culture of healthcare. In such times, I’d useful to look at our roots. Here’s an attitude tidbit from 1871 that our friends at the BMJ published sixteen years ago.
“Your patient has no more right to all the truth you know than he has to all the medicine in your saddlebags …. He should get only just so much as is good for him”
“FOUL,” you say – “That was 145 years ago!” Well, a friend says that in 1980 a doctor was feeling around on her neck and, being a curious e-patient type, she asked what he was doing. “It’s none of your business what I’m doing,” he said.
And last year on Twitter someone (I forget who) said she’d introduced herself to a new doctor, saying “I have idiopathic [something],” and the new doctor snapped: “Where’d you get that word??”
(The great irony is that “idiopathic” is a fancy Greek-based word for “We wise docs have no freakin’ idea why this is happening.”)
Do you have a culture problem in your medical life? Have you experienced that treatment? Please share… including how recently it happened!
The question is not “do you have a culture problem in your medical life?” but “who hasn’t experienced such behavior from at least one of their doctors?”
I would say that if you ask that question to 100 patients at least 90 will tell you they have experienced this lack of respect at least once. And the other 10 are liers :-)
This is the magnificent answer I was given by a doctor many years ago.
Yeahbut I’m looking for anecdotes. Every time we get a recent story like this, it’s useful for enlightening folks who think the past is gone. :)
Following a breast biopsy, I met with the oncologist through my Medicare Advantage program. My pathology report in my purse, and aware that I was at risk of bone mets, I asked about starting Zometa, recommended in many cases to strengthen bones. “You don’t need to worry about that kind of thing”, he said, without additional explanation. Expecting to discuss the biopsy, I was shocked to hear,”Go get your breast removed and then come back to me.” Not bloody likely at that point!
PS He recommended an abdominal surgeon! New doctor within a week!
Holy crap, Peggy! How long ago was this??
And did you say he recommended an ABDOMINAL surgeon, for a mastectomy??
What happened with the new doc?
Did you by any chance complain to anyone about this incompetence and dismissiveness?
No anecdotes, Dave, but if your doctor acts like he believes that quote from Holmes, here is one to quote back at him:
“The [medical] journals contain much that is crude and unsound, yet I have known a practitioner–perhaps more than one–who was as much under the dominant influence of the last article he had read in his favorite medical journal as a milliner under the sway of the last fashionplate.” Oliver Wendell Holmes, 1881
Or this in 1860:
“The truth is that medicine, professedly founded on observation, is as sensitive to outside influences–political, religious, philosophical, imaginative–as is the barometer to the changes of atmospheric density.”
This is not quite the same but comes to mind. Last year my hand surgeon was using me to teach some students. After I showed them the results of the surgery on my wrist, he said “Some patients will tell you they have trouble with personal issues. Don’t worry, they’ll figure it out.”
This from a man with a roomful of OTs next door. My jaw dropped. Luckily he has retired.
Pardon me for being thick, but what did he mean by “personal issues”?
I agree with Gilles re the OWH quotation (or else my blog readers are somehow uniquely qualified to share anecdotes that would make your hair curl!)
My own favourite anecdote happened in 2008 while I was in the ER being misdiagnosed with acid reflux – despite my textbook Hollywood Heart Attack symptoms. But at one point during this visit, the ER nurse returned to my bedside alone and sternly told me I’d have to stop asking questions of the ER doctor: “He is a very good doctor and he does NOT like to be questioned!” This of course made me feel horrible! I was already feeling very embarrassed for making a fuss over what they were telling me was just heartburn, and now I was being scolded by an angry nurse for being such a difficult patient. Oh, by the way, the question I’d had the temerity to ask the ER physician?
“But Doc, what about this pain down my left arm?”