Orlando's picture

    Why do doctors suck so much?

    I’ve known a lot of doctors in my life. And when I say known, I mean spent five minutes in a small room with, while I explained what was wrong with me after which they made their diagnosis and got irritated when I asked my inevitable questions.

    What can I say? I like to learn stuff. I’m inquisitive that way.

    While I’ve known a lot of doctors—mostly because I’ve moved around a lot—I haven’t liked very many of them. They seem to be, for lack of a better word, snotty. Granted, I do ask a lot of questions. I’m like a four year old in the doctor’s office and I realize how irritating it can be when the four year old you are babysitting asks “Why?” for the gazillionth time but I think I’m entitled. The doctor is getting paid, after all.

    In some situations, I barely ask any questions. When I go see my mechanic, I only ask one (How much is it going to cost?). When I call the plumber, I only ask two (How much is it going to cost? & How long do I have to wait at my house until you get here?) But I don’t really care how my car works. Only that it does. I have even less curiosity about how waste leaves my house. Only that it does so quickly, and in a way that I don’t have to think about.

    But my health is different. When I don’t feel good, I want to know why and I want to know what I can do to make it better. So, I ask a lot of questions and doctors get snotty and I decide that I don’t like them very much. It’s not like I’m questioning their judgment (not always, at any rate). I just want to understand.

    My mom has doctors too. She has lots of them and they change sometimes. Occasionally, when they change, I don’t know about it until after the fact and sometimes that makes me want to reach through the phone line and rip someone’s throat out. But I digress.

    I’ve had doctors that simply refuse to answer questions. I’ve had doctors tell me one thing was wrong with me, when I knew it was something else. (They NEVER apologize when they’re incorrect.) I’ve had doctors talk to me for less than thirty seconds before making their pronouncement and charging my insurance company $160. I’ve been seeing my latest doctor for almost six years and I’ve never really liked her. She’s a pusher. I don’t know if she gets a kickback from the pharmaceutical companies or if she simply believes that anything can be cured with a little pill, but she’s much too eager to pull out the scripts, in my opinion. I could get a new doctor. But she’s really close to my house and I probably wouldn’t like a new doctor better anyway.

    It’s different with my mom’s doctors. She lives in a nursing home about 100 miles from my house, so when I visit, it’s almost always on the weekend and the doctors aren’t around. I’m responsible for making decisions about my mom’s care, but largely I trust the nursing home staff and follow their lead. That means, for the most part, I talk to nurses and aides. They take very good care of my mom and they are as concerned as I am when she is upset.

    Her particular brand of upset takes a little getting used to. She doesn’t walk anymore and she can’t talk either. Her fine motor skills are pretty much gone, along with most of her gross ones. So, her freaking out takes the form of bone-chilling teeth grinding, flailing her arms and legs, and occasionally launching herself out of her wheelchair using whatever gross motor coordination she still has left.

    They’ve tried lots of different drugs, but there’s only one thing that really works to calm her down. The sanitized name for it is ECT. I forget what it stands for. It was one of the questions I asked when they started the treatments, but I was more interested in what the treatment involved. Turns out, ECT is electric shock, only not the One-Flew-Over-the-Cuckoo’s-Nest variety. Same basic procedure, only now with a lot less juice and under anesthesia so the muscles won’t twitch.

    At first, I was reluctant and scared to allow it. But I was also desperate to relieve my mother’s distress.  The doctor answered every single one of my questions. With patience. With kindness. And so I consented. The day after the first treatment, I drove over to see her. My mom, the woman who three days before had been screaming and kicking and terrified, was smiling and chatting. Not chatting like “How’s your day, honey?” but chattering away to herself in her secret mumble language. She knew me instantly when I walked in and, for the first time in months, she looked happy to see me. Talk about a miracle.

    Now, going on two years later and due to circumstances beyond my control, my mom has a new psychiatrist. Despite consultation with Dr. Good-Kind-Question-Answerer and numerous nurses, at both the hospital and the nursing home, who have advocated for continuing ECT, Dr. Stupid-Snotty-I-Know-What’s-Best-for-Everybody-in-the-World-Despite-Evidence-to-the-Contrary decided to stop the treatment. He’s been slowly weaning her, and nobody told me it was happening until he declared that he was discontinuing the treatment altogether.

    Predictably, the distress has been returning. She launched herself out of her chair the other day and banged up her arm. She’s grinding her teeth. She’s stressed out. So much so that she had to go back to the hospital psych ward for a little reset.

    Generally, when I talk to my mom’s doctors, there is a point in the conversation at which I break down. It pisses me off every time, but I can’t help it. I can’t calmly discuss my mother’s pain. The problem is that it is very difficult to be an effective advocate using a squeaky crying voice. But this afternoon I talked to Dr. SSIKWBfEitWDEttC for the first time and I didn’t dissolve into tears. I was too pissed. He made his point. I made mine. He didn’t budge.

    It can feel pretty powerless facing opposition from doctors who control the means of making my mother feel better. I’ve been practically on my knees before, begging for them to give her sedatives or anything to calm her down. They can refuse and they have. Once, I almost went to far as to ask my own doctor for a sedative (She’s the pusher, remember? I totally could have gotten a prescription). My plan was to cut the dose in half, crush it up, and slip it in my mom’s applesauce when the staff wasn’t looking. In the end, I was too chicken. The doctors and the nursing homes have a lot of control. At any point and for any reason, they can essentially evict my mom, which would leave me in the position of having to find a new place for her to live. I’ve been through that before and, frankly, it was almost more than I could deal with. I am certain that I can’t survive round two. So, I am very, very careful not to piss anybody off.

    Today though, I had some back up. The nursing home wants her to get ECT as much as I do and yesterday, the nurses at the hospital told me there was a way to get my mom outpatient psychiatric care so that she didn’t have to keep seeing Dr. Stupid. Still, I felt kind of bad about doing an end run. Bad, that is, until he was an unbelievable jerk. I told him (nicely) that I thought she could get the treatment at the other hospital in town. He said to me, in his most condescending voice, with a little mild threatening thrown in, “I can transfer her, but of course if you go that rout, I’ll no longer be able to see her at the nursing home.” I was more than happy with that arrangement and I told him so.

    Now my mom is out of his care and tomorrow morning, she’ll be resuming the treatment that makes her happy and smiley. That makes me calmer. But after four days of mom getting worse while I tried to figure out what to do, the victory feels a little hollow. I’m left waiting for the next crisis, wondering why so many doctors suck, and if any kind of reform to our health care system will address this well-known but little talked about fact.



    O, I am so sorry to hear about your mother and the whole situation. I couldn't agree with you more: Doctors tend to suck and are often all the negative adjectives you've abscribed to them. When I look for a doctor, I'm of course looking for competency and some confidence (most of the time, I find Google just about as useful as a doctor for good info), but mainly I'm looking for someone who cares, who is patient and understand, who listens, who wants to help. In short, someone with a good bedside manner, and I can't tell you how rare of a thing that is.

    I've always thought and still feel there is a huge opportunity for some who can compile an effective and comprehensive ratings Web site, like Yelp, but solely for doctors and other medical practitioners. One of the problems with finding a doctor you like is unless you have referral for a doctor from a close personal friend, it's almost impossible to know what to expect when you go to one, and you often just end up doing what you do: See the nearest one, regardless of competency or bedside manner. There are sites out there that have tried to do this, but all the ones I've seen fall way short of being actually useful, mostly because they fall way short of being comprehensive.

    But it's our health and our bodies. And it should be much, much easier to find the best possible care.

    I'm glad you've vented here, O. That alone can sometimes help relieve the stress.

    Orlando, good on you for choosing a new doctor. Don't feel bad at all. I think that many people have difficulty separating personal relationships from their choice of medical providers. It's not about whether your doctor is offended (or even whether you feel victorious). It's about getting the best care for your mother.

    My dad and brother are both doctors. My brother is a surgeon, and he says that surgeons tend to be particularly bad. Though the medical profession is improving in terms of recognizing the importance of bedside manner, it's still not set up to reward good personal service, particularly in the specialties. Have any readers ever be given a survey to evaluate doctor performance? I haven't. The system is also very hierarchical. The body of knowledge is held by the senior physicians, and the residents and med students are discouraged from questioning them or even to referring to them by first name. Small wonder that they don't like to be questioned by patients.

    That said, I expect that it's tough for doctors to deal with challenges from patients. Some like you may be intelligent and have done careful research. Many others subscribe to crackpot ideas and don't listen to reason. That doesn't absolve the doctors of trying to help them understand, but it's probably very frustrating for those doctors who make the effort.

    FYI, for any New Yorkers, I can't recommend highly enough my physician, Dr. Adam Stracher. He combines competence and professionalism with respect for his patients. Fortunately, I've never had any serious medical issues, but friends of mine have received excellent advice and diagnoses from him concerning theirs. Plus, I've never had to spend more than five minutes in the waiting room (though I did once have my appointment cancelled because I was late).

    Orlando, as you know, I was not hip to what was going on with your mother until just recently.  First, I commend you for fighting the good fight on her behalf, it can't be easy.  Secondly, and even more important somehow, I applaud you for coming out and speaking about it.  I know you are naturally reticent about personal issues as opposed to world issues, so the fact that you posted so eloquently about your frustration with doctors speaks volumes, to me.

    I wish you and your family peace.


    First I'm so sorry for your troubles, and I commend you for not being a dumb ass and letting a stranger treat you without thoroughly questioning them. I can't stand the presumptions of our medical establishment, that they can do as they like without your consent (other than the extortionist consent form) and that they have supreme authority over your being and that you're the one who is being obnoxious if you should so much as have a passing curiosity about what potentially life altering treatment they are administering let alone a desire to hear about options or give preferences. I think a good percentage of doctors abuse their power and have an unhealthy degree of narcissism. Even when you find a good one, there is often the doc in the box administrative staff and nursing teams that may not be as friendly as your doc. I wonder if it's better in other countries.

    You should get a concierge doctor. Just pay 100-500 a month extra (there are all kinds of plans) and the doctor will give you longer vists. They can even make home calls, give you their cell number if you forgot to ask a question or give you same day/next day visits. I love it.

    Doctors need to wake up and learn to treat patients as professionals and customers like any other business. This means, show up on time as scheduled; smile; and say thank you when we write you a check! Profiting from sick people is your profession, admit it!

    Two things would change sucky doctors (which is most of them)

    1 single payer health-care that decreased payouts for all medical professionals (that's right Dr. wages would go down, or don't implement it).  It would not really decrease the ability of great doctors to make money.  If they are that good, they could charge for cash only services.  I think only 5% of them would warrent such payment


    2. Make medical insurance (except catastrophe) illegal.  Then physicians would get paid only for the quality of service they deliver. 

    the western medical machine’s approach is simply torture you enough with red tape and incompetence that death is a happy relief from dealing with those fucks

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