Jerome Groopman fired his. Know how and when to say it’s over.
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Groopman is a fine writer and all that, but he writes as if he never had to account for his time, either in running his own practice or in spending time as a patient at his doctor’s practice. If his doctor suddenly became so “popular” that he no longer felt he had as much of his time and attention, does he think so many of that doctor’s other patients, those who find him popular enough, are similarly disserved? Or was the good Dr. Groopman simply the sometime beneficiary of the underscheduled workday of a junior physician whose practice would eventually place the good, and fortunate, Dr. Groopman in the kind of time allotment he was actually paying for? If he thought his needs significant enough, would he have considered asking for a longer appointment time slot that he would have been willing to pay himself for? Doesn’t sound so.
It is easy to give armchair advice like “demand to have your doctor answer all your questions.” Really, who could argue with that? But the corollary is never spoken, that is, if you think you need more of your doctor’s time, be prepared to pay fairly for it, even if means money out of your pocket. Too bad there isn’t an easy solution for those who have Medicare. If they want extra time, they essentially have to steal it.
I wish Dr. Groopman the best. With all his book proceeds, I am sure he could afford a nice long appointment in the concierge practice of his choosing. Otherwise, he can mooch some extra time from another bright, young internist just starting his new practice. And in a couple of years, when this bright doctor becomes a little too “popular,” he can fire him then too.
I’ve had patients whom I thought would be better served by someone else, much of the time because I felt I didn’t know enough about their condition, but sometimes just because we weren’t working well as a doctor-patient combo.
On some level I expect a certain element of trust from the patient, realizing that I have to earn increasing trust as time goes on, but without trust things just can’t work. If someone isn’t going to take my advice, then we’re wasting each other’s time.
I’m more than willing to answer reasonable questions, but when every little thing gets questioned, so much so that it becomes apparent that as I am explaining they’re thinking about the next question to ask rather than listening to my explanation, then it’s just not working.
Anonymous raises a good point– in today’s system, many people will not get the amount of time with a doctor that Dr. Groopman discusses. Those that decide that they want to have a much more personal relationship are starting to drift to concierge practices and paying dearly for the privilege.
It strikes me as funny that there is no middle ground– use of physician coordinated resources that answer questions in a way much more efficient than 1 on 1 time with a MD. Online modules, seminars, coordinated use of physician extenders, and electronic communications all seem like more modern means of carrying on a conversation and helping patients address questions.
I find it amazing that people are willing to pay and want answers and our medical establishment doesn’t find a way to give that to their customers…
I don’t think Groopman has many patients of his own, or that he has a very productive research lab.
Otherwise, how could he write so many books and letters to journals?
dr. groopman clearly has no real idea what it’s like to run a medical practice.
Statements like his, coming from a “doctor” who doesn’t actually practice, but sits in an ivory tower writing profitable books, only further damage the doctor-patient relationship by refusing to acknowledge the realities of practice.
Unfortunately the “doctor” title gives too much undue credibility to his statements (& his books).
I disagree. I think that his comments do help in that they raise the bar and help all of us, doctors and patients, caught in the Medicare/Medicaid/PPO gulag to remember and envision what excellence in medical care looks like and should always look like.
Only by keeping that vision before us can show the dysfunction of the current system, and highlight how much of what is important about the doctor patient relationship is not accounted for in the CPT manual, practice guidelines, or provider rating programs.
Keeping the pressure on benefits us all, even if it makes us uncomfortable with the compromises that we have accepted. We should at least acknowledge that they are compromises.
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