How patients can annoy their doctors

A study suggested that doctors rated up to 15 percent of patients they see as “difficult.”

What does that mean? This piece from MedPage Today and ABC News, gives six examples of what patients can do to frustrate their doctors.

I’ll leave the obvious ones for you to read, such as stopping medications without notice, or keeping silent about the herbs and supplements patients may be taking, and instead focus on two instances where patients play an active role, not only to annoy their physicians, but in driving up health costs.

The first is demanding a brand name medication they see on television or read in the newspaper. Indeed, there are some “who are simply sold on a drug can interfere with their own care,” and, “view doctors as simply a source of a signature for something they want, without really wanting the physician’s guidance or opinion.”

Discussing the appropriateness of drugs they hear about is welcome and encouraged. Demanding them, without considering a doctor’s opinion, isn’t

And next, is the demand for a variety of tests, in the mistaken belief that more tests equals better medicine. There are conscientious individuals, like blogger Duncan Cross, who are wary of the risks and complications diagnostic tests can expose patients to. But he’s in the minority.  Unfortunately, as some physicians observe, there is a “bias some patients have to just doing more, without any understanding of how more care is not only expensive, but actually often leads to complications, poor outcomes, and lower quality.”

Granted, especially with the spate of recent articles on health reform, mainstream media is increasingly focusing on the downside risks of testing, and more patients are realizing that more tests can lead to worse outcomes.

But the prevailing mentality continues to be on the side of over-testing, and that’s something both doctors and patients need to realize first, before it can be reined in.

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  • ltcmsi

    As a pharmacist I couldn’t agree more with your first point.. Those wonder drugs advertised on TV give me more headaches. I work at Medicine Shoppe and know my customers well. Especially with seniors who are anxious about their declining health, I explain again and again that only their doctor can approve a new prescription, and that I am always suspicious of such grand claims. It’s marketing not medical information!

  • family practitioner

    How about blowing off an appointment and then having the chutzpah to call and ask that refills to be called in?

  • Anonymous

    Not just over-testing, but over-medicating. There is a CNN transcript on the web somewhere claiming that 81% of American adults in any given week used some sort of medication. As the pharmacist who commented previously mentioned, those television ads (and other ads aimed at the general public) for drugs are not helping matters.

  • Caroline the NP

    I, for one really hate when I see a patient bearing printing pages from the internet. Usually it is about some drug they simply have to have, regardless of whether or not it is appropriate for their treatment. I also do not enjoy telling the parents of a sick kid they cannot have antibiotics for a cold or allergies. No, you can’t have Adderall because you tried your son’s script and lost three of the 10lbs you’ve been trying to lose for years.

    I also want to scream when people call at COB for a maintenance script that has “just” run out.

    Don’t get me started on the patients who give me guff and demand to speak to a DOCTOR when I do not give them the warm fuzzy they feel so richly entitled to.

  • http://www.kellykirbyfisher.blogspot.com Kelly

    I had a patient call me the other day asking for a “new patient appointment”. When I told her it would be about 4 weeks, she asked if it would be okay for her to come in and pay the $275 and “just get a script for some Adderall”. My response was “Um, NO!” She proceeded to ask my why not…it would be the easiest money the doctor made. Needless to say, the conversation ended.

    The worst are parents who chose to take their children off their medication during the summer….for about 8 weeks…and basically offer them NO structure whatsoever. It usually ends up being a disaster summer for the entire family. Then, they try and re-start the meds the first day of school and wonder why their kids were sent to the principal the first day of school.

    Caroline, we had a parent of a patient bring in a stack of paper that was about 9″ thick. Needless to say, I promptly told her that I thought she had the worse case of “google-itis” I have ever seen! :D

  • http://roseblum@aol.com GingerB

    I’d be interested to hear opinions about bring someone with you to the appointment. It seems like it can turn something into a side show.

    A lot of cancer patient literature advises bringing someone with you. Is it OK to do that for the first appointment and then if your loved one is capable let them go by themselves?

  • ray

    totally agree that unless there is acknowledgement that 30% of care is overtreatmens and may lead to harmful to patients. All those contrast CT will tax kidneys and mutiple medications have potential for interactions. Less than 10% relaize that getting more doesn’t mean best care. Needs good doctor and a sensible patient for this.

  • W

    Last November my 72-year-old mother suffered facial skeleton injuries in a bad fall. The plastic surgeon who saw her in the ER told us to call his office for an appt. the next week, after the swelling subsided, so he could determine if surgery would be necessary. When we called, his receptionist insisted that she could NOT POSSIBLY have been seen by this doctor, since it was his partner who was on call that night. WE were mistaken, she would NOT schedule with the doctor we requested, she would ONLY schedule one with his partner, and that would NOT be possible for two more weeks. Mom, whose left eye looked like hamburger, was in tears and totally distraught. She did not need this bullsh*t from an arrogant receptionist who couldn’t even bother herself to talk to the doctors and resolve her mistake.
    BTW, the doctor who saw my mother in the ER was white and British…the doctor who the receptionist insisted we actually saw was black and female. Not two people that you would easily confuse.
    So, while you’re all chuckling about what idiots patients are and how much trouble they bring to your lives, just remember that you’ve got your fair share of airheads making difficult situations more difficult for the people who come to you for help. I talked to the receptionist’s supervisor after we finally got everything straightened out (which required cancelling the incorrect appt that the receptionist had made and unfortunately requiring Mom’s actual doctor to make a last-minute adjustment to his schedule — NOT OUR FAULT). The supervisor replied with a laugh, “Well, maybe she shouldn’t get a Christmas bonus this year.” Yeah — or maybe she should have had her backside fired for interfering with a patient’s treatment and making an old woman cry.

  • family practitioner

    GingerB:

    I think it is good to bring a family member or friend to an appointment, particularly in the case of an elderly person. However, the term you use is a good one: don’t be a side show. Don’t ask questions about yourself (which is frequently done). And mostly listen. Ask a few questions, but don’t argue. Don’t tell the patient that they should see a specialist (something else that occurs).

    By the way, I do not mind patients who have reasonably researched their symptoms via the internet; ofttimes, this makes things interesting. Just do not argue with me. If I suggest something, I will tell you why, we can discuss it, and you can either accept my advice or not. I do not have time for 30 minute self-obsessed debates.

  • http://everythingchangesbook.com/ Kairol Rosenthal

    Ginger B:

    In my recently published book Everything Changes: The Insider’s Guide to Cancer in Your 20s and 30s, I recommend patients bring a friend to appointments. I totally see your point about the side show factor and agree that is inappropriate. But there are benefits too: Cancer patients often tune out and become overwhelmed during an appointment and walk out the door forgetting to ask the questions they came in with and not remembering a damn word the doctor said. This results in unnecessary follow up calls to docs from patients who need clarification. I find it extremely helpful when my husband and I download what happened during my appointments and review all the recommendations my docs made. I never go alone.

  • http://www.dentist-in-sanantonio.com/ Dental San Antonio

    This is a very interesting article. If over-the-counter medications are not helping or it make one person’s health condition worst, according to doctors and pharmacists; then why is it still allowed to be sold in the market? We also have to consider that doctors does not cure our illnesses and they discipline us to look at our health; but I don’t think that they should blame people for getting “alternative medications” because here are lots of reasons to consider, like financial problems and other various reasons. Doctors chose their career, there are difficult times and I believe it is the most fulfilling job in the whole world; they should be proud to do their best for their patients.

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