Patients often think doctors do nothing, but they’re wrong

Very often I ask patients about their recent visits to other doctors.  While I am taking a history, it’s important for me to know if you’ve recently been seen by another provider for the same or similar complaints and what they did, what they diagnosed you with, what they prescribed, etc.  I often get a kind of irritated response such as “Oh, he didn’t do anything” or “he said it was nothing” or “he didn’t say anything to me.”  Although I know my share of lazy doctors, I bet the vast majority of times, the doctor did do something and did say something.

Just not what the patient either wanted to hear or that their perception or comprehension was wrong.  See, I can often tell that a patient has “nothing” by just reading their triage note and taking a look at them.  Nothing serious or something self-limited that gets better with no treatment or testing that is.  Guess what, your doctor can do that too.  Certainly after a directed history and exam, a doctor can usually tell if an otherwise healthy, young(ish) patient has something very minor. In other words, he (or she) doesn’t have to order tests or give you a prescription because you have a virus.  What did he really do for you? He used his brain, experience, and training to ask the right questions and his skills at knowing what to look for on examination.   He did this to reassure you that you have “nothing.”

Now, maybe he is not a good communicator. Maybe he doesn’t have the time to sit there and explain the pathophysiology of viruses or something like benign peripheral vertigo  – and thus you feel short changed. After all he “just asked me a few questions, listened to my lungs and told me to go home and rest.”

Anyway, my point is that ask questions if you feel like you don’t understand what your doctors is thinking – but rest assured, most probably, he really didn’t just “Do nothing.” If you do this, perhaps you won’t be back in the ER with the same complaints and me having to “Do nothing” all over again.

“ER Stories” is an emergency physician who blogs at his self-titled site, ER Stories.

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  • Anonymous

    Or perhaps he did nothing because you don’t really have a virus.

    And if the patient does have a self limiting virus, why is that patient sitting in front of you with the same symptoms?  “The virus” is the standard catch all statement for “I don’t know what’s wrong with you so you have a virus.”  What a virus really means is that the patient wasted his time and money seeing a doctor and therefore got nothing.

    • Terry M

      Perhaps it might be useful to write a post, blog, etc about what you’re trying to convey rather than taking a potshot at a posting which is actually pretty spot on.  Taken out of context, your reply is “Exhibit A” for the type of mentality described in this article.

      • Anonymous

        When I first got sick, my PCP said it was just a virus.  When my symptoms didn’t go away, I was told it was just a virus.  When the fatigue was unbearable, I was told it was just a virus.  When the preliminary culture came back, I was told it was just a virus.  When the final culture came back, it was clear I had a serious infection and I didn’t have a virus.

        I am just bitter and angry and post potshots help me deal with the PTSD I acquired during a horrible medical experience.  Of course, I don’t have PTSD…I have a virus.

        • http://pulse.yahoo.com/_KCL4AO3HM6GTZ2X4RD3BQD5JPI GPZ

          You post the same tired old story in every comment section of every single physician blog. 

          Have you considered seeing a mental health professional? You sound obsessed and angry. I feel bad for you.

          • Anonymous

            “You post the same tired old story in every comment section of every single physician blog?”

            An exaggeration?  I come here off and on.   I don’t visit any other physician blogs.  All those other complaints you read are other bitter and angry patients.

          • http://pulse.yahoo.com/_U625VZJPD24OSKFEDQQHQSNSI4 Texas

            Actually GPZ is right.   You post on nearly every thread I read on this blog, and your comments are always bitter and angry to the point of absurdity.   You have an axe to grind and just can’t allow for the possibility that there are actually doctors who know something, care for others, and help their patients.  Your Ahab-like vendetta detracts from others trying to discuss issues rationally.

          • Anonymous

            Another exaggeration?  Of the twenty posts on the first blog page, I have commented on two.  One comment on the next twenty.

            Didn’t I admit I am bitter and angry.  I haven’t met many doctors are willing to do more than an cursory evaluation.

  • http://twitter.com/PorterOnSurg Chris Porter

    When I’m about to do nothing, I always frame it this way:

    The good news is you don’t need an operation, you get to keep your gallbladder! Bad news is I’m not sure what’s causing your pain, but I don’t think it’s anything serious.

  • Terry M

    Well said.  Communication is definitely important in making sure that patients don’t feel that they have not been heard and, therefore, not been served.

  • http://www.facebook.com/DocRate.net Angela N. Vance

    I agree that many times, tests are run, everything within limits set by insurance may be attempted, but however, I feel that the patient needs to feel that their concerns are being taken seriously.  Time restraints aside, it would be comforting to at least, suggest some area to seek information regarding your diagnosis.  

    Let’s be honest, things are missed during standard examinations and/or the true diagnosis may be out of the physicians’ realm of expertise.  Also, there are some physicians who habitually make assumptions regarding the character of the patient.  There are also those healthcare professionals that treat the patient with dignity, admit they are not 100% sure, but do go above the call of duty to refer the patient to a better suited caregiver.  I have been the patient in both circumstances.   The “nothing” led me to emergency surgery two weeks later with the one doctor.  The “I’m not sure” printed out materials, talked to me like an educated human, and I left with no diagnosis (and satisfied).   Patients are humans, most of which have very little knowledge of medicine.  It is the physicians job to advise them.

  • Pamela Curtis

    I had an appointment with a new doctor on Friday. I’m fine with doctors having skepticism. I’m fine with having blood tests to verify that what was reported last time still holds true. What I don’t like is doctors insisting that everyone before them is wrong. I don’t like being told that all my previous doctors were probably fooled by this that or the other and how I don’t really have what I think I have. If that’s the conclusion you come to *based on the data* that’s fine. But don’t come out at our first meeting with the insinuation that my previous years of work were with quacks who had their MDs signed in crayon. It looks especially bad now that the blood tests show their first-meeting-theories didn’t hold water.

  • Joe Kosterich

    Those who are good at what they do make it look they are doing”nothing”.This applies to medicine as well