One doctor’s holiday wish list

Many years ago, I wrote this essay in which I wondered why I receive so few gifts from my patients in the holiday season. I was prompted to write the essay by the memory of my father, an orthopedic surgeon in solo practice, whose patients showered him every December with foil-wrapped bottles of booze, tins of cookies, and all manner of goodies, including a “World’s Greatest Doctor Figurine.”

I speculated that perhaps dad’s speciality, his age (I recalled only his 50s and 60s), his gender, his cozy office on the ground floor of an apartment building, and the era in which he practiced explained his patients’ relative generosity. When I wrote the piece I was a young woman caring mostly for other young women in a large internal medicine group housed in a mega-sized, late 20th century hospital. These factors, and not my patients’ lack of affection, surely explained why I went home every night with the physician’s equivalent of a lump of coal, right?

All these years later, most of these factors remain the same, though a few have changed. I’m older, and so, on average, are my patients. My group has doubled in size and the hospital in which it is housed is now part of a multi-hospital health care system.

And so far this season, I’m still coming up empty-handed. No booze, no cookies, no figurines.

I’m not complaining. I know how expensive health insurance is, how costly the co-pays are, not to mention the parking fee, the babysitter, the time off work, the time wasted in the waiting room … I’ve experienced all these as a patient, myself. And, to be honest, though I love my own doctors, and appreciate them greatly, I’ve never given one a holiday gift.

But, if you were thinking of getting me something, here’s what I want:

Real health care reform. The passage of the Affordable Care Act was a step in the right direction, but is not the same as universal health coverage. In the richest and most powerful country in the world, basic health care, like education, should be a right and not a privilege–and a healthier population, like a more educated population, would benefit everyone. I come at this as a doctor, not a politician or an activist. I see people all the time who’ve skipped mammograms, left prescriptions unfilled, or deferred mentioning a symptom because they’re unemployed or have poor coverage. It’s just not right.

More time. I wrote in this column that perhaps the most gratifying period of my 20+ years in practice were the three weeks when I returned from medical leave after shoulder surgery and was required, by my hospital’s occupational health department, to take double the usual time to see patients. I’m convinced that more time would make for healthier and happier patients (and doctors) and fewer costly tests and medicines. Unfortunately, as this article reports, “slow medicine” is not coming any time soon.

More health, less health care. According to the World Health Organization, the top ten causes of death in the developed world are mostly conditions that could be prevented or ameliorated by changes in lifestyle including diet, exercise, injury prevention, and stress management. But “lifestyle medicine” is still not quite in the American medical mainstream–not much taught in medical schools, and not much practiced in clinics and hospitals. I’d love to see diet and exercise prescribed as frequently as “the little purple pill,” but that takes time, and a change in how health care is financed (see above).

Suzanne Koven is an internal medicine physician who blogs at In Practice at Boston.com, where this article originally appeared. She is the author of Say Hello To A Better Body: Weight Loss and Fitness For Women Over 50

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  • http://www.facebook.com/beau.ellenbecker Beau Ellenbecker

    Well if they get you that for Christmas, hopefully they can find a two for one deal and send it my way too…

  • Suzi Q 38

    This year I got very, very, angry and over the top when I told off my physician for a very good reason. He deserved it.
    He felt so bad that he listened to my wrath for about an hour and a half (after he called me) before we concluded our much needed conversation.
    Two months later, for Christmas, I gave him a box of candy and a blue rosary.

    The rosary was given to me over 20 years ago from a Catholic physician.

    Instead of my leaving him a pen or pads of paper, he wanted me to have the rosary and a beautiful paperweight that I had admired on his desk.
    He also called the local catholic goods store and ordered a lovely bible and had it delivered to me. The bible was beautiful. He told me that he liked to give things to people that liked them, hence, his gift of the paperweight. He said that he had accumulated a lot of things over the years, and it all was such nonsense, really. What do we really need with all the things we buy??

    I was one of his pharmaceutical sales reps that visited him on a regular basis. I was a very unlikely recipient for such personal items.

    Anyway, at the time, I just thought that this very proper loving family man and physician was going through a “religious phase” and wanted to make sure that I kept up, too. He had asked me if I was a Catholic. Not PC, but I answered the question honestly. I did not care that he asked, as I had known him for several years.
    It was all so very odd for a prominent doctor with a practice in a very large, metropolitan city, his building adjacent to one of the teaching hospitals.

    The next time he was on my call list was two months later.
    I walked up to his office and noticed that his name was no longer on the door, and the door was locked. At first, I thought…Wow, Dr. Jones retired and forgot to tell me…I just had to find out what happened to him.
    I grabbed my bag of samples and almost ran downstairs to the pharmacy in the large building.
    I panicked as I asked the pharmacist where Dr. Jones was.
    He just shook his head and said: “Dr. Jones passed away a month ago, Suzi.” “He died of ______cancer.”

    I had kept the gifts for all these years and decided to give the rosary to a doctor that I was angry at. I had decided to forgive him and move on, as he was young and the young ones sometimes make huge errors.His nurse had told me that he was a newly converted Catholic. Not that I would have ever asked.

    I realized that Dr. Jones had given me the gifts so that I could use and enjoy them over the years. I decided to give the rosary an even longer “life,” so I gave it to a physician that I was very angry at. I hope that he forgives someone that has wronged him.

    I too, get loads of gifts from my adult students. I think it is because I stop now and then, look at them and tell them what I think of them. In a nice way.
    As if I really want them to know that they are cared for, loved, and important in this world.

    If having to rush through each patient way too fast is making your day a blur and patients unreal, take a day and try to take things a bit slower, or make one patient a day seem very special, like a favored child.

    The things that your father received were probably not expensive, but meant something because your father was special to his patients.

    I still try to remember to give a little something to my doctors at Christmas.

  • querywoman

    So you want gifts as well as your fee? After paying and paying for medical care, I have no obligation to give to a medical doctor. Most doctors in the urban area where I live reside in homes that start at a minimum of $300,000. I check it on the tax rolls!
    Did your father ever accept produce in lieu of cash?

    I seldom “gift up” to people who make tons more money than I do. I’d rather tip my good cab drivers well!
    I have occasionally given doctors gifts, and those gifts are usually my small original paintings which have shared personal meaning. I am thinking of giving a small sculpture to a doctor who treated me recently for pneumonia. First, I have to decide how to finish it. I have my reasons with her.

    If a doctor wants a gift from me, said doctors needs to DO a little extra, like make a followup phone call after I”m sick.

  • querywoman

    Oh, and here’s some more food for thought for you: do you preach against alcohol and sugar? If so, you should not expect booze and cookies as gifts. Perhaps in your daddy’s heyday, docs were less preachy!!!