Dealing with physicians who have lost empathy and compassion

I am a regular reader of patient blogs, and I find myself frequently gasping at the mistreatment they experience at the hands of my peers. I recently had the “pleasure” of being a patient myself, and found that my professional ties did not protect me from outrageously poor bedside manners. I suppose I’m writing this partly to vent, but also to remind health care professionals what not to do to patients waking up from anesthesia. I also think my experience may serve as a reminder that it’s ok to fire your doctor when conditions warrant.

I chose my gastroenterologist based on his credentials and the quality of training and experience listed on Healthgrades.com I had no personal recommendations to rely upon — so I used what I thought was a reasonable method for finding a good local doctor. When I met him for our initial office consultation he seemed rushed and distracted, without genuine curiosity about my complaints, complicated history, or how to help me find the correct diagnosis. I brushed my instincts aside, presuming he was just having a “bad day” and hoping for more time to discuss things fully once a battery of blood tests had been completed.

Sadly, I didn’t have the chance to review the results with him – instead he instructed his nurse to read me the results over the phone and to schedule me for a colonoscopy. I wanted to discuss the pros and cons of the procedure and what he thought he might be able to rule out with the test. He did not provide me with basic informed consent information, nor was he able to articulate medical necessity for the scope. I decided not to have the test, and I didn’t hear another word from him or his office.

Months later my symptoms had worsened and so I decided that a colonoscopy might help to further elucidate the potential cause. I was not able to get through to my doctor via phone, so I scheduled the test via his nursing staff. I planned to be the first patient of the day, so that we would have time to discuss my symptoms and concerns.

On the day of the procedure my physician stormed into my surgical bay and began reading my medical history to me from the computer screen, without exchanging basic niceties or introducing himself to my husband. I confirmed the information and tried to offer some nuance since our last office meeting. He cut me off, and made me feel as if my observations were completely unhelpful and were getting in the way of our scope time. He left in a rush before I felt that he had any clear sense of what we were trying to accomplish or rule out with the procedure.

A jovial anesthesiologist then entered my curtained cubicle, and made genuine human contact with me. He inquired about the reasons for the procedure and expressed appropriate glee regarding my Mallampati grade I airway. I asked him if he would be so kind as to not position me directly on my left shoulder during the procedure as it was exquisitely tender from a recent orthopedic injury. He promised to do his best to protect the injury while I was sedated.

Cut to the endoscopy suite where the gastroenterologist enters with a grumble as the techs bustle around the scope equipment and the anesthesiologist explains the slightly altered positioning for my comfort. As the propofol anesthetic goes into my vein I feel the gastroenterologist push me fully onto my injury as I lose the ability to protest.

After the procedure I’m back in my bay with my husband, groggy but with more pain in my shoulder than anywhere else. The curtain is drawn back with a yank and in marches the GI doc, relaying the unanticipated abnormal findings. I ask (in a slightly slurred tone) for more information, to which he responds in a loud voice, “You’re not going to remember any of this so just be quiet and listen!”

I persist in my attempts to understand the details to which he shouts “shut up and listen” with increasing decibels. When I say that the findings still don’t explain my symptoms and that I remain perplexed he says that I should “try probiotics.”  Finally he leaves the room, not offering any reassurance about the possibility of bowel perforation and stating that we’ll “Just have to wait for the pathology report, and it will take a while because of the July 4th weekend.”

I was dumbfounded, and not just because of my post-anesthetic stupor, but because of the open hostility showed to me by one of my peers. I asked my husband if I was out of line in my questioning and he said that I sounded “like a drunk person” but that the doctor was definitely being “an a**hole.”

As the nurses untangled me from the IV and EKG stickers and rushed me into a wheelchair and out to my husband’s waiting vehicle, all I could say was “Wow, my gastroenterologist was really mean to me.”

The nurses just nodded and suggested that I wasn’t the first to notice that.

As I recover from the whirlwind interaction with the health care system, I feel relief and anger. I’m relieved that my GI doc didn’t perforate my bowel and that we accidentally caught some very bad stuff early on, but I’m angry about how I was treated and feel no closer to an explanation for my symptoms than when I started investigating a year ago. My experience was probably fairly typical for many patients dealing with physicians who have lost empathy and compassion. I am sad that there are so many like that out there and I promise to do my best not to follow suit.

My bottom line on gastroenterologists (sorry for the horrible pun): Go with your gut. If your doctor displays jerk-like tendencies during your office visit, rest assured that they can bloom in time. Have the courage to find another doctor before you put your life in their hands and/or they get the chance to verbally abuse you in a post-anesthetic stupor. I am firing my doctor a little bit on the late side, but doing it nonetheless. I just hope that my orthopedist is a good egg (like my anesthesiologist) — because I’ve got one heck of a sore shoulder coming his way!

Val Jones is founder and CEO, Better Health.

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  • ErnieG

    Sorry to hear about bad experience. Although this is not the main issue, I have always been perplexed that many GI’s discuss the findings and recs with their patients right after a procedure with sedation, and most can’t remember what was told to them, and obviously are not in a position to ask good questions.

  • Margaret Fleming

    Your article is right on point! Thank you for spotlighting this. You are kind to say “lost” empathy, assuming they once had it.
    This issues is doubly scary for Medicare patients who are, even in affluent areas, already finding it IMPOSSIBLE to find a doctor to switch to.
    I wish you a happy shoulder!

  • buzzkillerjsmith

    A lot of docs are surly because they have been abused for years, animals in cages being poked with sticks at irregular intervals. Stress experimentation.

    Some a naturally mean as snakes.

    Sounds like this guy needs a new job, retirement, or perhaps a new career better suited to him.

    Anybody got ideas on a new occupation?

  • Patient Kit

    I’m sorry that you went through this. Doctors with no empathy or compassion are unacceptable to me. Some doctors seem to think their bedside manner doesn’t matter. It does. A lot. I am surprised that you, being a doctor yourself, looked for a doctor via anonymous online reviews at Healthgrades rather than getting recommendations from doctors you know and trust. Can I ask whether there was a reason for doing that?

    I will also add that, when I read about bad experiences like yours and many other patients’, I am so grateful that I’ve had and still have such good doctors who are not only highly skilled and competent but also have compassionate and communicative personalities. I will never take that for granted. How did we get to the point where so many doctors really don’t think that matters at all? Or do they just not care?

    • LeoHolmMD

      Bedside manner always matters.

  • Hexanchus

    I too am sorry you went through this – unfortunately your story is far from the first I have heard along these lines and I’m sure it won’t be the last.

    Personally, I would have fired him as soon as I encountered the attitude you described during the meeting immediately prior to the procedure, cancelled the procedure, filed formal complaints with every agency applicable, then found another doc.

    Maybe if patients would stand up to this type of physician more often, things would improve.

  • SteveCaley

    What system allows that to persist and survive? Why do we allow such systems?

  • Lisa

    I would have found a different doctor after the first consultation. This doctor sounds truly awful. I doubt if he was ever compassionate.

  • JR DNR

    I hear all the time that when looking for a doctor, skill, not bedside manner, is all that should count.

    Yet, if a doctor doesn’t listen to a patient and take a good history, they can’t really diagnose the patient properly. My current doc listens for a long time, and doesn’t do very many tests. I like that.

    • Lisa

      I think a doctor’s skill and knowledge maybe more important than his bedside manner in some instances. My orthopedic surgeon has a lousy bedside manner. He tends to be brusque and speaks so quickly i sometimes have trouble understanding him. But he is a great surgeon. When I was interviewing surgeons, I also saw my husband’s orthopedic surgeon. This surgeon is has a great bedside manner. But he would have used a metal on metal prosthesis if he did my hip replacement and I would probably be facing an early revision. I am so glad I made the decision on which surgeon to see based on technical reasons, not bedside manner.

      I do think there is a difference between someone like my orthopedic surgeon and the OP’s doctor. I never feel like my surgeon is being mean or rude. That would be unforgivable.

  • DeceasedMD

    Unfortunately I doubt this is uncommon. Especially for pts that have unusual problems and don’t have a lot of choice in specialists, I think they can be quite abused and abandoned. I think the system can be very jarring with no time to ask questions, even about complex procedures. It happens more than we like to think. And I don’t think that Medical Boards and so forth stick up for pts. Especially pt abandonment issues.

    • lurking for answers

      Not uncommon at all. Definitely true for patients with unusual problems. I have one doc with horrible bedside manners, but he is extremely smart. Every time I see him, I want to fire him because he treats me like his special menagerie animal, but I don’t because he is the ONLY game in town for the condition I have. If i fire him, I will have no doctor. If I question him, or call him on his conduct, he will fire me, and I will have no doctor. I have to put up with his conduct in order to get treatment.

      • DeceasedMD

        quite abusive.

        • lurking for answers

          What choice do I have?

          • DeceasedMD

            if i am may ask what kind of specialist is he? how often do you have to see him?

          • lurking for answers

            I would love to reply, but unfortunately he reads this blog. I have to see him every three months.

          • JR DNR

            Sorry to hear you are struggling.

          • lurking for answers

            Thank you for the empathy. Everyone struggles with something.
            At least I know what I am going in to every three months, and how to act to keep my needed meds. It has made me more self reliant and studious. I continue to quietly look for a replacement specialist, but they are few and getting fewer.

          • JR DNR

            I’m on a three month rotation too (I asked why I was being seen this much and my doc dodged the question, I’ll ask it again next time).

            I have an older family/geriatric doctor. I think geriatric doctors end up having lots of patients with multiple conditions that need monitoring, so it’s the perfect combination for me even though I’m one of his youngest patients.

            He admits he “doesn’t know much about Celiac disease” but there really isn’t any other treatments other than checking key nutritional statuses and eating gluten free, so I wouldn’t really benefit from specialist care.

            The problem with Celiac is its not a Zebra disease, it’s a horse disease, but most practitioners aren’t up to date on that, how to screen for it, etc, so most people go undiagnosed. I was undiagnosed for so long that I have a lot of complications. Unfortunately, the literature on the complications I have is very sparse and there are no treatments for it.

            I do wonder if the “family curse” isn’t Celiac disease, I’m the the third generation with the same symptoms (5 women in total) and I’m the only one with a diagnosis.

          • lurking for answers

            I would have to go to an out-of-state University Medical center to get outside his sphere of influence. I have tried.

      • DeceasedMD

        sounds like an abuse of power.

        • lurking for answers

          This doc actually has a reputation for this. Unfortunately, he also has a just reputation for brilliant diagnosing skills.

          • rbthe4th2

            Mine doesn’t have great diagnostics skills but is a subspecialist surgeon (read makes $$$$$ for the hospital).

      • rbthe4th2

        This is what I had. No doctor and even a couple of weeks ago, having been dumped for more than a year, he shut down care for me. Care that other docs wanted me to have and agreed I needed. How fair is that to my current docs?

    • RenegadeRN

      Medical Boards are so contrary to Nursing Boards -whose sole purpose is to protect the public from nurses.
      They make no bones about it and will hang a nurse out to dry in a minute! Their quarterly bulletins mailed out have many pages of nurses named and what action the board has taken against them.
      Thankfully I have had no personal dealings of that sort in my 20 years of nursing. I would like to see a nice mixture of purpose on both boards.

  • LeoHolmMD

    Physicians can learn a lot on the other side of the stethoscope. It seems like word of mouth still rules in terms of finding someone decent.
    There was a time when specialists would depend on the recommendations of PCPs and provide service worthy of it. Now it is about referring within your own system or network.

  • JPedersenB

    I, too, am very sorry that you had to go through this! It is rather unbelievable that he would say you wouldn’t remember any of this while he was also saying to shut up and listen. Why bother giving you this information if you won’t remember any of it?

    Unfortunately, I have encountered this type of behavior from doctors far too often and I come from a family with 5 MD’s and 10 nurses…

  • Robin

    Thank you for a thoughtful and eye-opening article. As a cancer patient, I experienced a very cold and insensitive surgeon. I have also worked with many women who have horror stories of being at the mercy of doctors who lack compassion. I even wrote a blog about it: http://wp.me/p3itJT-1f

  • SarahJ89

    This is almost the same experience I had with a broken radius/chipped ulna. To this day I don’t know if I really needed the surgery. And the bright light in the whole situation was the anathesiologist, who actually provided me with some degree of informed consent, allowed me to waive pre-op sedation and answered my questions.

    My orthopod was pleasant but rushed me out the door, didn’t bother to go over the X-rays or explain anything.

    Over time I realized he was probably treating me like a second class citizen (a week’s wait for surgery, no post-op PT/OT, etc.) because I don’t work outside the home. (I do work from home, but couldn’t see how that could possibly be relevant so I didn’t mention it.) We call him Bob, the Socially Inept Orthopod in our house. I hope to never see him again. My husband has instructions to drive by that hospital no matter how much pain I’m in.

    • Patient Kit

      Why would whether or not you work outside the home have any bearing on how a doctor would treat you? I expected to be treated like a second-class citizen while covered by Medicaid. But I did not have that experience at all with my GYN ONC surgeon, who I’ve probably seen 9 or 10 times now over 1.5 years (pre-surgery, surgery, post-surgery and continued monitoring). And he has treated me respectfully every time. He has never treated me like a second-class citizen because of my lowly insurance. He listens, answers questions, returns my phone calls, anticipates and explains things that he thinks I might worry about that I haven’t brought up, asks me how I’m feeling emotionally as well as physically and how I’m handling the stress, has expressed real compassion and concern about things that are not specifically abdominal tumors, has offered to write letters when I needed one for Medicaid. Most of the time, unless I’m talking to him about insurance problems, it doesn’t feel like he cares or remembers that I’m a Medicaid patient. Of course, he’s a salaried, hospital-employed doc. A private practice doc would care that I’m covered by Medicaid.

      • SarahJ89

        I’m on Medicare. I don’t think it was an insurance issue. The first words he said to me–before introducing himself–were “Do you work outside the home?” I was so stunned I answered no, totally forgot about the five part time jobs I have, three of which are from home.

        I think he simply felt “not working outside the home” meant I had nothing better to do than cool my heels, take pain pills and wait to have the arm fixed. Not so, but I never had time to say anything more. He walked through the day surgery unit when I arrived and seemed quite amazed to see me there.

        I actually had an 8-page newsletter to write that week. Which I did, one handed. I couldn’t take the pain pill because I needed my brains to write to deadline.

        The anesthesiologist was the one who came to see me after the surgery. He answered my questions, showed me a picture of the plate in my arm, in all it’s metallic glory.

        During the brief post-surgery visit I asked about OT/PT. I’m a former rehab counselor so I actually had gotten a referral to OT from my PCP and saw someone *before* the surgery. Much to my surprise Dr. Ortho said “Oh, you’ll do that yourself.”

        Which I did. I raise poultry so when I hauled water to the chickens I made a point to lift the bucket with my left hand. I flexed my hand endlessly. I used that hand and arm as much as possible, way more than I ever have in my life. I made a point to put as much of the 50 pounds in a bag of grain onto my left arm and hand.

        I’m now seeing a PT for an unrelated shoulder problem. He was not impressed with Bob, the Socially Inept Orthopod, has done some extra work on my wrist.

        I ran into Bob in the hospital soon after my post-surgery appointment. As usual, he seemed astonished to see me, as if I don’t exist outside of his waiting room–hence the nickname. Laughing beats crying any day of the week, although I do enjoy a good spot of snarking now and again.

      • JR DNR

        I’ve been taught that there are many things that impact a doctor’s treatment of their patients that really are out of the patient’s control.

        1. Uncertain Diagnosis: If the patient has something that is wrong but isn’t pointing to a clear diagnosis, that is frustrating for the doctor.
        2. Uncertain Treatment: Once a diagnosis is made effective treatments do not exist, that’s also frustrating for the doctor.

        Your diagnosis was very serious, but the doctors could feel a lot of confidence in both their ability to identify it once found and their ability to treat it since it was caught early. The doctors helping you can feel like heroes who saved your life.

        In addition to the first two items:

        3. Is it something that the patient can be blamed for?

        Lung cancer in a lifelong smoker? Foot ulcer on a type 2 diabetic? These kinds of conditions are less likely to evoke much sympathy in providers and sometimes they provoke anger.

        So when a patient has symptoms that are hard to verify, such as fatigue, pins and needles, pain without a clear source, numbness, brain fog… and tests come back negative, it’s easy to switch into “blame the patient” thinking: This patient is either mentally ill or lying about their symptoms.

  • Doug Capra

    Here’s the lesson for other doctors who think that most patients speak up and really give them feedback. They don’t. We have an example here of a physician who is hesitant to speak up and complain. The physician has a peer-peer relationship with her doctor. Ah, but not so. The physician is now in the “role” of “patient.” Read about Erving Goffman’s research and learn about Dramaturgy. The roles we play or are forced into can change everything. If doctors who undergo surgery are hesitant to speak up and complain about this kind of behavior — imagine how difficult it must be for patients who are not medical professionals to do so. These are the kinds of narratives that should be read by every medical school student in a special class dedicated to this topic. Physicians who think there is little power dynamic between them and their patients, are misinformed. Physicians who think that wide-eyed nods of approval are always true informed consent, are also misinformed. Not with behavior as described in this post. It’s a rare patient that will speak up and tell a physician like this to wise-up and behave. And if they do, they’re too often labeled and forced into the “role” of the “bad” patient.

  • ethanspapa

    Went to see a neurologist . Had a 2.5 cm mass pressing on my lower spine. He walked into the room after quickly looking at the films and said you can’t be any pain, goodbye. I called my insurance carrier and told them not to pay his fee. I got a call from his office staff later and asked what the problem was. I said you’re working for it.

  • lurking for answers

    “I chose…based on his credentials and the quality of training and experience listed on Healthgrades.com I had no personal recommendations to rely upon — so I used what I thought was a reasonable method for finding a good local doctor.”

    Is there a better way to do this?
    What if the doctor you’ve chosen won’t take you at all?

  • Kaya5255

    My husband encountered a very similar situation last year with his GI.
    Unlike your husband who just sat there and didn’t defend you, I looked at my husband and said, “get dressed! We’re leaving! No one who pays as much as you do has to put up with that attitude!”. I thought the doc and the staff were going to faint! I had the nurse remove the IV. My husband dressed and we left…..never to return.
    My husband was shocked at first, but then realized I was 100% correct. I was thanked for being his advocate.
    I did get a call from the practice manager, who was profoundly sorry, but the damage was done. Neither of us will ever recommend the doctor or practice to anyone.
    Until health consumers assert their rights, nothing is going to change.

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