I was spending time with friends and family over the holiday when I started to experience various vague symptoms without an obvious etiology. Having been treated for high blood pressure about ten years prior before successfully overcoming the issue with exercise, I immediately recognized the return of the condition. (As an aside, it should be stated that elevated blood pressure typically produces no symptoms at all.)
Stopping by my local pharmacy, I silently accepted reality as the cuff from the blood pressure machine eased off of my arm reading a disturbing 165/100. I was going to need medicine again, at least until I can reorganize my lifestyle. While I will be the first to admit that I could lose a few pounds, the floundering job market for radiologists, coupled with living in an unfamiliar city, seemed to be taking its toll on my health.
The casual reader may wonder how a doctor chooses a doctor. In my case, I simply picked a clinic associated with a hospital I’d prefer to be admitted to and asked for a doctor with the soonest opening. The doctor I was assigned turned out to be a fellow of the American College of Physicians with over 20 years of experience and was a former teacher of residents in addition to being married to a radiologist. When I walked into the exam room, I also learned that he was a fitness buff of sorts, as his wall was decorated with various photos of marathon completions and certificates.
It was not hard for me to get the inexpensive medicine that I’d requested in addition to the screening colonoscopy that I was due for given my family history, however, much of the session turned into a lecture session about my diet. While I do feel that every physician should absolutely discuss food intake with patients and recommend healthy options, engaging a former molecular biologist in a discussion regarding GMO foods is something that belongs in the barber shop, not the doctor’s office. I wasn’t impressed. The key to a successful lifestyle discussion starts with what caused the correctable behavior in the first place. I didn’t come for a lecture. I didn’t come to be made to feel worse.
I get it. My body mass index is 30 which is technically obese, but world class bodybuilders are obese according to this definition as well. Good medicine takes all factors into account, and had he performed a physical exam or attempted to empathize with my personal circumstances, we may have been able to establish the sort of trust that is necessary for a successful doctor-patient relationship. He never picked up on the fact that I couldn’t wait to get out of the room or why.
It amazes me that someone with so much experience as a doctor had forgotten the very basics they teach you in medical school. When I first meet a patient, the initial moments I spend in the room are used to gauge what kind of vocabulary I am going to use so that we can communicate on the same level and how I can make sure that the patient gets the most from our encounter. To this doctor, I was a list of lab values and vital signs just like any other patient. He barely looked up from the paper.
Next came a laundry list of unnecessary tests, all offered in his office, of course, some of which I simply declined. No attempt was made to explain why I needed what he wanted or what he was going to do with the results afterward bearing in mind that I, too, spent a year as an internal medicine physician prior to residency. The fact of the matter remains that I may have agreed to some of what he wanted. He just failed to, as they say in the car sales industry, “earn my business.”
I went back for a follow-up six weeks later, and as expected, the blood pressure medicine worked. My colonoscopy was basically normal. He didn’t ask about medication side effects even though I was visibly coughing in front of him. The doctor’s advice? “Now all we need to fix is fat Cory.” As I glanced at the bill before I left, I couldn’t help but giggle at a $45 charge for weight loss counseling. I didn’t schedule another appointment.
I just wish I hadn’t shared this story with the last person I spoke to at a job interview who asked me what I thought was wrong with health care in the U.S. In reflection, I think she may be this doctor’s wife. I may need to add another medication. Does anybody know of a good doctor?
Cory Michael is a radiologist.
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