Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Patients can lift doctors up during a challenging day

Linda Pourmassina, MD
Patient
April 4, 2011
104 Shares
Share
Tweet
Share

I will be leaving my current practice in a couple months and starting work at a different clinic in a different city. This type of transition really brings to light how much I had really gotten to know patients on a personal level. This became surprisingly clear not too long ago.

One day, I saw a patient on my schedule that had historically required more of my emotional energy. We often have patients like this. It is the nature of our job (unless we are anesthesiologists or radiologists). Let me tell you about this particular patient.

Our relationship started simply enough a few years ago. He was middle-aged, healthy, and on just one medication for a relatively simple medical issue. He would come in yearly and get this refilled for a whole year. He was happy-go-lucky, it seemed. Unfortunately for him, he inherited me as his doctor when his prior PCP relocated. I ordered some overdue screening labs that led to a cascade of other events. Now, thanks, to me, he is on multiple medications. He told me this outright, by the way – that things were essentially better before I took over his care.

At every appointment I would find something else wrong, something else that needed tweaking. The condition that he has is relatively “silent” so, to him, I was just pumping him with drugs for no reason. I had turned his world upside down.  At every visit I dreaded having to tell him that he should be on another medication or that a lab was abnormal. I began to feel that I was perhaps overwhelming him, so I started to pick just one thing at a time to reveal to him.  Every time he saw me, I felt he disliked being in that exam room with me, listening me telling him to do this or that. That translated into hesitancy on my part.

Through all this, though, I tried to listen to him and to engage him in decision-making. I tried my best to educate him on why every step was being taken. I would always ask how he felt about this or that particular approach, but he seemed to just begrudgingly go on with treatments.

There was one particular day I was sure he was going to be done with me as his physician. I had sent him via ambulance to the ER when his labs came back showing an elevated potassium level (I checked it twice to be sure) and an abnormal EKG. He didn’t have any symptoms, but I feared a cardiac event could occur. The ER doctor, having had the opportunity to see that the potassium level returned to normal on the 3rd check in his lab, suggested to the patient that I had overreacted. This set the patient off. He came back and basically laid into me. He vented and vented. I could only listen in silence. At the end, I addressed all his questions. I know with my knowledge of medicine AND with my gut that I had done the right thing for the patient. Any good physician would have done the same. But I empathized with him and gave him the option of seeing another doctor within our group. I was sure I wouldn’t see him again.

A few months later, he was in my schedule.  And he kept coming back. I didn’t understand why. But I continued with business as usual, trying my best to manage his illnesses without getting to the point of overwhelming or frustrating him, the discontent from that prior incident still very clearly in my memory.

It was business as usual, that is, until the last time I saw him. Two of his major medical conditions were now well-managed. We were getting close on the third. But it was the day I was going to let him know of my relocation. I was certain he would be elated. I had come to believe that he felt he was “stuck” with me.

On the contrary, he admitted that the news was going to make him cry. To be honest, I did not realize he was serious – he tends to like to joke around – but there was a period of silence before the visit ended. “Thanks for putting up with me,” I joked. The nurse that was tending to him after I left the room said that she had “lost him” after I gave him the news. She said that he felt that I was his only doctor, the only one he would listen to.

Sometimes appreciation can feel sparse in a field that is built on trying to fix problems. Sometimes a kind word from a patient can lift us up during a challenging day. I have had many patients who have done just that. But on this particular day, this patient’s silence was the most touching and heartfelt expression of gratitude. I completely misjudged the nature of our relationship. The mere fact that he kept coming back to follow-up with me should perhaps have been a clue, but the confidence I now realize he had in me reminds me why I chose to do primary care. It also taught me that doctors and patients alike should not “give up” on each other hastily. It taught me that fixing every single problem in one visit is not always the answer. The best medicine sometimes involves a careful consideration of a patient’s own “pace” or ability to digest complex information that seems simple and straightforward to us. It taught me that sometimes patients are listening to us, even though it may seem to be the contrary. He taught me a lot that day.

A doctor-patient relationship truly is like no other when it works well.

Linda Pourmassina is an internal medicine physician who blogs at Pulsus.

Submit a guest post and be heard on social media’s leading physician voice.

Prev

After the ACO regulations: Accountable care organization answers

April 4, 2011 Kevin 11
…
Next

The Relative Value Scale Update Committee (or RUC) impact on health care

April 5, 2011 Kevin 7
…

Tagged as: Patients, Primary Care

Post navigation

< Previous Post
After the ACO regulations: Accountable care organization answers
Next Post >
The Relative Value Scale Update Committee (or RUC) impact on health care

More by Linda Pourmassina, MD

  • How physician education is similar to Master Sommelier training

    Linda Pourmassina, MD
  • What doctors can learn from working at Starbucks

    Linda Pourmassina, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Dr. Google is currently only medical student Google

    Linda Pourmassina, MD

More in Patient

  • There’s no one to drive your patient home

    Denise Reich
  • Dying is a selfish business

    Nancie Wiseman Attwater
  • A story of a good death

    Carol Ewig
  • We are warriors: doctors and patients

    Michele Luckenbaugh
  • Patient care is not a spectator sport

    Jim Sholler
  • Me is who I am

    Michele Luckenbaugh
  • Most Popular

  • Past Week

    • The untold struggles patients face with resident doctors

      Denise Reich | Conditions
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Beyond pizza and pens: National Doctors’ Day should be about saving lives

      James Young, MD | Physician
    • Physicians are a finite resource we need to protect

      Jack Resneck, Jr., MD | Physician
    • From clocking in to clocking out: the transition to retirement

      Debbie Moore-Black, RN | Conditions
    • How understanding cultural backgrounds can lead to better patient care [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • The Titanic sinking: a metaphor for the impending collapse of medicine

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD & Shreekant Vasudhev, MD | Physician
  • Recent Posts

    • How understanding cultural backgrounds can lead to better patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • From license to loneliness: the dilemma of retired physicians

      Richard Plotzker, MD | Physician
    • Tackling the health care crisis with artificial intelligence: Combating physician and nursing shortages in the United States

      Harvey Castro, MD, MBA | Tech
    • From hope to heartbreak: a story of loss in the ICU

      Ton La, Jr., MD, JD | Conditions
    • Unlearning our habits: a journey from intelligence to wisdom

      Brian Sayers, MD | Physician
    • Lessons from an orthopedic surgery journey [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Experts Call for PBM Transparency During Senate Hearing
  • Want to Fix Medicare Pay for Primary Care Docs? How About Two Fee Schedules?
  • OTC Narcan Approval Opens New Doors in Fight Against Opioid Crisis
  • U.S. 'Flying Blind' When It Comes to Data on Substance Use in Pregnancy
  • Fear of Family Separation a Barrier to Addiction Care During Pregnancy

Meeting Coverage

  • VTE Risk in Recurrent Ovarian Cancer Increases With More Lines of Chemotherapy
  • Obesity's Impact on Uterine Cancer Risk Greater in Younger Age Groups
  • Oral Roflumilast Effective in the Treatment of Plaque Psoriasis
  • Phase III Trials 'Hit a Home Run' in Advanced Endometrial Cancer
  • Cannabis Use Common in Post-Surgery Patients on Opioid Tapering
  • Most Popular

  • Past Week

    • The untold struggles patients face with resident doctors

      Denise Reich | Conditions
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Beyond pizza and pens: National Doctors’ Day should be about saving lives

      James Young, MD | Physician
    • Physicians are a finite resource we need to protect

      Jack Resneck, Jr., MD | Physician
    • From clocking in to clocking out: the transition to retirement

      Debbie Moore-Black, RN | Conditions
    • How understanding cultural backgrounds can lead to better patient care [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • The Titanic sinking: a metaphor for the impending collapse of medicine

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD & Shreekant Vasudhev, MD | Physician
  • Recent Posts

    • How understanding cultural backgrounds can lead to better patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • From license to loneliness: the dilemma of retired physicians

      Richard Plotzker, MD | Physician
    • Tackling the health care crisis with artificial intelligence: Combating physician and nursing shortages in the United States

      Harvey Castro, MD, MBA | Tech
    • From hope to heartbreak: a story of loss in the ICU

      Ton La, Jr., MD, JD | Conditions
    • Unlearning our habits: a journey from intelligence to wisdom

      Brian Sayers, MD | Physician
    • Lessons from an orthopedic surgery journey [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Patients can lift doctors up during a challenging day
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...