What is your expectation when you visit a physician?

As a physician, and as an interventional radiologist, I consult with many patients. Similar to anyone who sees and talks with many people, I encounter a significant diversity of personality types, cultures and attitudes. One thing I have noticed is that each person has a certain level of expectation regarding their care, illness, and our potential interaction.

I have visited with many people who are simply happy to have someone who cares enough to sit and talk to them about their options, saying to me “You’re the doctor. We are comfortable with you.”

Others are more probing, with pen and paper in hand, asking many questions regarding their illness, and wondering what I might do for them. Their knowledge of the current situation is helped by the vast amount of information available on the internet.

Yet others are annoyed with the last physician(s) they saw and want to know what I can offer them in the way of honest discussion and appropriate care.

I could go on listing the various types of people we physicians encounter. They are not dissimilar to the types of people that anyone in a service industry may encounter. All of these personality types or behaviors are absolutely appropriate. Depending on a person’s experiences, one will fall into one of these “categories” or any number of other potential groups that I haven’t even listed.

But the underlying aspect to all of the possible groups that patients may fall into is simply “expectations.”

What is your expectation when you visit a physician? Do you know what the physician’s specialty is and what his/her role will be in your care? Has your primary/referring physician explained anything or nothing about the upcoming consultation?

I find many people who visit me for a consult are relatively prepared and basically understand why we are sitting in front of each other.

But more importantly, I also find, once in a while, that some patients expect that the person sitting in front of them will “fix” or “repair” their illness and make it disappear, completely resolving their issue and relegating it to the distant past. While we physicians would love to be able to cure every person we see and heal any ailment, it is unusual to completely return a person to their pre-illness state. There will always be some residual such as a scar.

For instance, if I treat a woman for bleeding related to enlarged fibroids by performing uterine fibroid embolization, those fibroids will not disappear. They will always be present on the uterus, though they will shrink by about half their original volume after treatment and should no longer cause the symptoms that prompted treatment.

If I treat a man who has a varicocele, that tangle of veins will not disappear, but should shrink as well. Any testicular atrophy that may have occurred as a result of the longstanding presence of the varicocele will probably be arrested, but will not reverse.

Many other illnesses are similar in that we physicians can offer improvement in symptoms, but not necessarily removal of the aesthetic changes that have already occurred. This is not a failing of the treatments and does not indicate that the treatments being performed are inadequate. It is simply a matter of understanding the disease process and keeping our expectations realistic and appropriate to the goals of treatment.

So the next time you visit a new physician to discuss options for treating a particular illness, please make sure to evaluate your expectations and gauge whether they are realistic and appropriate to the current situation. Your consulting physician should be able to help you understand the situation as well. And of course ask as many questions as necessary so you feel satisfied with the course of action being offered in your care.

Paul Dorio is an interventional radiologist who blogs at his self-titled site, Paul J Dorio, MD.

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