Doctors and Why Trust Matters

trust-me

Last week, I became ill on the way home from a long trip to Asia. In fact, I saw a doctor at the airport in Hong Kong to get some relief. Still, I had a long, painful flight home. I knew I needed to see a specialist when I got home. My wife made an appointment with a doctor I had never met before. I came in on a Wednesday morning, showing ID, an insurance card, and of course, a debit card. I was informed of the payment amount, and given a cup for providing a sample.

I then saw the doctor. He was focused on a laptop inputting information. He asked me several questions. I did too. He informed me that the medication I received in Hong Kong was not the best choice, though he didn’t say just why. He told me he was going to give me some new prescriptions. He also stated that I needed to go through some additional tests to figure out what was really causing the problem. No explanation as to why I need the tests, or what they would tell me, other than they would indicate what was wrong. Little was done to get to know me, or to establish a relationship.

I was asked to make a follow up appointment, along with a time to do a follow up lab and a script for getting a sonogram. The medications seemed to help, and I gradually began improving. Often when going to the doctor, I just get the meds and move on. But I wanted to be sure I was really well, and that there weren’t problems. I came back the next day to the office to take an additional test. The following day, I paid to have a sonogram performed at a nearby imaging center.

Those events happened between a Wednesday and a Friday. On Monday I called the doctor’s office. After being placed on hold three times, I explained to a staff member that I needed to know the results of the three tests, as I was traveling the next day. I was almost out of the antibiotic, and also wanted to know if I needed a refill. The nurse explained that I needed to set an appointment to physically come in and see the doctor to find out the results. I told her I had set an appointment for the following week, but I explained that I was leaving town the next day, and though I had set an appointment to see the doctor the following Monday, I needed to know the results of those tests that day.

After considerable discussion, I’m irritated. I’m being told that they don’t share confidential information over the phone. My wife mentions that’s a stark contrast to the doctor downstairs below him who actually provides you with a PIN that you can use to get that information over the phone. With the excuses of not simply having the doctor talk to me over the phone, I’m beginning to feel that the results of these three tests I’ve already paid for are being held hostage.

Finally, after some frustrating discourse, I was given the option to have a consultation with the doctor over the phone—of course that will come with an advanced payment of $75. I’m upset that I have not only paid to have these tests, but now I’m paying to find out the results of these tests. I’m livid about this—but I have a trip the following day, and I really need to know what’s going on. I agree to the consultation.

Later that afternoon I get a call from the office. She informs me the doctor is ready to talk to me as soon as the payment is taken care of. She also notes that insurance wouldn’t be applied to the appointment, but that the payment for chatting over the phone was less than coming in to visit—so it was still a good deal. I pay for the call, and soon I’m with the doctor. The doctor inquires as to my health. Fortunately, I’m doing really well, and that I seem to be improving. I mention having gone through the antibiotic, but he says that I should be fine and not need anything more. I ask about the results. He says they suggest that I probably did have an infection (what the doctor already told me in Hong Kong). But he then notes that I need some additional tests to determine how I became ill. He indicates that the problem could still suggest other potential problems such as cancer. He informs me that his “girls” will contact me to set up appointments.

Five minutes after the call the office calls me back wanting to set up appointments. I let the call go to the messaging machine. Where earlier in the day I feel happy for my improvement, I now have this foreboding feeling—what if there is something else wrong with me? What if I go 30, 60, 90 days and then all of a sudden things start to flare up—or get worse?

My wife suggests that we be thoughtful about what next steps we take. She shares an event last year where she was being asked to go through a sonogram. Her regular doctor, who happened to be in the room at the time, looked at my wife, then looked at the nurse and said—she doesn’t need a sonogram. She needs to go home. Rolling his eyes, the doctor said, “So many times they are milking you for tests you really don’t need.” My wife wonders if I’m not being led down a similar path. We lament the passing of a time in our lives where we simply trusted what we were being told by medical professionals as being the truth.

What happened?

  • Little effort was made to initially build the relationship
  • Little explanation was given to the “why” behind the “what”
  • Shallow excuses were given as to why I couldn’t talk to the doctor informally over the phone
  • Involvement with my insurance was shelved in favor of a “lower price”
  • Results for tests I paid for were held hostage to paying additional money
  • Dismissive language was used when referencing fellow staff
  • No conclusive information is given–only requirements in doing further paid tests
  • Processes support the practice, not the patient

Make no mistake. This doctor did provide medications that have made me feel better. But the doctor’s demeanor as well as the office practices in place make me feel like he’s there to milk whatever they can get out of me. The results for tests I pay for should not be made hostage. I may seek further consultation. But it will be with a different professional. In the end, it’s not just about health. Trust also matters.

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