July 15, 2011

May I See Your Resume, Doctor?

My husband says I should wear a sign that says advocate...with a pair of devil horns.  It seems I always have the opposing viewpoint in a discussion...I say it's because I think all the way around a scenario.  Tomayto, tomahto.

Regardless, I do ultimately tend to speak for the unpopular opinion...and I'm about to do it again.

Image found here...and I think you can buy it, too!

I am a HUGE supporter of the educated patient.  I very firmly believe that the best thing a patient can do for him or herself and their doctor is to learn about their condition(s), risks, treatments, etc.  And, I hear stories every single day (literally) about doctors who obviously didn't know their head from a hole in the ground based on the absurd, uneducated, or downright negligent things they've said. 

It needs to be said: we need to trust our doctors.  They know things we don't.

Hang on, put down your pitchforks and hold back the angry mob, hear me out (ha, haha, a devil joke, get it?  I don't think I can write a post without a pun these days).

Image found here.  This one's not for sale.

I know the right (nay, need) for a patient to think independently and not blindly rely on the initials MD or DO to lead them is a huge rallying point, and for good reason.  But ultimately, we see doctors for guidance - or at least we should.  I don't go to doctors just because they have the legal right to order my prescriptions, I see them because I need someone more knowledgeable than me to take responsibility for keeping me in tact.

We've all encountered the doctors we're pretty sure graduated medical school by a fluke in the system which gave everyone passing grades; the ones who didn't believe our symptoms were real; the ones who told us things like "live with it", "it's part of aging", or "there's nothing to be done".  But I suspect the solution isn't to write off every doctor as a hack.

Instead of resigning ourselves to ignorant doctors and taking the responsibility for everything on ourselves, maybe we should learn how to recognize a good doctor from a bad one!

My rheumatologist (who I consider to be the captain of my health ship) has my trust.  There are certain things I believe just because she's told me so - but boy did it take a lot for me to trust her that much.  I can't research everything afterall.  Since I've found someone I'm that comfortable relying on, I thought I'd share some of the ways I go about finding, evaluating, and staying with a good doctor.

Finding a GOOD DOCTOR:
1. Get referrals - but dig deeper.
Referrals are great.  I'd MUCH rather spend my limited time & money seeing someone that has been recommended to me than a complete shot-in-the-dark stranger.  But just because someone does (or doesn't) like a doctor doesn't mean you're going to feel the same way.  Getting a name is great...but ask some follow up questions: why does your friend like this doctor?  What does this doctor do for them that others don't?  Are there any drawbacks or negatives to this doctor that they choose to accept in order to get the positives?  This will help you consider if this doctor will work for YOU and YOUR life.  The same goes for online rating & review sites.

2. Sometimes those who CAN do, teach.
The first places I turn when I need a new doctor are my local teaching hospitals.  While not a guarantee, I find many doctors associated with these hospitals have a few great traits: they tend to be better at explaining things, they're more receptive to self-educated patients, and they tend to have knowledge of the most recent developments (heck, sometimes they're even part of them)!  Living near Philly, I know I have a surplus of these institutions at my disposal, but sometimes doctors at these facilities will also have locations that may be closer to you.

Evaluating a GOOD DOCTOR:
3. Get answers.
Please note - I didn't say "ask questions", I said "get answers".  We all ask questions, but we don't all get answers to them from our medical team.  One of my favorite examples of what I think a good doctor should be able to do is answer "how will this medication help me?".  Things that do NOT count as answers:
*It will make you feel better (this is arguably the worst answer)
*It reduces inflamation (sounds good...but you end up with no more information or understanding than you started with)
*The hydrosomethingdohicky combines with the gobbletygook via the Hokiepokie Reaction thereby minimizing the inflamatory reaction you're experiencing (this person is either being condescending because you dared to question them, or may just be completely out of touch with reality - neither is good)

An example of a good answer might be: "This medicine combines with a chemical already in your system, which will interfere with the Hokiepokie Reaction that causes you to experience inflamation.  By interupting the Reaction, you will have less inflamation overall".  This answer isn't attempting to talk over your head in 'doctorese', but actually gives you information on the mechanism at play.  Think of it this way, if you can't explain to your friend why you're taking something and how it actually helps, your doctor isn't 'answering' your questions.  (BUT - to be fair, you may never have really asked or driven at a better answer.  Give your doctor a fair chance by making sure you're asking questions and letting them know if you still don't understand.)

4. R-E-S-P-E-C-T.
A doctor, like anyone else you turn to for guidance in your life, should help you be realistic but still true to your priorities.  For people with many chronic conditions, this can be trickier than it seems.  One way I knew my rheumie was a winner was during a visit while I was in college - we were discussing my weight and certain musculoskeletal symptoms, and instead of telling me to find a way to work out she said "well I know your schedule isn't going to change until school's over so let's figure out what to do now".  I think I actually did a double-take.  All other doctors (before and since) basically look over their glasses and give me that "now child, we know you're just being lazy" stare while telling me to find a way to work out somehow.  This doctor acknowledged the priorities I had in my life at that point (certain organizations, classes, part-time job, etc) and wanted to work within that, at least for a while.  Now that my schedule is indicative of a more lasting lifestyle, she does encourage some changes when necessary - trying to find more downtime (ha, haha, hahahahaha), actually finding ways to incorporate some reasonable amounts of exercise, and so on - but she knows if her advice doesn't jive with my life, I won't listen to it anyway.  One question she asks at every single visit is how my marriage & husband are doing...now that's a doctor who's concerned with my LIFE, not just my Sjogren's.

Staying with a GOOD DOCTOR:
5. Determining your limits.
There's a world reknowned Sjogren's specialist in my backyard here in Philly - I was actually a patient for a brief time.  Unfortunately, there's a group of us who used to see this doctor but eventually left the practice because of the office staff.  My experience included weeks of unanswered messages, undelivered test results, even unfilled prescription requests, and I've been told I'm in good company.  It wasn't the doctor, but the front line of people a patient encounters are that inept, and it hurts the practice.  My current doctor's staff isn't perfect, I had some issues again with slow response times, messages that weren't passed on, and scheduling issues.  I also go to every appointment prepared to wait an hour or more for my visit if I'm not first that day.  So why am I willing to deal with staff problems and long wait times, but I left the previous doctor for similar reasons?  I have determined my limits and what is most valuable to me.

Personally, I value my doctor's care enough to cope with the frustrations I encounter.  I'm willing to wait for my appointment well past my scheduled time because I know I'll get a thorough exam and all my questions answered when it's my turn in the room.  The communication problems aren't as bad as at the former doctor's office, and I know that I can email my doctor directly if I have to and that once she gets my message she'll give it the appropriate attention.  While I'd prefer a perfect office to go with my perfect doctor, I'm ok with this situation.  Just like I expect my doctor to respect my priorities and lifestyle, I have to accept not everything in her office will be ideal.

It's funny - to find, evaluate, and accept a Good Doctor, we have to remember to view them as humans with imperfections.  Just like other relationships in our lives, the one we have with our doctors should be filled with acceptance and respect.  This way, we all come out ahead.


  1. Dear Jenny,
    I've read (and written) several posts on finding (or evaluating?) doctors, but I still found your post valuable & refreshing. These type of points are seldom included in such a post. I especially love point 3. Really makes us think about the process. Now, to *find* doctors who will answer!

  2. What a timely article... diagnosed a year ago and been seriously considering looking for a new Rheumy... well yesterday's visit included 4 very specific questions and each was answered with knowledge that showed his consideration for my wife's condition and if it would be useful in her treatment (and when the benefits out weighed the side effects / cost). This article states very well the feeling we had - a good doctor is a great find, and we have one.


I'm excited you're here - and can't wait to read your comment!

* Transparency Note *
If you are commenting as someone affiliated with a professional organization to promote said entity, please identify yourself as such. I'm not opposed to hearing from you or your organization, but must ask that you provide transparency by stating this for my readers and myself. Thank you for your compliance.