6 things you know that your doctor doesn't

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We doctors may be intelligent but we are not always smart. Some things that are obvious and well known to our patients completely escape us. Here are some important things you know that we probably don't.

1- Our explanations are so confusing that you have no idea what we are talking about.

We think you understand us, but we are often wrong. We are so accustomed to using big words and medical terms that we can talk for 10 minutes and not say anything that makes sense. I recently observed a student interview a young patient about migraines. She asked, "Do you have an aura?" The patient replied, "No." I then asked the patient if he knew what an aura was- "Nope!" He had no idea! This kind of  poor communication is common. Tell us when you don't understand. You deserve an answer that makes sense.

2-How much your medication costs.

Medication costs vary widely and many doctors have no idea how expensive a prescription is. I have seen patients pay $115 for a prescription at a major chain pharmacy that could be purchased for $10 at a discount store. I have also seen dermatologists prescribe an expensive brand name acne antibiotic instead of a generic version of the same medication. The difference in cost- $900 a month! The dermatologists had no clue! Tell your doctor when your medication is expensive and ask for other options.

3- How rude or nice the office staff is.

Doctors are often very poor business managers. They are frequently unaware of the customer service provided by their staff. They probably don't know how long you were on hold, how abrupt the staff was when you arrived, are how long you waited before your needs were addressed. Before leaving and finding another doctor (with equally rude staff), let your doctor know how you are treated.

4- Your Name

This one is embarrassing. I frequently encounter patients while out at the movies or shopping. Many times I am better at remembering diagnoses and medications than I am a patient's name! On more than one occasion I have made my wife hurry down a different store aisle to avoid seeing a patient whose name I could not recall! Be kind and reintroduce yourself!

5- What your insurance covers

Most doctors contract with multiple insurance plans, all of which have different rules, provider networks and conditions for coverage. We just can't keep up with it all. You may be more likely to know which lab to use, what hospital to go to or what your co-payment is than we are. It is wise to confirm with your doctor or insurer before getting tests or X-rays done or before seeing a specialist.

6- How worried and frightened you are

We deal with illness every day. You don't. As a result we may forget how frightened you are of a serious diagnosis. We sometimes say things like, "We want to make sure it isn't cancer," and think we are being reassuring. What the patient hears is-"You might have cancer!" Fear and panic may set in. Cancer may be low on the list and we may just be being thorough, but our words cause needless worry. If you are worried or fearful, tell us! 

 We are doctors and we are educated, but we are still people, with all of the limitations that come with being human. Communication is a common weakness. Our patients are uniquely equipped to help us do better, because you know things we don't!

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The Key to avoiding conflict in your marriage

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Ever wonder why you fight? A recent patient interaction illustrates a common reason-

The visit was for a physical. His form stated his marital status as “divorced” so I asked him about it. They had been married for 26 years. It had not always been wonderful, but he thought they were making progress. A few months prior to the visit he went for a week long trip, and when he returned she was gone, packed up and moved back in with her parents. No real reason as far as he could tell. They had discussed “it” many times, yet he still wasn't sure what had happened.

I wasn't sure how to help him understand, so I simply did what Family Doctors are trained to do. We are taught that common things occur commonly, so I looked for a common cause of "unexplained" conflict. Frequently, sudden decisions are emotional decisions, so I ventured a guess- maybe she just felt really unhappy and didn't know why.

 “Some people are very emotional, and just feel things," I said, "the feeling is so strong that they just believe it,  and then afterwards work to develop an explanation for the feeling. If you try to rationally show them why their explanation doesn't make sense, they may not be able to let go of the feeling. Instead they will just come up with another explanation, and then another.  Since they feel it so strongly, they are sure it must be true. Maybe she just felt really unhappy, and you were blamed.”

“THAT'S IT! YOU NAILED IT!” He replied.

While diagnosing the cause of the conflict was easy, providing a cure for such conflicts is not. How do you deal with conflict that is based in emotions? The key is to realize it is an emotional conflict and to learn that emotions can't always be trusted.

A question I often ask people who seem to be driven by emotions in this- “Is it possible to feel something strongly and believe something deeply and be wrong?” Almost everyone answers "yes," but then is stumped by the follow up question, “So how do you know when you are right?” If we can't trust our feelings, what do we trust?

Stories such as this patient's lead to me to reflect on my own marriage and how we have been able to avoid such conflicts. I think it might be because as people of faith we believe that our own thoughts and emotions are inherently flawed and untrustworthy. We naturally question our feelings and measure them by an external standard. (As Christians, it the teachings of the Bible that provide us with a standard.)

For people who have no such external compass, no standard by which their thoughts can be measured, resolution is much more difficult. When spouses disagree it devolves into an argument about which person is “right” and which person is “wrong.” The dispute is either “won” by the better debater, or by the person whose feelings are the strongest. Most often, no one wins and the conflict is never fully resolved.

Personally, I have learned that when I start from a place of "Maybe feelings are wrong," agreement is less elusive, and arguments and conflict can be avoided. (Of course if I start with “I am wrong and she is right” there is no argument at all!) Next time you have a conflict, don't automatically trust your feelings. Question your emotions, and challenge your thoughts. You may be surprised.

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8 Memorable Christmas Gifts

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The gifts we remember the longest are not always the best or the most expensive. It is the gifts that create memories, the gifts that are a part of a story that endure. With that definition in mind, here are some of the most memorable gifts I gave or received-

1- A blue 3-speed bike, with a basket. The gift embodies my childhood. My older brother got a 10-speed, the ultimately cool bike of that era, and my twin and I got 3-speeds with a basket. It's good I was too young for a man card, for a bike with a basket would have resulted in instant revocation. To add insult to injury, on the inaugural ride later that morning I didn't pay attention to where I was going and crashed into the neighbor's camper and damaged the bike.

2- A ukelele. There is nothing wrong with a ukelele- I just didn't want one. At All. I had been taking banjo lessons, so somehow my father concluded that I would like a ukelele. Uh... no. It is reminds me how, as a child of divorce, my father did not know me very well at all. (He apparently knew my twin brother who got a totally awesome catcher's mitt! But I am not jealous...)

3- A table-top Pac-man video game. A gift from Lisa our first Christmas together. I played it for hours. It is a part of one of our favorite memories, as I took it (and a large container of her awesome Christmas sugar cookies) with us on a weekend trip to Big Bear. We stayed in a rickety cabin, it snowed, and we found a secluded hill where we inner tubed in the fresh snowfall. Best. First. Christmas. Ever.

4- Stinky golf-ball Christmas ornaments, emblazoned with cheesy golf cliches. I am not making this one up. My mother, who I rarely saw, came by my office unannounced to drop off the “gift”. The packaging reeked of smoke, and the ornaments were not suitable for any sane person's Christmas tree. A symbol of my relationship with my my mother, wrapped in a bow.

5- A Jane Fonda workout tape. I actually gave this to Lisa. What kind of an idiot is so stupid as to give his wife a workout tape for Christmas? This kind of idiot.

6- A photo mug. Lisa took 6 year-old Nate and one year-old Jamie shopping at the mall. They posed for one of those “put your photo on a mug” mugs to give me as a gift. Nate was so excited. He burst through the door when they got home, loudly proclaiming, “Daddy, we got you a mu-,” before realizing he wasn't supposed to say anything! We still laugh at this one.

7- Puff paint T-shirts. We were tight on money in 1989. It was my last year in medical school, and Lisa was 8 months pregnant. We set ourselves a limit of $25 to spend on each other, so I bought T-shirts and a Teddy Bear stencil. I painted bears on the shirts, one for each of us, and wrote the words “Baby Barrett”, “Mommy Barrett” and “Daddy Barrett” on the t-shirts. The shirts were a big hit. It was not then, nor is it now, about the money.

8- A bat handle hat rack. In 2004 I moved into my new office. Each room has a theme, and for the baseball room I wanted a baseball bat hat rack. I had seen one online and thought it would be awesome. I put it on my list. My father-in-law couldn't find one to buy online, so he made one. He went to a bat factory and bought broken bats for two of the handles, and then made two bat handles on his lathe. It was perfect. He was like that. He made things for the people he loved, and he made it clear then that he loved me. It was the last Christmas I shared with him (he died 4 months later) but the gift and the memory remain.

These are some of my memories, I would love to hear yours. Here is praying that your Christmas will be filled with wonderful stories and happy memories, but most of all that you will remember the greatest Gift of all, the Savior who was born.

Got any gift stories? Share them in the comments!

 

You may be praying wrong

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Our adult group sends out prayer requests through email a few times a week. As I am sure is the case with many such groups, these requests primarily revolve around physical and financial issues- someone is sick or injured, or someone is in need of a job. Pretty standard stuff. With this mindset of community prayer, as I was reading through the book of Colossians, I was struck right off by what Paul prayed for. Early on in Chapter 1 vs 9 he declares his prayer for the recipients of his letter-

“we have not stopped praying for you and asking God to fill you with the knowledge of his will through all spiritual wisdom and understanding. And we pray this in order that you may live a life worthy of the Lord and may please him in every way: bearing fruit in every good work, growing in the knowledge of God,”

He prayed-

  • That they would be filled with the knowledge of His will, through all spiritual wisdom and understanding

  • In order that they might live a life worthy of the Lord.

    It is interesting what he did not pray for. He did not pray for a change in their circumstances or improvement in their earthly condition! I wonder if that is why he prayed they would “get” God's will. Makes sense to me, as recognizing and understanding that my current crummy state is in fact God's will for my life is definitely going to require a wisdom I do not currently have!

Wonder also, if Paul was hinting that God's will for us is something that is different than what we would think or expect. Paul seemed to have a much better understanding of the long term will of God, His eternal plans and design, and a greater ability to live his life with that in mind. In fact, it seems that Paul's ability to endure all of the ridiculous abuses and persecutions he faced came about as a direct result of his ability to place things in the correct eternal context.

This is suggested by the second part of Paul's prayer, his reason for praying for understanding of God's will, “that they might live worthy lives”. Worthy means “appropriate”. He wanted the Colossians to live like the children of God that they were.

In the office I had a conversation with a Christian who is an alcoholic. The patient had been trying to serve God, but continued to battle a drinking problem, one day teaching a youth Bible study, the next day downing a whole bottle of wine after dinner. As I tried to encourage the patient, I shared my favorite line from the Lion King- the scene where the “ghost” of Simba's father says to him, “Remember who you are.”

I shared, “Remember who you are, you are a child of Almighty God, chosen by Him from all eternity to be his child. God wants you to live like it!”

As we talked, it was clear that part of the reason for the drinking was a focus on earthly struggles which distracted from a true understanding of the eternal will of God. And that the correct prayer was not simply, “Help the drinking stop”, but rather, “Give a full understanding of your Person and your eternal will, the perspective that will allow this person to live a life worthy of you, a life free from alcohol and focused on your kingdom.”

I need to pray better! How about you?