A Family Doctor Rant

I love my job and particularly enjoy taking care of my patients. Most of the time. Every once in a while I find myself in an unexpected debate with a patient over a straight forward issue. Some of these debates make me want to scream. In order to save my lungs and my sanity, I have decided to resolve some of the debates here.

1-Cholesterol medications are safe.

They have been prescribed for decades and have a long record of safety and effectiveness. They decrease heart attack risk by 20%. If you run into the patient I saw recently who was convinced that everyone who takes statins has complications and felt the need to argue this with me, tell him he is just plain wrong.

2-Colon cancer screening is the best cancer prevention test ever.

1 in 20 Americans get colon cancer. Less than 1 in 2000 people have a complication from colonoscopy. Sorry, patient who “had a friend” who told her the procedure was dangerous, but when you are 100 times more likely to be helped by a test than be hurt by it, you should get the test done.

3-Diabetes is a serious disease that needs serious attention.

Particularly for those individuals who are on insulin, consistent meals, in both timing and content, are a crucial part of managing the disease. Some of my patients with sky high blood sugars try to tell me that they can do it “their way”, but they are wrong. Winging it doesn’t work with diabetes.

4-The Physician/Patient relationship is a true partnership.

Good health care happens when patients and doctors work together. No, Mr. High Blood Pressure, you don’t get to take your blood pressure medications 3 months out of the year and expect to remain a patient in my practice! An essential truth about medications- they don't work if you leave them in the bottle!

5-“Feeling Good” and “Being Healthy” are not the same thing.

One might think, given all of the focus on prevention, that this truth was obvious. It isn’t. We have many patients who refuse to come in for follow up, refuse to get tests done and who haven’t had a check up in years. This is understandable when someone is 20 years-old but hard to accept when someone is 75. I had no choice but to accept it this week- a patient  hung up on me when I called to remind him!

I share these stories for two reasons. The first is to encourage people to not be one of these patients. Doctors do have the best interests of patients in mind and work hard to do a good job. It is incredibly frustrating to have to argue to get people to do the right thing. The second reason is to encourage a little grace when your doctor is grumpy. You never know what he may have been dealing with in the previous exam room!


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