Mean Patients by Val Jones MD

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As I sat in my orthopedist’s exam room, the discussion quickly turned from my chief complaint to his: “I don’t know why I’m doing this anymore,” he said. “Medicine is just not what it used to be, and I don’t enjoy my work anymore. The bureaucracy and regulations are bad enough, but what really gets me is the hostility. My patients are chronically angry and mean. The only comfort I get is from talking to other doctors. Because they all feel the same way.”

Perhaps this sentiment strikes you as the spoiled musings of a physician who is lamenting his demotion from “god” to “man” – reflecting the fundamental change in the public perception of doctors that has occurred over the past ~50 years. Or maybe you wonder if this surgeon’s patients are mean because he is a bad doctor, or isn’t respectful of their time? Maybe he deserves the hostility?

I’ve found this particular surgeon to be humble, thoughtful, and thorough. He is genuinely caring and a proponent of conservative measures, truly eager to avoid surgical procedures when possible. He is exactly what one would hope for in a physician, and yet he is utterly demoralized.  Not because of the hours of daily documentation drudgery required by health insurance and government regulators, but because the very souls he has been fighting to serve have now turned on him.  Their attitudes are captured in social media feeds on every major health outlet:

Doctors? I no longer afford that kind of respect: I call them “medical services providers.” They and their families and the medical cabal created this mess when they got control of med schools so that the wealth of a nation would remain in the hands of a few medical elites and their families. The very notion that doctors are smarter, more productive, more anything than others is ludicrous. They are among the worst sluff-offs of our society, yet the richest at the same time. It is an unreal world they have created themselves and they are now watching the natural outcome of such a false system.

The very best physicians have always been motivated primarily by the satisfaction of making a difference in their patients’ lives. That drive to “help others” is what makes us believe that all the sacrifices are worth it – the years of training, the educational debt, the lack of sleep, the separation from family, the delay (and sometimes denial) of becoming a parent, the daily grind of administrative burden, the unspeakable emotional toll that death and disease take on your heart… All of that is offset by the joy of changing and saving lives. But when that joy is taken from you, what remains is despondency and burn out.

What patients need to realize is that they have been (and still are) the primary motivator of physician job satisfaction. Patients have the power to demoralize us like no one else – and they need to take that power very seriously. Because if negative attitudes prevail, and hostility spreads like a cancer in our broken system, the most caring among us will be the first to withdraw.

And in the end all that will be left is “medical service providers.”

Val Jones MD blogs at www.getbetterhealth.com

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  5 comments for “Mean Patients by Val Jones MD

  1. November 2, 2013 at 2:40 am

    Have often heard doctors comment about the adversarial relationship they feel with their patients. Used work as a Med/Surg RN. Remember the family members posted by the bed looking for screw-ups and questioning everything. Perhaps too many Reader’s Digest articles about how hospitals are out to kill people through incompetence and ambivalence. Had a hard time not taking it personally. After all these folks are scared shitless. Since they cannot control the disease, they try to control everything and everyone else. We are encouraged to try to team up with them instead and to address their concerns. Difficult to do when they view you suspiciously. Amazing how many of them come out of the woodwork right before somebody dies.
    Frankly, had a hard time being polite, causing me much grief with the Powers That Be. Work in a Psych now, where families are not allowed in the ward. Find that much easier.

  2. John
    October 31, 2013 at 2:45 pm

    As the decades went by, more and more patient encounters in my FP practice seemed to consist of patients presenting their list of expectations and demands; then my explanation of why these could not all be met; then the patient’s leaving in a huff to get another opinion.

  3. Mark
    October 31, 2013 at 1:37 pm

    That is a well written article which speaks to my everyday experience as a physician. Well done, Val. It articulates exactly what I have been seeing occur in medicine these last few years.

    Doug- keep providing this type of material in Authentic Medicine. It makes me almost forget “Don’t Count on Pink to Save Your Hooters from Cancer” last week. Well, almost.

  4. Bridget Reidy
    October 29, 2013 at 3:25 pm

    There’s always been the mean and sceptical ones but what gets me nowadays are the liars. My scientific brain thrives on truth. My biggest source of dissatisfaction now in the US is I rarely encounter a patient that wants to let me be a physician: Tell me your acute symptoms honestly and not whatever you think will get the outcome you planned in advance, let me manage your chronic disease (ie ask what the diagnosis is, what other problems you have, and how well the medicine’s working before I refill it), have an honest discourse where if you don’t believe or care what science says no matter how convincing I am, don’t make me waste my time… Believe me it’s way better in Canada, and everyone’s nice too, though a little too unsceptical.

  5. Pat
    October 27, 2013 at 7:54 am

    Dr Jones absolutely nails it. I got into this work thinking it would be fun, never dreaming of the pandemic resentment borne of the entitlement mentality in the great majority of patients.

    That patients and their media/politician drivers actually believe that a “medical cabal created this mess when they got control of med schools so that the wealth of a nation would remain in the hands of a few medical elites and their families”‘is no joke. I wish I could truly impress upon every would-be med student the real significance of this quote.

    To survive, many of us have learned to persevere not for patients, but in spite of them.

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