How to be an Authentic Doctor#15: Professional Courtesy


Times have sure changed. It is nothing like it was in the good old days. I say this admitting that I am in my late 40’s and really was never part of the good old days but is just sounds good.

A few years back, when I was in Maine, I made a phone call to a local endocrinologist. You see, I had this condition that we will call congenital adrenal hyperplasia (CAH) because for one, that is not what it is and secondly, no one really knows what congenital adrenal hyperplasia really is.

I asked the secretary to speak with Dr. Richard Dickhead (not his real name) who I had seen before. Within minutes he got on the phone. Here is the conversation:

“Hi, Dick, I don’t know if you remember me but I saw you about a year or so ago.”

Silence. Now this guy isn’t exactly located in town but may travel a measly twenty minutes once a week to the local hospital clinic. I do know, however, that he heard the secretary say, “Dr. Farrago” is on the phone.

“No, I don’t remember you.”

“Okay, anyway, I have this CAH that I want to talk to you about.”

“You need to make an appointment”

“Sure, I will, but I have a couple of quick questions first. What are you doing with….”

“I don’t have time for this. Call 888-9999. I am in the clinic seeing patients.”

Click. The phone goes dead.

Where is the professional courtesy there? Sure I was technically a patient but if any physician curbsides me for a question or calls my office or even comes to my house, I would give him the shirt off my back. What happened to taking care of your own?

Here are your answers. In a medium sized town, some specialists have monopolies. I don’t want to name which ones (endocrinologists) but they exist. With monopolies comes the death of capitalism. In other words, you don’t have to worry whether you are an asshole to you peers because you know they have no where else to send their patients. What this meant for me personally was that I had no choice but to go this prick’s office for my CAH. Go somewhere else you say? My insurance only allows me to see physicians “in network”. Who is “in network”? Dr. Dickhead. For me to see someone else for my CAH would cost me out of pocket. What are the chances that another endocrinologist would comp me for his or her service? Zilch. In today’s world, only mafia bosses get something for free or what we used to call in New York “four on the arm”. We physicians, it seems, don’t give a shit about each other enough to give professional courtesy.

That being said, I do remember an exception. One of my physician partners got his vasectomy for free or what I like to now call “two on the arm” if you will. The urologist is a nice guy (besides my buddy’s insurance wouldn’t pay for this procedure anyway) and he is not part of a big urology group to ruin his compassion for other docs.  It was a swell thing to do for a peer.

So where do we go from here? The answer is simple. If we all banded together as physicians (all except endocrinologists) we can be one big happy monopoly that takes care of each other (again except endocrinologists) and totally screw the hospitals and the insurance companies. Unfortunately, there are laws against this and we are too busy seeing patients to every come together on anything. Instead, maybe we could be a little nicer to at least our fellow docs (except Dr. Dickhead) so that in some small way that compassion can leak back to our patients. Or maybe this is just my congenital adrenal hyperplasia talking.

52290cookie-checkHow to be an Authentic Doctor#15: Professional Courtesy