Writer Bob Brody tells us “Why I Almost Fired My Doctor,” and reinforces those reasons that payers, academicians, government, and medical organizations will ignore. Brody liked his doctor, “But I often questioned his judgment in medical matters.”
As a patient, the writer doesn’t like the doctor giving obtuse answers and ineffective patient handouts, after not performing a complete exam. I can see his point. He wonders at the doctor advising instead, to see a specialist. I can see the doctor’s point. He wondered why the doc would prescribe what he admitted was an unnecessary medication. I can see why both the doc and patient would have a point.
Much is made in the article of the relationship between patient and physician, and how a poor one predicts the patient leaving the practice. Makes sense to me. But how did this writer and his doctor get to this poor place? Between the lines, I read physician burnout, and mistrust. A tired or apathetic doc might well not examine a wrung neck and toss it off to the orthopedist. Like this doc, I have written statin scripts aplenty not to treat the patient, but only out of lawsuit fear. As this unhinging progresses, the writer has finally had enough when the doctor spends the entire visit with his back to him, pecking away on his computer.
The author raises an important concern, asking, “Was I going to risk my longevity to avoid hurting my doctor’s feelings?” I applaud taking charge of one’s health, and responsibility for seeking out the right physician. I also suspect that this is a nagging “former health care journalist” that made a pain of himself by debating minor clinical points in the middle of a busy day, but that’s just my gut.
Of course, referencing a former AAFP president is emblematic of poor public insight. And Brody quoting a director of the Center for Primary Care at Harvard Medical School on the deleterious effects of mandatory EHR’s is akin to asking the fox to wipe the chicken feathers off his chin. “How do you go about firing your longtime doctor? Does the American Medical Association recommend a protocol?” Not satisfied with this deep digging, Brody seeks out an academician, who had written a book on physician-patient collaboration. The advice he gets: “You should reach out to talk to your doctor. That’s the key. Make clear how you feel. Say what you need.” And you should do it in the little 10-minute blocks you get while his back is turned sweating over the keyboard, fulfilling the dreams of tenured med school professors and Big Insurance-cms.gov parasites.
In the end, the old doc retires, saving Brody the trouble of hurting his feelings. “As it turns out, he’s done me a big favor. Ending his career just might have saved my life.” Yes, writer Brody covers a lot of reasons why doctors are increasingly ineffective, even if he left out “jerk patients.”