Whine of Fire by Pat Conrad MD

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.”

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  4 comments for “Whine of Fire by Pat Conrad MD

  1. Mamadoc
    February 14, 2018 at 10:01 pm

    Lord, please keep this jerk out of my office.

  2. Steve O'
    February 11, 2018 at 10:15 pm

    Remember, the American Way in the 21st century is to enter every “business” relationship is as a contemptuous consumer. You are there to buy the product, aren’t you? The clerk (physician) with whom you have to deal is, of course, the very bottom of the food chain. Isn’t that why she/he is required to deal with the public? Public school teachers usually get to rise out of the classroom within a few years of graduating college. They get away from the children. But of course, any doctor who’s over 25 who’s stuck facing the patient must be some version of a screw-up, you think?
    Look, the internet’s made everything a snap. After understanding what it’s all about, in 15 minutes or less, the job is to deal with the schlemiel whom the hospital firm has left in the clinic.
    If the clerk is inefficient, or you just got a dent in the parking lot and are in a bad mood, you can complain to the Customer Service operators.
    I got a complaint from an angry family whose loved one with mitral stenosis presented afebrile, no dyspnea, no white cells, and with JVD. I didn’t give the antibiotic that they demanded! What poor service!
    I used to be hopeful that the system would be reformed before it fell into inefficiency. That was years ago, and now that it’s plunged below mediocrity, nobody cares. It’s going to be a sorry gulch into which Retail Medicine will fall. I hope to be retired by then. Good luck, customers!

  3. Steve O'
    February 11, 2018 at 10:08 pm

    Remember, the American Way in the 21st century is

  4. sp
    February 11, 2018 at 3:06 pm

    This article is an old one from October 2017. A “former healthcare journalist” is critical of how his doctor diagnoses and treats him but then admits that the articles the doctor gave him about neck pain were “over his head”? Just a little self-enamored? anyway, I agree that the doctor should not turn his back on his patient literally and possibly figuratively. If you are not looking for feedback from your patient during a medical encounter, you make it clear that this whole interaction could be done remotely or with you out of the room and with an extender instead. So the arrangement of the intake really does speak volumes about the message that this doctor is sending. On the other hand, how about a couple of minutes of empathy and self reflection? If all of his patients are pain in the asses like you, maybe that led to his burnout?
    If you really have this long time relationship with your doctor, why not ask him, how he is doing? Why not include that in this story?
    I get the feeling that the story was slanted to serve the headline but not to be a true journalistic investigation.

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