Bad Medicine

Bedside manners are supposed to be secondary when it comes to providing health care, but I believe that is a myth. I believe that they are part of communications skills (or lack thereof) and that doctors who have terrible beside manners are not good communicators, either.

Just to be clear, it's not that I simply dismiss something I don't want to hear. I was heartbroken to discover that in my early 20s I already had osteoarthritis in my toes and could not wear high heels. I've had an exceptionally unpleasant autoimmune disease since I was eight years old. What could I look forward to in life but looking less than unattractive and feeling horrible about my appearance? I know this sounds superficial, but ballet flats will never make you look as elegant as high heels do. Duh, that's why dancers perform en pointe.

But I digress. Recently I saw a periodontist for an evaluation about why I suddenly lost bone in one part of my jaw. I was puzzled because I've taken enough calcium and I've been diligent about oral hygiene. I adore my dentist and trusted his recommendation. Unfortunately, I had a bad feeling from the get-go about the periodontist who works in his office. He wasn't at all friendly. Worse, he was totally negative and predicted that I would lose a tooth in two years or ten years if I didn't undergo surgery. His voice was staccato. And did I mention that he didn't answer my questions?

Last week I went with my mother to see a vascular surgeon at Stamford Hospital's wound center about a venal ulcer. My mother is of the generation that believes doctors are demigods and that you just don't question them. I didn't like this guy from the moment I met him. She dismissed his unfriendliness as just having poor bedside manners. Later, she mentioned her visit to a friend of hers who used to work at Stamford Hospital. Her friend said he's "a nasty bastard." I agreed with her friend, especially after today's visit. I questioned how long recovery is expected to take. He nearly bit my head off and said, "It could take a year. It could take two years." Excuse me, but that's not an answer. Try saying, "Under ideal conditions, if you do this, that and the other, it will probably take x number of weeks, but it could be longer." But, no, he went on to tell us that two patients had this and one ended up in the hospital because of a stroke and the other because of a heart attack and because they were off their feet, they each healed in one week.

Am I being unreasonable about wanting better communications? I don't think so. But I am somewhat demanding as a patient. I expect a doctor to take the time to listen to patients' concerns. Hey, people are scared. They want to be reassured that they're going to get good care. The last thing they need is someone to make their anxieties worse.

I also expect a doctor to be up-to-date on techniques and procedures. It's shocking how many doctors haven't learned much since they completed their residencies. I'm very lucky that my job requires me to interview many of the specialists I may need one day. It's interesting that many of them have completed fellowships after they did their residencies. Many also say that they listen carefully to their patients. One told me that doctors who listen to their patients get the diagnosis. Lay people may not know the name of what ails them, but they know they're not well. And they deserve to be heard.

I once read that many people who have eventually been diagnosed with Epstein-Barr Syndrome went to three or four doctors before someone took them seriously. How frustrating that must have been for the sufferers. It was also costly for the insurance companies.

In my next blog, I will post the names of good doctors. I warn you, though, you may have to travel a bit, but it's worth it. Why waste your time and money on someone who is still practicing old-fashioned medicine in the worst way?