I am writing today to let you know why I won’t be coming back.
You came highly recommended by someone I trust more than almost anyone else in the medical world.
However, the first red flags came before I set foot in your office when your scheduling staff told me I would need a referral even though my insurance company did not. This is a blatant money grab employed by hospital systems that is happening more and more often. I know this is a policy you may not control, but it was off-putting. Maybe if it had been the only thing, I could have gotten past it.
But there were other things, both administrative and personal, that didn’t work for me. On the admin side, the same scheduling staff thought it would be ok to schedule an initial appointment as a virtual appointment. No. Just no. Not for diabetes, where the trust relationship is so vital. Actually, not for any first visit with any clinician. AI may be taking over, but medicine will always be a hands-on field. And when I asked for one, your receptionist wouldn’t submit a request for a lab slip to you, though everything would be outdated by the time I saw you. What is there to talk about without current labs?
But the appointment itself showed me the light on why you delay your labs until after the initial visit.
I have never attended a doctor’s appointment with less substance in my entire life, not even with the jackass of my teenage years who treated me into an eating disorder. I hated him, but things did happen during appointments, for better or worse.
Before I get into it, I would like to say that I liked your office medical staff. Your assistant and RN were kind, casual, and engaged.
But, when you arrived, it was pretty clear you hadn’t taken the time to even glance at my file. I have other doctors in your hospital system, and everything I brought with me is well-documented. Still, you spent the entire appointment standing at a computer halfway across the room re-entering it. You never shook my hand or sat next to me or looked me in the eye. Oh, except for the mandatory listening to heart and checking glands that are necessary for you to bill for the appointment.
I tried to begin a discussion on weight loss, which was the reason I selected you, as well as the stated reason I was there, but you did not engage, and at the end of the appointment, you told me that was for next time. Instead, you focused only on the things directly related to the basic diabetes regimen – things I handle better than you can advise me after 32 years. You suggested I change what works for me, unconventional as they are, though my numbers fall in the healthy (for a diabetic) range. You never asked me about my goals, and only peripherally listened to the plans I had formulated on my own.
As an experienced patient, I have spent decades with other clinicians honing my regimen. Without knowing me at all, you pushed both ideas and medication that were clearly unwelcome. I say “clearly”, because I vocally pushed back on what you were saying, but you seemed unable to take the not-so-subtle hint. (I haven’t had a glucagon prescription since, what, 1997, and there is no one living with me to administer it during a crisis, anyway.)
You made no attempt at the very basics of active interviewing. You did no depression screening, asked no questions about my psychological well-being, and barely acknowledged my concerns about the fatigue I’ve been fighting for years, and which has recently worsened. Other than checking on my employment status (never asked what I actually do for a living), you made no inquiries about my life beyond diabetes. This is important because I know for a fact that life stresses affect the disease itself, as well as my ability to stick to my regimen. I guess whole person care isn’t part of your practice.
You were rushed. You spoke very quickly. On my way out, your office staff told me your usual time slot is 20 minutes. I’m sorry, that’s just not good enough for someone with needs as complex as mine. I don’t think I have ever spent less than 45 minutes with one of my core docs – GP, ophthalmologist, nephrologist, and endocrinologist. Not with the second tier, either.
In fact, none of it is good enough. Remind me why I bothered to show up? I went to your office looking for support and accountability, and I got nothing resembling that. It’s obvious to me that you haven’t dealt with experienced patients like me very often, if at all. I think you have potential, and I am sure you are good for the newbies and those struggling with glucose control, but I am as far from that as it is possible to get. I need someone who can hit the ground running, take one look at my chart and understand that there is no need to cover basics, and that 20 minutes will never cut it.
I thought about giving the second appointment a shot. Maybe once intake is out of the way, you would be an amazing clinician, but that shouldn’t be the second appointment. It should be the first. Since this has never happened to me with all the clinicians I have seen, others have figured out how to work better within tight time constraints – difficult, but not impossible. And frankly, this role is too important and the progress I have made on my own in the past several days is too fragile to risk another whiff (the baseball definition, not the aromatic definition).
I confess I was so disappointed; I got a little choked up on the drive home.
I truly wish you good luck in your career. You could be great, but please, please find ways to expand your horizons, or you will never become the physician my friend already thinks you are.