We all have them – those healthcare stories which invariably result in the silent question, “Did you really just say that to me?”
The one that stands out most in my patient life was when a Fellow who had never met me before spent time arguing with me over my labs, then dismissed three months of hard work as the margin of error. I still want to slap that chick when I think about it.
In the interest of the absurdist nature patient life often assumes, here’s another one.
Once upon a time, there was a woman who contracted COVID. When a friend pointed her in the direction of the very effective Paxlovid, she told the friend that a doctor said there was no point because people were rebounding after 3-5 days and ending up in the hospital (false). Understandably, she was now scared to take the Paxlovid.
Finally, without knowing things like the timeframe in which the drug is effective (the first five days after symptoms appear), the COVID has gotten bad enough that she decides to call her doctor and get a prescription.
She schedules a telehealth appointment with a doctor in her GP’s practice because he is out of town. The first thing the doctor says is, “You look really sick.” Well, she has had COVID for a couple of weeks without symptom abatement, so, yeah.
It becomes obvious this doctor hasn’t taken 30 seconds to skim her chart because she recommends “nutritional counseling” to a patient who walks a very narrow and healthy nutritional line. She also recommends the patient take Advil, to which the patient is allergic.
The doctor asks how allergic the patient is. ( . . . crickets . . . )
When the patient answers that she is allergic enough that it will put her in the hospital, the doctor responds with, “Well, I guess you shouldn’t take it.”
In the end, she could only treat the symptoms and wait while her body recovered. Which is a legitimate discussion with a medical professional, but would have been much more effective had there not been so many missteps.
This is what happens in a patient’s mind when episodes like this happen:
Has she even read my chart? Is it because I’m not her patient, and she resents having to pick up her practice partner’s cases? Does she know anything about me and my case? What if I was incapacitated and a loved one who wasn’t aware of my allergies was authorizing care? I’m also allergic to penicillin. Taking a medical course of treatment from a doctor who can’t take a minute to read my chart could kill me. Why did I even make this appointment? I could have done just as well on my own, and without this frustration.
This is dangerous and pushes at-risk patients away from experts who can help. I’m not sure the clinicians, who may be overworked and burned out, understand the potential damage caused by these often unconscious approaches.
I am lucky that no one in my care team has these habits, and I can walk away from anyone who does. There are millions who can’t.
For those patients, we need to do better.