One hand doesn’t seem to know, or care, what the other hand has done, gripes Mervyn Kaufman of his physicians, and he is sore about it.
Simply stated, I think our physicians are, for the most part, shockingly and perhaps arrogantly out of touch.
“Sit on my finger.”
That was a memorable command, from my urologist, about to do the usual (and perennially unpleasant) digital exam of my prostate. His particular approach, and I’m sure he’s got good reason for choosing it, is not to stick his gloved “bird” finger up his patient’s ass—a procedure most men over 50 learn to endure—but ask his victim to do the heavy lifting or, in this, squatting.
Later, after I was dressed and having my exit meeting, I asked if the doctor would be sending his report to my internist, the physician who’d recommended this specialist to me. “Certainly,” he insisted.
Six weeks later, in the middle of my so-called annual physical, I stopped my internist whom I saw don a disposable glove.
“I had that exam already,” I said. “Dr. K. said he’d send you the report.”
“Never got it” was the response, and since no annual physical is considered complete—for men of a certain age and vulnerability—I had no choice but to undergo yet another digital probe.
“Right lobe … left lobe. Good, good. You’re a little enlarged, but nothing serious.” Then he withdrew. Yes, my butt was a little tender, but what really made me sore was my certainty that no insurer would pay for this phase of my physical, since it duplicated what I’d received little more than a month earlier.
This is clerical stuff. Procedural. With computerized networking, it should be the easiest one of today’s complex health-care issues to deal with, but apparently it’s not. Here’s another example:
Sniffling my way through a ticklish exam by a ear-nose-throat specialist, I acquiesced when he handed me a written order to take to a local imaging lab. While leading me into the treatment room, my technician asked, “We’re doing a CAT scan of your sinuses, right?”
“Yes,” I said.
“What’s wrong with them?”
“Maybe you should ask my doctor,” I suggested.
“If I did that for every patient, I’d be on the phone all day.”
In truth, I didn’t know what was wrong with my sinuses—nor did my doctor, hence the CAT scan. Moreover, I didn’t think that I, or any patient, should be asked to be a medical message-bearer.
In this era of instantaneous electronic communication, why is it that in so much of our country each medical practice functions like a private fiefdom, and unless pressed, most doctors are loath to share their findings with one another?
I’ll have to admit that neither of these recent experiences was a big surprise, but they did add to my growing anger at what I consider part of a backward form of medical care that should no longer exist—not here in the U.S. or anywhere.
Yes, yes, I’ve heard that doctors are too burdened today to write things down, or to communicate with their staffs or colleagues. I think that’s bullshit, but if true, it puts an enormous burden on patients who may or may not be savvy enough to carry and share information responsibly or accurately.
In medical circles, it would seem that “back to the future” means turning one’s back on progress and the possibility of utilizing advanced social networking possibilities to share information, eliminate duplication and refine patient care.
I think our country should be a leader in health-care communication, with every physician armed and prepared to access up-to-date medical histories even before us patients arrive in the waiting room. Instead, we move from doctor to doctor like giants leapfrogging islands, each island its own socked-in preserve.
—Photo stev.ie/Flickr
Double dammit. I have a chronic, frequently fatal disease that affects arteries, vision, and muscle coordniation. Neurologist, vascular physician, rheumatologist, ophthalmologist don’t communicate. I feel dismembered.
I guess the answer is to demand copies of every test and report and carry them with you from one doctor to another. It seems cumbersome—and stupid—but it’s important that each specialist be made aware of the others’ findings and recommendations. Regarding prescriptions, I carry a printed-out list with me each time I make a doctor visit. If a new prescription is suggested, I hand over my list and ask, “Any conflict here?” And, of course, sometimes there is. You, as the patient, have to be responsible because, clearly, most physicians are not.
You are blessed, David, and your experience is really not typical—not yet, anyway. Consider yourself very lucky indeed!
I LOVE my doctor and his office. Very 21st Century – everyone has tablets. He can pull up every appointment I’ve ever had with all the tests and results, all the meds I ever took (or didn’t), even images. He once accessed my MRI results directly from the lab across town, tech notes, zoom, the works. I don’t even get scripts. He taps away and they are sent to my pharmacy.
There is nothing better than using humor to make a good point… This fellow Kaufman writes about something important in an amusing way. I suppose if you can’t get satisfaction , skewer the hell out of it.
All kidding aside, sometimes miscommunications can be very serious.
It finally occurred to me the other day that one of my doctors, whom I see every six months, never looks at me. He’s not good at listening either. It’s time for me to tell my other docs, who say this man is an excellent clinician, that that is not all that matters in medicein. If it’s not by the book, he’s not interested. I could be green and have an arm hanging off, and since it’s not in his purview, he wouldn’t comment nor care. The other docs, however, are great about everything. And I take my own copies… Read more »
Electronic medical record systems are highly efficient at producing vast amount of data but are so far pretty much helpless when it comes to “understanding” what it all means. Typically, the system makes available far more data than one can even look at much less carefully consider. And of course, most of it is irrelevant or out of date. If the machine is allowed to edit, prioritize, or try to think medically, it will routinely make mistakes along these lines. Maybe someday the promise of EMR will be fulfilled. So far, it is just making clinicians feel numb and alienated.… Read more »
I work in the medical industry and I agree with you. Most of them are ignorant in personal patient knowledge and too puffed up with their own importance (God Syndrome) to give a dam to listen to the patient anyway. As long as they are meeting the numbers and getting a paycheck and getting their needs meet they don’t care. This infuriates me to no end. I don’t see any changes in the forseeable future either. Sorry but that is my take on it.
It’s sad, really, Orianna, because the few physicians who do connect are so often thwarted when having to deal with colleagues who don’t. Presently, I have an internist who inputs everything I tell him; his fingers move swiftly on his keyboard as I talk to him. Also, he keeps an up-to-date list of all the meds I take. The problem is: he transmits this information to the various specialists he sends me to…but not one of them bothers to read it! Once, after a brief hospital stay, I complained to a cardiologist that during the 24 hours or so I… Read more »