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Medical Forum / General / General / April 2006

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Doctor to patient bedside manners.  How to ask your doctor for better manners?

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Sammy Smith - 04 Apr 2006 16:16 GMT
Currently I am seeing a doctor is very perplexed IMHO.  He seems to be
carrying but his bedside manners are somewhat in need of improvement
IMHO.  I can never get a direct phone call from him when dealing with
minor issues.  When I call his nurse, I only get a minimal
reply/response or no call back!!! If she does call back she just says
"if its so bad, go to ER!!" and most cases its not an ER issue or that
requires ER so it pisses me off when she does that.

Lately I was in an car injury and when the MRI showed I needed to see
a specialist it took over 3 weeks to see him, which my doctor's nurse
set up. Now if he was caring about me why didn't he seek another
specialist with an open time slot?

My past doctor (whom is retired) I had seen for over a decade and felt
very comfortable with. I felt he really cared about me but this doctor
I am not sure of. *BTW this doctor was selected my HMO*

My question is are there any general rules doctors are bound to by
their hypocritical oath in regards to bedside manners?

I don't want to be rude or disrespectful when asking for better
bedside manners such as a call back when I call him or at lest his
nurse returning my calls in a more quicker time. So, what would be an
appropriate way to discuss this with my doctor (thus assuring him I'm
not trying to be a mental case but need to know where he stands)?

how would the group handle this?

Comments please.
TIA!
Howard McCollister - 04 Apr 2006 18:38 GMT
> Currently I am seeing a doctor is very perplexed IMHO.  He seems to be
> carrying but his bedside manners are somewhat in need of improvement
[quoted text clipped - 23 lines]
>
> how would the group handle this?

You haven't specified any problem with his bedside manner. You've only
complained that he won't respond to you by phone as extensively or as
promptly as you think he should, and that specialists in your area are very
busy.

The conduct you describe is pretty typical of a moderately busy doctor, and
has nothing to do with the Hippocratic oath.

HMc
Pete - 05 Apr 2006 03:14 GMT
> Currently I am seeing a doctor is very perplexed IMHO.  He seems to be
> carrying but his bedside manners are somewhat in need of improvement
[quoted text clipped - 26 lines]
> Comments please.
> TIA!

Doctors stopped talking to their patients on the phone many years ago.
There is no such thing as a "Marcus Welby" anymore (the kind and caring TV
doctor who made house calls back in the fifties - played by Robert Young).
You don't want to get me going on doctors and their lack of "bedside
manners".  I hate doctors, except for you Howard :-) ...Pete
Howard McCollister - 05 Apr 2006 03:41 GMT
> Doctors stopped talking to their patients on the phone many years ago.
> There is no such thing as a "Marcus Welby" anymore (the kind and caring TV
> doctor who made house calls back in the fifties - played by Robert Young).
> You don't want to get me going on doctors and their lack of "bedside
> manners".  I hate doctors, except for you Howard :-) ...Pete

Today's environment in the medical business is brutal compared to the Marcus
Welby era. If Marcus were practicing today, he'd be on the bread line.. Sad,
but true.

Not that today's doctors can't do better than they are in their
communication skills.........

HMc
Pete - 06 Apr 2006 01:59 GMT
>> Doctors stopped talking to their patients on the phone many years
>> ago. There is no such thing as a "Marcus Welby" anymore (the kind
[quoted text clipped - 11 lines]
>
> HMc

Well thank you Howard...I was expecting a mild attack from you, but you have
quasi agreed with me on this type of subject before, at least indirectly by
not attacking me :-) .  Unfortunately I consider the vast majority of todays
doctors rutheless capitalists who really could care less about the patient,
and you are just a chart to them and they don't even know who the hell they
are talking to - I have said this before so sorry for the repetition.  I
have expressed my dislike for doctors early on when I joined this group [and
in my other ng that I participate in (not the sci med) - I go to the sci.med
ng mainly to learn from your comments - that Robert in the sci.med ng is a
smart bugger isn't he :-)].

I believe that there are few people on the planet that have more experience
with doctors than me and I will go out on a limb here and say that 70-80% of
them have no personality or bedside manner, and maybe 5% at best are what I
would call a kind, caring, knowledgeable doctor, who knows what your name
is, and won't get mad at you for researching your disease or condition.

I hope you are one of the 5% Howard - I think you are.  The fact that you
dedicate your personal time to this ng and the sci.med ng indicates that you
are, and you are awesome for doing that, and I have told you before how much
it is appreciated.  There is a urologist in Spain that does that, and even
accepts personal e-mails, and he is also awesome.

But I don't think either one of you are in any bread line, and I doubt you
take phone calls :-) .  The funny thing about the phone calls, and the "go
to the ER" crap from the receptionist or nurse (that the OP mentioned in
this thread) is the following.

Doctors will say (or their staff will tell you) that they don't take calls
anymore because if they did they would be stealing time from a patient that
may need assistance or help (even though a lot of the patients are probably
just routine quarterly or semi annual visits).  That may be partially true,
but all us intelligent patients know the real reason the doctor won't get on
the phone with you anymore (they used to in the old days) is the almighty
dollar.  It's quite simple, they don't get paid for talking to you on the
phone :-) .

IMO you are a good doctor Howard, but one of a few, and it is unfortunate,
but real. Just heard on the news Massachusettes is thinking about going to
mandatory health insurance and it could be used as a model for other states.
The poor and the unemployed will benefit and the people in the middle will
get screwed royally as usual.  Have a nice day...Pete
Pete - 06 Apr 2006 02:22 GMT
>>> Doctors stopped talking to their patients on the phone many years
>>> ago. There is no such thing as a "Marcus Welby" anymore (the kind
[quoted text clipped - 23 lines]
> sci.med ng mainly to learn from your comments - that Robert in the
> sci.med ng is a smart bugger isn't he :-)].

Sorry Howard, I got a little tongue tied here (thought I was answering you
in the heartburn group) but it blends in well anyway.  There is another
medical group I participate in besides the heartburn and sci.med group and
that was what I meant.  Sorry to you also Robert if you are reading this
(but I gave you a nice complement :-))...Pete

> I believe that there are few people on the planet that have more
> experience with doctors than me and I will go out on a limb here and
[quoted text clipped - 28 lines]
> benefit and the people in the middle will get screwed royally as
> usual.  Have a nice day...Pete
Howard McCollister - 06 Apr 2006 03:07 GMT
> Well thank you Howard...I was expecting a mild attack from you, but you
> have quasi agreed with me on this type of subject before, at least
[quoted text clipped - 33 lines]
> days) is the almighty dollar.  It's quite simple, they don't get paid for
> talking to you on the phone :-) .

I enjoy my job, and I enjoy my patients, but I'm a businessman too, Pete. I
care about the almighty dollar, both for my lifestyle and so that I can keep
my business open. However, I don't happen to believe you have to sacrifice
patient satisfaction in order to stay out of the bread line.

Our opinions are shaped by our experiences. My experiences with doctors are
different than yours, and therefore my opinions about doctors are different
as well. That doesn't invalidate your opinions, but your experiences don't
invalidate mine either.

HMc
Carol - 09 Apr 2006 01:33 GMT
I would ask the doctor directly why you can't get a call back from him, only
his nurse. I would cite a specific example where you needed to speak w/him
but were told "go to the ER" if it's bad and explain how that was not an
appropriate response to the problem.

Medicine is just like any other consumer product - if you don't like who
you're buying it from, buy it from someone else. I understand that in an HMO
there are limitations, but you should be able to request a different primary
care. When I wasn't happy with mine, I went to the medical manager of the
clinic and had a private conversation - told her my complaints about the
doctor I had, and asked her which doctors would do better on those issues. I
ended up with a fantastic physician who cares, knows my name and my
problems, and personally returns all phone calls the same day.

As for getting an appt w/specialist - I live in Houston, ground zero for
specialists - and even here sometimes it can be weeks for those appts so
don't take that one personally.

> Currently I am seeing a doctor is very perplexed IMHO.  He seems to be
> carrying but his bedside manners are somewhat in need of improvement
[quoted text clipped - 26 lines]
> Comments please.
> TIA!
Pete - 09 Apr 2006 02:30 GMT
> I would ask the doctor directly why you can't get a call back from
> him, only his nurse. I would cite a specific example where you needed
[quoted text clipped - 10 lines]
> with a fantastic physician who cares, knows my name and my problems,
> and personally returns all phone calls the same day.

Lucky you Carol.  Very rare indeed  :-):-)

> As for getting an appt w/specialist - I live in Houston, ground zero
> for specialists - and even here sometimes it can be weeks for those
[quoted text clipped - 30 lines]
>> Comments please.
>> TIA!
Howard McCollister - 09 Apr 2006 03:03 GMT
>> I would ask the doctor directly why you can't get a call back from
>> him, only his nurse. I would cite a specific example where you needed
[quoted text clipped - 12 lines]
>
> Lucky you Carol.  Very rare indeed  :-):-)

Pete, I gotta tell you in all honesty, *you* are the rare one...

HMc
Pete - 09 Apr 2006 20:46 GMT
>>> I would ask the doctor directly why you can't get a call back from
>>> him, only his nurse. I would cite a specific example where you
[quoted text clipped - 16 lines]
>
> HMc

Howard...so you have finally attacked me, after all the nice praises I have
given you over and over.  I am sorry, but you are wrong.  You don't have the
experience I do, going to doctors.  If you are a good doctor, like I have
continuously said you are, then good for you, and you are to be commended.
But, most doctors are not good, kind, caring doctors, and do not even know
how to spell "bedside manner", and they don't know your name, and they don't
like you researching your disease/condition.  I have said this repeatedly,
and will stand on it forever.  *And it is indeed very rare for a doctor to
talk to a patient on the phone and certainly to return all calls the same
day*.  That is pure fact.  I hope we can still be friends...Pete
Howard McCollister - 09 Apr 2006 21:38 GMT
> Howard...so you have finally attacked me, after all the nice praises I
> have given you over and over.  I am sorry, but you are wrong.  You don't
[quoted text clipped - 7 lines]
> return all calls the same day*.  That is pure fact.  I hope we can still
> be friends...Pete

It's not meant as an attack, Pete. It's a simple observation, and I'm sorry
but I stand by it - the degree of your seething opinion of  doctors is
extreme and rare. Were you heaping "nice praises" on me only because you
thought I wouldn't then "attack you", or disagree with you? (the two are the
same thing???) Sure we can be friends - but do all of your friends agree
with everything you say?

I see thousands of patients every year, and as a specialist, most are
referred to me so they already have a doctor, often more than one. I have
the opportunity, over 20 years, for more insight into and evaluation of
doctor-patient relationships than you could ever have, based only on your
own personal experiences going to them. Yes, there are doctors such as
you've described, and I don't doubt your experience has been bad for
whatever reason - but to tar "most doctors" with that brush - that's just
wrong Pete, in my substantially greater experience.

You can take my disagreement with you, and this reply, as an "attack",
thereby reinforcing your opinion of doctors - "even good ol' Howard, whom I
thought was a good doctor, turns out to be just like them". But if you see
disagreement with you as an attack, then I think maybe we're getting some
valuable insight into the mechanism of your negative experiences with
doctors.

HMc
Pete - 10 Apr 2006 03:08 GMT
>> Howard...so you have finally attacked me, after all the nice praises
>> I have given you over and over.  I am sorry, but you are wrong.  You
[quoted text clipped - 14 lines]
> with you? (the two are the same thing???) Sure we can be friends -
> but do all of your friends agree with everything you say?

Howard...I hope you read all my praises about you (most of them, if not all
of them are in the heartburn newsgroup).  I can search them and e-mail them
to you if you want.  They were based on my extreme admiration for you for
volunteering your personal time to this group and to the heartburn group,
and for appreciation of your medical knowledge - and that is it - it had
nothing to do with you attacking me - although I thought you would attack me
eventually because of my admitted negativity about your profession in
general, which I will not back down on.  Most of the patients who go to
doctors are medically ignorant - I am far from that.

I have been abused and insulted by doctors and I do not like them - and I
have been to what I would call incompetent doctors, and I have had my blood
lost in hospitals and have had my catscans misread by radiologists, and I
could write books about bad doctors.  So if you want to say it is my problem
and most of your patients don't dislike doctors, that is your opinion.  The
original poster of this thread seems to feel otherwise (but not to the
extent I do because most people have not been to as many docs as I have),
and I was just amplifying what he said, and what another person said later
on (which started this).

But you appear to be a good doctor like I said - if you weren't, you
wouldn't be volunteering your time to the ng's like you do.  I don't know
how your bedside manner is, or whether you are opened minded to your
patients doing research and asking you questions, that you may take wrong,
and dismiss them.  Sorry Howard, I do not like doctors - blame it on me if
you like, but I could give you detailed accounts of my bad experiences, that
certainly would prove it's not all my fault, or my personality causing the
problem.  That is not to say I may not be partly to blame.

It took me six years to get my last internist to call me by my first name
and he up and left.  He wasn't a bad doctor, and he used to admit I knew
more about certain details of certain things than he did, and he was right
out of his residency (doctors are not gods like most people think they are -
one individual can only know so much - that is obvious).  I bet you call
very few of your patients by their first names, or you don't know their
first names.  That is very important to me, just to feel comfortable, so you
don't feel you are just some chart in a lineup (like cattle waiting to be
slaughtered).

Medicine is not that cut and dry where you can just keep saying "next" (as
in next patient) .  Doctors need to communicate with their patients.  And
please don't tell me the standard response that you see patients all day
long and you can't remember them all.  I don't buy that.  Believe me, if I
was a doctor, I would know all my patients if they returned for followups,
and I would call them by their first name (unless they preferred otherwise).

Let me close by saying that a doctor's diploma, and the school he went to,
and his residency, and all his surgical skills, don't mean a thing if he
can't communicate with his patients, and make them feel comfortable when
they are talking to him, and let them ask reasonable questions about their
condition and their treatment options.  That is the key.  Without that, the
rest doesn't matter.  I do not believe I am alone on this either, but I
admittedly feel stronger than most other people do (who haven't been to as
many doctor's as I have).

I still like you Howard, and hope I can discuss my manometry and 24 hour ph
with you some day in the heartburn ng (the one that I had in Baltimore a
year and a half ago and I never got to talk to anyone about because of the
incompetence I told you about).   It would be better to do it by e-mail but
I'm sure you don't take e-mails.  I have been meaning to ask you about this
in the heartburn group, but I kept putting it off since I was sure you don't
take individual e-mails.  The urologist in Madrid I told you about does take
e-mails, in addition to his time in the ng, and I can definitely tell you he
is probably one of the finest, kind, caring, and knowledgeable doctors on
the planet, and boy do I wish he was my urologist :-) .

Incidentally I told the Madrid uro about you also (not by your name), and
how the two of you were similar, and how awesome you both were for
volunteering your time to the ng's. There are indeed very few doctors on the
planet that do that, so I will thank you again.  A lot of doctors have
websites for advertising their business, and a lot of doctors answer
e-mails, but you have to be their patient of course.  I like to think that
if a doctor volunteers in a ng, he is doing it more in the interest of
helping people globally, relative to their medical condition or problems.

Pete

> I see thousands of patients every year, and as a specialist, most are
> referred to me so they already have a doctor, often more than one. I
[quoted text clipped - 13 lines]
>
> HMc
Howard McCollister - 10 Apr 2006 14:47 GMT
> Howard...I hope you read all my praises about you (most of them, if not
> all of them are in the heartburn newsgroup).  I can search them and e-mail
[quoted text clipped - 72 lines]
> if a doctor volunteers in a ng, he is doing it more in the interest of
> helping people globally, relative to their medical condition or problems.

Let's clear this up, Pete, and move on.

You percieve I "attacked" you, when a simple re-reading of my posts will
show nothing that even resembles an "attack". I disagree with you. It's that
simple.

Your "praises" are irrelevant to me. You know nothing about me other than I
write a lot of stuff on the internet. I can assure you that, as a determiner
of skill, internet newsgroup ramblings by a doctor mean nothing. Even
his/her willingness to participate here means nothing. If we've all learned
anything from the internet experience, it should be that it is unwise, and
sometimes dangerous, to take internet communications and the person behind
them at face value.

Your experiences with doctors are certainly unfortunate. I don't dispute
their accuracy as you report them. Neither do I take them at face value.
That's because I don't know you any better than you know me. You're entitled
to vent and rant as in your post above. That, after all, is what the
internet is for. Or at least what it has become.

You don't have to justify your opinions to me. You can just put them out
there for people to accept or disbelieve as they wish, and IMHO, you
shouldn't care which. Anyway, that's what I try to do.

HMc
Pete - 10 Apr 2006 18:21 GMT
> Your "praises" are irrelevant to me.

Howard...I don't understand why you would not appreciate someone thanking
you (or praising you) for your contributions to the ng, just as I appreciate
your contributions to the ng.  That was not a misworded sentence I just
wrote.

I always thank everyone who provides (what I consider) "good" advice to me
on the Internet, whether its in a medical ng, or a computer related ng, or
whatever.  It is the polite thing to do.  I apologize if it is "irrelevant"
to you.  In the case of doctors who volunteer their time to a ng, I try to
go beyond a simple thank you to express my appreciation.  Apparently you
don't care.  I will always thank you, but I will try not to go beyond that
in the future.

Have a nice day...Pete
 
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