Thursday, December 03, 2009

The Good and the Bad

Today was one of those days when even my office manager told me to take it in stride and not let a few bad apples bother me. But it's true, as much it is a science, medicine in many ways is an art too, and a very human one at that. Even for me, as a physician.
The first was a patient who said he wasn't coming back because my nurse pissed him off. Also claimed he didn't see eye to eye with me, and accused me of making him wait while I played tic-tac-toe on the PC. He requested a meeting with my supervisors but within a few moments it was clear something didn't add up. He was tangential, and went on and on about his animals at home, and his orchard, and kept talking about what his mother wanted him to do (he was 55). Also, the day he accused me of making him wait, he didn't have an appointment to see me, but rather he just showed up and wanted to see me. And not being very IT saavy, must not have realized I was on the computer typing up patient notes on people I saw and thought I was playing games (actually I hate tic-tac-toe). And he was pissed because I kept him waiting 10 mins, when he showed up unscheduled on a full clinic day and I still did him a favor by seeing him.
The 2nd was a patient who was seen by 4 of my colleagues previously, who refused to take their advice about a treatment, and instead left our practice to find someone (who wasn't even a physician) to start her on some non-FDA approved treatment she was wanting. She knew she wasn't going to get it from us. And so, after she was able to get on this treatment, she decides to return to our practice for us to manage this unapproved treatment regimen that some witch-doctor started her on but apparently can't manage anymore because of licensure issues. And so she sees me for the first time. I said what I thought, very professionally and courteously, but I made it clear I did not sanction that treatment and will not continue it though offered to at least supervise things until she got back to her previous provider. To which she took great offense, and wrote a nasty letter to the clinic accusing me of being a liar and threatening to sue me for 'stupidity'.
Neither one of these have merits, and my supervisors, after having reviewed both cases and my notes have unanimously supported my recommendations. On the logical side, if I wasn't on the receiving end I would have laughed my head off reading these stories simply because these were ridiculous. However, as professional as one can be, being a doctor, there is always an emotional side, one I do not share with most patients except my closest (I have on occasion shared hugs, and sometimes tears, with patients). And I have to say that eventhough your patients may be totally irrational or have their own ulterior motives, these things do sometimes get to you. You want to feel like you're really there to help the patients and that you're making a difference, but sometimes these things really do take the wind out of you for a few days.
Thankfully, near the end of the day, one of my patients clasped my hand with both of hers, and tells me, "Thank you, Dr. V. I've never had any doctor listen to me the way you did, and be as honest as you did. I know you have my best interests in mind, and I know I am in good hands. God Bless You."
I just muttered an embarrassed "You're welcome" before I left the room, only because it left me almost speechless, God knows how she knew I needed a pick-me-up then.
Yea, like any other job you have to deal with the good and the bad, and thankfully, hopefully, you get a lot more goods than the bads. And all one can do is to use the warmth and smiles and handshakes from the grateful patients to help us get through the bad days.


Blogger pavlova said...

chin up, mate. the ups and downs of being in the health profession.
sometimes you feel like you are the greatest person on earth, because you cheered up someone's life.

but when the complaints come in then you feel such a crap. even though you know that it's not your fault but you still lie in bed thinking what you could have done to avoid the situation.

just take it in stride, really. part and parcel of private practice.

2:29 AM  

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