Tag: google

So, why did you come in to see me?

Just remember. This is supposed to be funny, but with a side of truth.

You know, my life is full and interesting. I get to help people every day and do what I love. That makes me one of the luckiest people I know. I will never forget that. I used to think, before I actually went into medicine, that every patient that would walk in that door wanted to be there and would be ready to be a part of their own healthcare team. Weirdly, that is not the case. This is true for a large portion of my patients, but for some, I am not so sure.

As I reflect over the last 20 plus years, I realize that there are several types of patients in my practice. Let’s review.

There is the patient that you inadvertently become friends with and become attached to. To some extent, this happens to me all the time. I always try to bond with my patients in attempt to care for them better. I try to get insight into their lives to help them through whatever issues they are trying to solve. They always tell you in medical school never to get attached, but sometimes I can’t help it. In my mind, it is a reflection of the depth of my caring. I am always careful to respect doctor patient boundaries though. It’s not like I go party at their houses or anything.

There is the patient that doubts literally everything you say. I mean everything. For every plan you come up with, they have a counter plan or they doubt that it will work. They question your every move. They constantly re ask the same questions to see if they can trap you into giving a different answer. I realize that most of the time, this has nothing to do with me. Often, these are patients that have been bounced from office to office without actually getting the help that they need. Or, worse yet, they have had a bad experience or suffered malpractice and this makes it very difficult for them to trust any doctor. I try to take that into consideration when working with them.

There is the patient who thinks THEY are the doctor. You know the one. They grew up with family members or friends that are physicians and they know just enough to be dangerous….to themselves and your 16 plus years of schooling are not going to change their mind.

There is the entitled patient, who thinks only of themselves and becomes indignant when attention is not focused on them. These are the patients that become irate when their pap smear is interrupted because I have to run to the hospital to save someone who is hemorrhaging. The “big picture” is somewhat lost on them. They want special treatment and have tantrums when things do not go their way, regardless of the reason. I try to set very clear communication and expectations with these folks, but sometimes they get upset nonetheless.

There is the patient that “never goes to the doctor.” This is the patient that hasn’t been to the doctor in years because they haven’t had any symptoms. This is the patient that doesn’t trust doctors and has to make sure you know it by repeating the first two statements multiple times during their visit. However, if this same patient suddenly has an issue that they determine to be urgent, you had better drop everything and address it right away. Never mind that they have neglected their health for years. It is up to you to fix it….and quickly……so they can go back to never coming in for check-ups.

Let’s not forget the self-diagnosing patient. We all know that with the help of Google, our friends, our family and the chiropractor, we can figure anything out on our own, even before reporting to the doctor’s office. Those are the folks that come in convinced they have a rare tropical disease because Doctor Google said so after they typed in their symptoms. It is often very difficult to talk them out of it, but I try. Half the time, they are apologizing for looking stuff up in Google, as they are insisting that it has to be correct!

There is also the patient with overbearing family members. In my case, this most often presents and the teenage patient with the anxious parent. The parent is often on a covert fact-finding mission to discover if the teen is sexually active or not. They talk over the patient, and try to fill in all the details to show how concerned they are, but then don’t really seem to want to hear what the teen has to say. I get that they want to make sure the patient gets what she needs, but this behavior only shuts down any potential successful communication that I was hoping to have the patient.

There is a final category. This is the one we spend our whole careers hoping to encounter: the patient that reminds you why you went into medicine in the first place. This is the patient that appreciates what you do for them and how you care for them. This is the patient that is nice to your hardworking staff. This is the patient that follows through with what you recommend. This is the patient that talks with you not at you at the office.

The bottom line is that my job offers infinite variety. All of these patient types keep me on my toes and my mind fresh and ready for anything. They each have their own advantages and challenges. It’s not exactly how I thought it would be, but I wouldn’t change a thing.

Dr. Katz

Be your own advocate, but DON’T be your own doctor.

These are words to live by right there. I am always encouraging patients to advocate for themselves. I think that every patient should be master and commander of their own destiny. It is so important that you listen with your eyes and ears open at every doctor’s appointment. Take notes and read everything that your doctors give you. At least attempt to understand what your doctor is telling you or ask questions until you do. Insist on clarification if you don’t. Pay attention, even if you don’t like what the doctor is saying, especially if you are getting news that you don’t want to hear. If you are getting any kind of unfavorable news, it becomes even more important to buckle down and concentrate so that you can be a part of your own management plan. If you disagree with your doctor’s diagnosis and plan, communicate that, in the right way, and talk about it together. Make sure that you have given him or her ALL the necessary information that you can think of, even if you think it doesn’t matter. Ask questions! I never understand when my colleagues complain about patients asking questions. I am like bring it on! I love questions! It means that you are actually interested in your own health and what I am telling you. I am actually more concerned if you don’t ask. Plus, if I have a problem with a patient asking questions, that poorly reflects on me if anything. So, please ask away.

So we have discussed how to advocate for yourself as a patient. Now let’s discuss the difference between advocating for yourself and trying to be your own doctor. When a patient advocates for themselves, they are being an active participant in their own management. They are agreeing to a team participation relationship between themselves and their physician. They are vested in their care. This is a good thing. Sometimes, patients cross the line and try to be their own doctor. This is when things get tricky and potentially harmful. Show of hands: who has done this before? I think we all have at one time or another, myself included. There are many different strategies that we use. 1) We self- diagnose with the aid of our friends or Doctor Google and seek our own treatment. 2) Sometimes we use left-over medication instead of seeking help or advice. 3) Sometimes we are so set on our own self-diagnosis that we call the doctor’s office and insist on a particular course of treatment and refuse to come in because we are sure that we are right. Then we lash out at the doctor for not instantly responding to our requests of convenience and daring to ask us to come for an appointment. 4) Sometimes we convince ourselves that nothing’s wrong and delay our treatment because we are either afraid or “don’t have time to bother with it.” I think that physicians in particular are guilty of this last one. We spend so much time caring for others that we don’t make the time to make sure we care for ourselves. It really is self-defeating because, if we don’t take care of ourselves and assume a patient role at times, we won’t be around to care for others.

All of these strategies have the potential to bite you in the proverbial ass at the end. I strongly advise against it. Mind you, I am all about patients being aware of their own bodies and health history. On top of that, I am always listening when a patient gives me their diagnosis and I take it into consideration. However, the bottom line is, when you are too close to a situation(i.e you trying to diagnose you), it is nearly impossible to always make the right decision. The chances of you being wrong are greater than the chances of you being right. You just can’t be objective. The decisions we make for ourselves are automatically imbued with our own agenda and baggage: We are worried about missing work. We don’t have time to go to the doctor. We don’t have time to stop. There are deadlines that we are worried about missing. We are afraid. When you “let your doctor in” on the decision making process, you bring back the objectivity that is crucial in determining the right diagnosis and treatment. When a patient comes to me with an issue, I am able to evaluate it with a clear head with objective information. My initial job is to get to the root of their issue and come up with a plan. I have the luxury of not having to be preloaded with concerns about their external factors until I have come up with a diagnosis. Let me clarify. I do not mean that I don’t consider their schedules or other life issues, I just mean that I don’t have to let it slow me down in terms of their diagnosis.

Now that we have described what it means to be your own doctor, let’s talk about why it is a bad idea. First and foremost, you just get it your own way. You slow down the path to diagnosis and treatment, if not cure. Second, if you are wrong, and there is a good chance that you could be, it could literally mean the difference between success and failure, life and death, etc. Third, you are not giving your doctor a chance to actually do their job. They did go to medical school after all and it was probably a more thorough training experience that what Dr. Google or your friend has. Let them get their ( and your) money’s worth out of it! Fourth, trying to be your own doctor can be really isolating and frustrating and often you have gone through multiple incomplete treatment options first when you could have just gone to the doctor and gotten the correct treatment the first time. If the risk of wasting time was your deciding factor in not going to the doctor, you just negated it by wasting your own time. Just don’t do it!

I fully realize that doctors need to step it up and not force this situation either. We are not free of accountability here. We need to try to work with your schedule. It’s not always possible though. We need to have same day appointment availability slots if possible. We need to make sure our staff is answering phones regularly when you call with questions when we are busy with patients. We need to make sure that we answer our phones when you have after hours concerns. I get that. It’s not just a one-sided issue. I make every effort to fulfill all of these criteria. But, none of these convenience and safety steps can make any difference unless you at least try to reach out in the first place.

Have a great day everybody!

Dr. Katz

ANY publicity is good publicity? I am not buying it.

bad publicity cartoon

I am forever hearing the adage, “Any publicity is good publicity” or “There is no such thing as bad publicity.” This has been grounded into my head as a business owner for as long as I can remember. My interpretation of this statement is that it means that any attention is better than no attention. It implies that even if something is deemed bad, wrong, incorrect or immoral, it only draws more attention to it as a sort of forbidden fruit, somehow making it even more desirable. I just don’t think that this is universally applicable.

It may work in the case of a movie star or a rock musician. We hear something potentially unfavorable about them and it intrigues us and makes us want to know more. This increased interest is basically risk free because these people are not likely to impact our lives in any significant way. They are just on a screen or a concert stage that we watch to escape real life for awhile. If they turn out to be a terrible person, so what? We can choose not to watch their movies or concerts or continue to do so with no real consequence either way. On top of that, they probably don’t really care one way or the other what we think. They don’t really need to.

The exact opposite is true for me in the medical field. If someone leaves a bad review for me on Google or Health Grades or worse yet, makes a terrible comment on one of my social media posts, I just can’t see that bringing me any sort of attention that I would actually want. I am fortunate in that this happens rarely, but when it does, I can’t stop thinking about it. I find myself researching who the individual might be and even attempt to reach out to see what I can do to remedy the situation or ease their pain, even if I realize that I have never actually seen the person. This happens all too often. After extensive research I realize that I have no record of this person and yet it still haunts me. These kind of hurtful reviews or comments do not achieve anything productive that I can think of. In fact, depending on the vulnerability of my current patient population, it can potentially affect their perception of me as well. There are people that truly take in whatever is in print as fact, without questioning it’s validity. The initial questions that are raised by these types of feedback can potentially cause ripples of unease that can spread through patients like wildfire. No good can come of that. No one wants to hear something bad about their doctor…ever. You have to have complete trust in someone who is so intimately involved in your life. You have everything to lose and nothing to gain by entrusting a potentially bad or dangerous physician. No one finds themselves seeking some infamous physician who botched a procedure just because they saw them on Dateline or something. It just doesn’t work that way. Have a great day everyone.

Dr. Katz