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And
the Survey says….”
Not
only do problems (communication and otherwise) exist but there is a
major difference between doctors and patients. Patients are generally
coming at the issues from a SUBJECTIVE perspective whereas the doctors
come at it from an OBJECTIVE point of view. Until each side recognizes
that they are the exact opposites, trouble will prevail. Let’s lay some
groundwork. I’ll introduce you to Marcus Welby, M.D., a model doctor
of old (TV) days. Then we’ll discuss many of the emotional aspects of
encounters with doctors. Start learning about the gatekeepers and the
reasons you feel like processed meat moving through the system from
making an appointment to getting home with your prescriptions. We’ll
talk about how the symptoms have to fit what a doctor is taught, how
they speak a different language than we do, how pills are easier to
prescribe than listening, how patients’ emotions play into their interactions
with the doctors. From tests to pills to insurance, find out how we’re
living in different worlds and get ready to find out what that universe
is like.
The
Gatekeeper Syndrome: It begins with frustration
You
probably know the frustration you feel even before you get in to see the
doctor. Not only are you sick and frightened, but you have to spend time
on the phone calling for appointments–often for more than one doctor if
you need a referral – or the insurance company. It’s as if you have to
ask your insurance company permission to be sick. Then you have to ask
permission to get something done about it.
You
have to go to a primary care doctor before you can get a specialty referral.
Even if you know that that’s what you need, there are still silly requirements
for the attending physician to refer you. It’s as if we’re never smart
enough to know whom we need to see.
Sometimes there’s the limit to the number of visits you can have
compensated by the insurance company. If you’re not better in that number
of visits you’re, shall we say, out of luck. The same goes with admissions
to the hospital. You’re only allowed a certain number of days, but your
body may not have gotten the memo and doesn’t respond the exact way it’s
supposed to.
The insurance company isn’t the only gatekeeper. The doctor’s staff
can be as bad or worse (of course, they can be excellent too). Often they
seem to be compelled to protect the doctor: protect
him from you. That makes you feel worse. You only have that 10 or 15 minute
visit and it’s tough if you have something that will take longer – be
it questions or complaints. Make no bones about it though; the staff consists
of the people who help the patients more than anyone!
The
Cattle Factory Syndrome
You
know what a cattle factory is, right? It’s where they just push the herd
through, one after another, without stopping. That’s what being in the
doctor’s office is like. They’ve got to get everybody in and out and the
doctor has to find the answer in a period of 10, maybe 15 minutes. In
some parts of the country the patient can't explain their symptoms in
10 minutes.
There is no way on earth that everything that needs to be done
can be finished in that short a time, not even for something fairly simple.
A change must take place in how you prepare for your visit, how
you interact with and what you expect from your primary care doctor.
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