Is This Really What You Think Of Me????
By: Rebecca Levy-Gantt
Tags: Patient Experience, Doctors, Healthcare

It takes only a short read of any social media group where medical information, doctors, and health-related conditions are discussed, to feel the distrust. I am often shocked to go through the conversations that people have concerning what they think about the medical profession in general, and even their own physicians or health care providers. The talk ranges from how they don’t believe the advice of their doctors, to how they are convinced that their doctors are doing things for their own benefit, to how they actually feel that their providers are purposely trying to do things that will harm them and also (in the forums I mostly read) their unborn babies.

WHO are these doctors? I know that most of the physicians I know spent many years studying, working and sacrificing to become physicians. I can only speak for myself as far as how I feel about treating my patients, but I am always trying to use what is called “best practice”, and evidence-based medicine to give my patients the very best care that I know how. We use studies, and journals, and go to conferences, and listen to thought-leaders in our field, and think hard and long about diagnoses and plans and risk/benefit ratios. We don’t arrive at our medical recommendations or decisions arbitrarily, or thoughtlessly, and we want the best outcomes for our patients.

I can definitely understand if patients feel that we have not thoroughly explained our way of thinking, or if things that we recommend don’t always make sense — (and maybe sometimes a doctor is just a bad fit for you) but in reading the on-line forums, it seems that patients are convinced that our lack-of-explanations are because we have some crazy agenda where we want to somehow bring harm!

On a daily basis, patients come in to my office with thoughts and ideas from Dr Google, from friends and relatives, or from on-line forums that have convinced them that a certain diet, or a certain treatment is exactly what they need. They feel that the information they have gathered from this “research” is equal (or, superior) to what I have recommended, and just want me to confirm that for them. I spend much of my time trying to convince them otherwise.

Of course, part of my job is to explain and discuss information, current recommendations, and medical advice as thoroughly and completely as I can…..but lately, these information-and-recommendation sessions seem to turn into more of a debate about why that “detox” diet is unnecessary (If you have a working liver, then anything that you are eating or drinking in order to “detox” your system is really unnecessary — in terms of biology, it makes no sense at all), or why the vaccine or medication I am prescribing for you is not specifically designed to injure or harm you in some way…..and if you really have to ask if I am doing something to harm you — — MAYBE you are in the wrong office!?

I love my job. And I realize that the “olden” days of the paternalistic doctor pat-patting you on the head and saying “this is what’s best for you”, without an informed discussion of alternatives and choices is not something I would ever want to go back to….but I know what I know. I know what the evidence says in terms of what is most likely to help you in certain situations. I cannot guarantee that what I do is one hundred percent going to solve your problems, one hundred percent of the time. The human body is astoundingly complex. No one completely understands it all.

I expect patients to participate in their health care decisions. I expect that they come to me for my expertise and my knowledge, as well as my penchant for clearly telling them what is and is not likely to help their condition and relieve their symptoms safely. People must realize that anecdotes do not equal evidence. Just because you “read an article” or “had a friend” that something happened to does NOT mean that you are in the same situation and likely (or unlikely) to have the same outcome.

The best patient-provider relationships are where the physician listens — really listens to the patient’s history, symptoms, attitudes, and fears. The physician gathers all of that information, and realizes that within her limitations, and with “best practice” and a knowledge of the most up-to-date evidence, she can help to put together a program for, and with the patient that looks at the “whole person”. The patient must willingly acknowledge and participate in this plan if that patient truly wants to do what is likely to help for future health and well-being.

I cannot “fix” someone who will not exercise. I cannot turn back the clock on lungs that have been filled with smoke for years. I cannot keep you from getting HPV, or from some other sexually transmitted infection if you do not use condoms. But I can start from here. From the moment you walk in to my office. I can listen to your history and give you my advice, and explain the evidence, and use all my resources and efforts to help you build a healthy life plan. I can have you see my dietitian, a counselor if needed, and will make my expertise and equipment available to you. I will work for you and with you, and do my best to partner with you for lifetime health. I have no pedestal……but I do have valuable information to share. So please consider that before complaining in an open, online forum that all of your doctor’s training somehow does not compare with your sister’s best friend’s anecdote about how she delivered her baby……and accept that anecdotes are not evidence, science has uncertainties, and we at least should always be moving closer to the medical truths.