We all lose patients. I'm not talking about death. More like the ones who leave the office cursing or call and harangue you over the phone. These cases are more clear cut. You evaluate the anger and the circumstances and then try to draw conclusions.
That guy was just crazy!
Boy she totally misunderstood me!
I could have done better!
Patients have left me for all sorts of reasons. Anything form my age, to my demeanor. Once a woman left my practice because her physical therapist didn't agree with my my diagnosis of coronary artery disease. This was a few weeks after her first heart attack.
I usually take these loses in stride. You can't please everyone after all. But I can't say it doesn't bother me. I question myself each and every time.
Sometimes the transition is more ominous. A relationship starts out intense and then suddenly disappears. Often it is only months later that I become aware of the absence. An errant pharmacy request for a medicine refill reminds me that I haven't seen a certain someone in quite along time.
With sadness, I realize that I have become a victim of the fade away. Unhappy with my services, I was dumped without even the kindness of a Dear John letter.
And as I sit at my desk and stare at the chart on the computer screen, I contemplate calling. Do I dispute the end of the relationship like a castaway lover? Or do I walk away with my tail between my legs?
Usually, I have my staff contact the patient and offer to forward the medical records. Experience has taught me that confronting the situation myself only leads to awkwardness and apologies.
When I was younger, I so badly wanted to learn from such experiences. But now, I no longer have the taste for hearing how I seemed distracted that day (I was dealing with a crises), or how I took too many calls from the ICU while I was in the examining room.
Furthermore, I admit that I am often not at my best. Some days I am cold, or distracted, or downright curmudgeonly. I still haven't mastered the trick of being open, attentive, and unhurried all the time.
Yet I do mourn these loses. Often more than the deaths. Surrendering to disease is about inevitability.
This, is about character.
You mention a Dear John letter-
ReplyDeleteThat is something I have wondered over the years after we have broken up with a Dr. if we should send a Dear John...
Usually, we break up pretty quick- you can usually tell within an appt our two whether the Dr. and patient share any serendipity when it comes to medicine..
Sometimes the Dr. is nice enough, but was rushed. Sometimes the Dr. just hasn't had any experience with patients with our chronic health issues..sometimes I can tell the Dr. doesn't like me anymore then I like them :-) Sometimes it is clear that the Dr. has more patients then he/she can even triple book, and either waiting a month for an appt or waiting in the waiting room for more then an hour is more then I can stand.
You know, if I had received a survey from the Dr. asking me why I decided to change Drs I would be glad to fill it out- but the question I have as the patient, is would it really make a difference?
If I sent a survey to a specialist who broke up with me the patient, would he/she fill it out honestly?
Would it change how I the patient behave?
You are a good Dr. You also have the advantage, there are a lot more patients then Drs. especially good Drs. Plus you have the advantage, you admit you are human like the rest of us.