Tuesday, March 19, 2013

Will They Follow?

It hurt, more than I was ready to admit at the time.

John walked into my office years ago with a stack of papers under his arm.  A few hundred pages to be more exact.  He carried his copy of the medical history like a burden that was more a part of his body than a separate, distinct object.  He pushed it forward onto my desk tentatively. 

There was the usual minutia of any medical record: labs, injections, consult notes. It was a cat scan, buried under reams of repetitive nonsense,  that caught my eye.  The little smudge noticed by the radiologist was a nothing, a ditzel.  But there was no followup.  No further workup.

Originally John was alarmed, then scared.  The biopsy showed a lethal malignancy if left untreated.  I put my arm around his shoulder as he shook.  A week later he underwent a successful surgery and was cured. 

For years he walked in and out of my office on a regular basis.  I was the doctor who saved his life, and he was my patient.  In 2007, I announced that I was moving my practice thirty minutes to the north.  Of all the people, I was shocked to find that John refused to follow.  Without apology, he explained that he preferred someone closer. 

My sense of professional worth dropped a notch that day.

Now, in 2013, I am again asking my patients to make a drastic change. Although I have had nothing but positive feedback, I can't help but feel a tad skittish. 

I will stand alone, exposed, and make my pitch.

But will they follow?


Anonymous said...

If you promise them cookies they will follow (only half joking).


Anonymous said...

Dr. Grumet:

Keep on writing. I so enjoy your heartfelt writings.

Marian Ead RN

Anonymous said...

I drive 15 min to get to a great mechanic. It is worth its weight in gold. As time goes on, people will begin to value a great physician more and more. They will clamor for your assistance. Have faith and one step in front of another. :)

Experienced MD said...

finished residency and started private practice IM 1982. In my area PPO and HMO were non existent. Then they began to appear and recruit physicians to their panels. I still to this day remember the shock and consternation when a patient first requested a transfer of medical records to another physician because I was "not on their insurance". It took me a while to come to terms with the implications of this seismic shift in doctor-patient relationships which is of course completely unknown to the younger generation of physicians. I can tell you that I never looked at the relationship with my patients in the same light ever since. No longer was there a bond of sacred trust and faith but rather an economical business model. They "use" a doctor because he is "on their plan". I no longer give it a moment's thought when someone's insurance changes at the beginning of a new plan year and they switch to another "PCP". New names and faces and medical histories will soon come along to replace them and keep me busy as long as I care to keep working. Sad state of affairs created by someone's brilliant idea of "third party" payors. I for one was much happier when there were only two parties. Good luck in your new endeavor and value highly those patients that will voluntarily reach in their pockets to come see you.