Wednesday, November 18, 2009

My Doctor Failed Me

I was interested to see the Cases column in yesterday’s New York Times, and especially glad to read the last line: “The answers are with the patients, and we must remember the unquantifiable value of asking the right questions.”

In fact, that article, coupled with my own recent up-close-and-personal experience in the medical world prompted me to write (although I probably will not send) this letter to my (soon to be former) internist:
Dear Dr. I-Used-to-Think-You-Were-a-Really-Good-Doc,

I’m writing to ask that you please forward my medical records to my new internist as I am leaving your practice effective immediately. Although we’ve been through a lot together in the last five or six years--ongoing control of essential hypertension, diagnosis and treatment of a lingering viral infection, antibody titres necessary for grad school enrollment, a Z-Pak or two for upper respiratory infections, and, just about two years ago, a four-day hospital stay via the emergency room that resulted in gallbladder surgery—it’s time for me to move on.

Why, you ask? Well, let me tell you.

Until now, we’ve had what I would consider to be a positive doctor-patient relationship and you’ve been, from my perspective, accessible, competent, compassionate and caring, qualities that are harder and harder to find in an internist. Back in January, however, during a routine visit in which you checked my cholesterol and blood pressure, I told you—with great difficulty—that I was increasingly stressed out and having trouble dealing with it.

Your response? Try to get more exercise and see if that helps. Anxious to feel better, I did start an early morning treadmill routine and found that, indeed, I was better able to handle the challenges of balancing work and school throughout the spring…until plantar fasciitis forced me off the exercise equipment for a few weeks during the summer.

By last month, with Biennial just days away and amidst mounting pressure from both work and school, I again told you during a routine visit that I was not handling stress well and that more and more I felt it was negatively affecting my ability to function effectively. Your response this time? An electrocardiogram (which was totally normal) and the suggestion that I “just need to get through this.” That day, I left your office more stressed than ever and, although I was unable even to envision life after Biennial, hoping that things somehow would be better once I returned from Toronto.

Unfortunately they were not, which only furthered my resolve to find an answer. Earlier this week, therefore, I saw my ob/gyn, a doctor I had previously seen only for routine care and with whom I do not have the longstanding relationship I have with you. And yet, to my great relief, she listened, asked good questions, answered mine, ordered a lot of blood work and (pending the results) offered a seemingly plausible diagnosis. In this particular instance, she also prescribed medication that, once it kicks in, will, she assured me, help me feel better.

Now that I’ve had a chance to read up on the diagnosis she provided, I’m compiling a new laundry list of questions for when I see her again in a few weeks. At the top of that list will be this one, very important question: Can you recommend a new internist?

I regret that our relationship has ended this way, but the bottom line is this: when I needed and asked for your help, you disregarded my concern, you blew me off, you just weren't there for me. I only hope that you’ll be there for the rest of your patients.


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