It’s not me, it’s you.

I’ve said it before – seeing doctors is a lot like dating. Just sent a Dear John letter to the last doctor I saw, a guy I was sent to by Dr. Primary Care. I had emailed Dr. PC after my latest fall, informing him that this was fall #3 in less than 3 months, and this time off the top step of  a bus, right onto my knees and my left cheek. Ouch. Freaked me out to the point I was too scared to drive home after the incident.

To Dr. PC’s credit, he called me right away. “Have you seen a neurologist?” “Yes, many.” “Time for a second opinion.”
(Or 12th, whatever.)

So he sends me off to his second choice, because he knows his first choice of neurologists has a waiting list to rival the French Laundry.  So, I get sent to Dr. Second Best, who has an appointment available relatively soon, and a very empty waiting room when I arrive.  That should have been my first clue. He does the standard neurological work-up, and decides that based on my symptoms, a brain MRI is in order.

Not having a recent photo of the inside of my head, and the fact that I had smacked my face pretty hard, I was agreeable to an update of the noggin.

Dr. Second Best also asked me to email some other MRI results, which I did. Twice. Since he didn’t respond  by email with so much as a  “Thanks,”  I assumed he had given me the wrong email addy, so also sent these results by snail mail.   Still no response.

After my brain MRI, I called the office to get the results.  “Everything’s fine,” chirped the receptionist. “Great, can you please mail me a copy of the report?” ” No problem.”

I wait. Nothing. Nada. He doesn’t call, she doesn’t send copies, crickets.

I shoot off an email to Dr. Primary Care, who thankfully does check his message box and responds.  He hasn’t contacted you?  Why I sent him a bunch of copies of reports (seemingly the same ones I did). No, he hasn’t followed up with me, either.

So Dr. Second Best, you’re done with me. Either you don’t have a clue what’s going on and your little ego can’t handle telling me that, or you’re really that disorganized or disinterested in your work to care.  Either way, I deserve better than what you have to offer, which is nothing.  I’m sure you won’t shed a tear that I won’t be going back to see you, but I will make sure that your colleague doesn’t send any more patients to you.   Also, make sure to respond to my requests for the medical records and notes right away, because if you don’t, I will have no problem in filing a formal complaint.

If you think I was too much trouble to bother with, wait till the State Medical Board knocks on your door.

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Wha? Doctors that seem to know what they’re doing? Twice in one day? Get out!

So it seems my iron levels are up again. I’ve finally rebounded from my little stint with anemia and my iron levels have gone back into the stratosphere. What I find interesting is that in the last six weeks or so, I’ve had a plethora of blood work done. First, because I went to the primary care doc and complained of rapid weight gain and feeling cold all the time. That was his cue to check thyroid, after I suggested to him it might be my thyroid. I was right, the thyroid numbers were off. Which got me handed off to an endocrinologist. He couldn’t figure it out and did do much. The primary care doc wanted me to get a physical and ordered a bunch more tests. I reminded him to order an iron panel. Good thing I did. Way high again. Time to go back to a hematologist again. Thyroid levels were even more way off. Send a message to endocrinologist, who responds back – follow up in 12 months. Really, are you kidding me? I think that’s code for “go get a second opinion and maybe somebody else can figure out what’s going on, because I sure can’t be bothered.”

I really didn’t like, no, make that despised, the hematologist that I saw last time. He was dismissive, arrogant, smug and overbled me. Worst of all, he contradicted whatever my hepatologist (who I think is a rock star) said. I had been avoiding this d-bag for months, and now that my iron levels were in the stratosphere again, I had to find somebody who would give me the “Mother May I” to dump some blood. Ah-hah, a review on Yelp from someone who has Hemochromatosis who raved about a doctor. Small world, she’s in the same office as Dr. Smug.

Side note to any doctors who might be reading this. You might hate Yelp, but until you come up with a better system to find a decent doctor, shut up.

You surely know me well enough by now that I have no problem breaking up with a doctor and dating his roommate, which is just what I did. It didn’t seem to surprise the office staff that I was cheating on the first doctor.

Best move I made in a long time. She actually had 21-st century training in hemochromatosis and I got the feeling that I wasn’t her first rodeo. She even pronounced it correctly. Matter of fact, reviewed what went wrong last time and how to tweak the treatment. Talked to me like I wasn’t crazy. There is hope!

To top it all off, as I’m parking the car in front of the Medical Center, I get a call from Rock Star Hepatologist office: “Dr. F saw your lab tests. He wants to see you right away.” Uh, oh. You mean to tell me that after all of these other docs who looked and my abnormal test results and blew me off, Doc RockStar paid attention? I haven’t seen this guy in a year, and he’s watching my lab tests? Dang! There’s a reason I think he’s a rock star, he’s that damn good. This guy is probably has a patient load three times what the other guys do, sees patients in a 300-mile range throughout the state, and yet will call you at home on a Sunday to answer an email, not to mention will testify in court on your behalf.

Of course, the downside is that finding a time slot to see him is tricky, I have to wait eight weeks, or hope for a cancellation. Hopefully my iron levels will be back to normal by the time that rolls arounnd and he’ll have nothing but positive things to say about my health. Glad at least to see that there’s some doctors out there who don’t blow off the hard cases, and have my back.

Why isn’t there a Zagat guide for doctors?

Why isn’t there a Zagat guide for doctors? Or a Michelin guide? Or even a Tripadvisor site. I know, there’s a whole bunch of “rate your doctor” sites, that essentially tell you nothing. Very few actually have any substantial ratings in amongst the clutter. Yelp tends to  have comments and review on some doctors and medical facilities, it’s almost become the default site for sussing out a doctor’s bedside manner and compatibility.  I know, I’ve dated more than a few doctors in my odyssey. Not dating-dating, but gone, seen and discarded a number of them as not being the “doctor for me.” I can’t even begin to tell you how that has impacted my family’s financial status.  So how, does one find out if the doctor that you’re going to see will be the one that actually figures out (or cares) what the heck is going on with you, or the one that labels you a hypochondriac after taking substantial amounts of money from you?

 

–        Recommendation by another doctor. Sometimes this works great, which is how I found my new primary care doctor. Dr. Black is very perceptive, and pinpointed my hemochromatosis after almost of five years of seeing other doctors. Dr. Robert Miller, a neurologist, recommended him to me.  When Dr. Black decided that I needed to be referred to a hematologist, he sent me to Dr. Knopf.  Dr. Black said he respected this guys expertise. I suspect that Dr. Black has never been to Dr.Knopf as patient. All I know is that doctors will never rat out one of their own, even if they’re horrible doctors, they’ll never admit that there’s an incompetent apple in the bushel. 

 

 

–        The hospital website with a list of their physicians. There’s usually a photo of the doctor here. Though doctors may judge you by the way you look, I’d like to think that looks shouldn’t count. Young? Old? Male? Female? Ethnic background? That’s about all you’ll get from the hospital’s website photo.

Of course, you’ll also find out where he/she went to the endless amounts of school and training. As a layperson, I really don’t know (or care) if there’s a difference between a doctor who went to UCSF or John Hopkins. The websites hardly give more information than that, other than letting me know that the receptionist speaks Tagalog. What I really want to know is, has this doctor ever diagnosed a patient with hemochromatosis? Have they seen a case of peripheral neuropathy caused by a vaccine before? Are they easy to talk to, or arrogant and detached?  Do they lie to patients instead of saying “I don’t know?”

Then there’s the scant selection of online rating sites. There are some with a slight amount of star ratings – based on “how easy is it to get an appointment” and “length of time to wait in waiting room.” Frankly, if it’s a really good doctor, and one that can help me, I can understand a wait to see him/her. If he’s a crappy doctor, it’s not worth waiting at any cost. These sites might as well have you rate the quality of the waiting room magazines, for all of the information they impart.

Then there’s sites like Yelp. Originally started to review restaurants, and the like, I’ve taken to venting my frustration with particularly bad medical experiences here.  Of course, you might be seeing this doc for a completely different reason than me, so the information might not be relevant. I do know that there is a business that has sprung up to “defend” a doctor’s reputation online. For a fee, they will neutralize the bad reviews by adding those “glowing” reviews – if you look closely enough, you can spot them. So, will Yelp give you an accurate view of the medical facility? Hard to tell. I can tell you that I do agree with the reviews for the surgery center at Seton Medical Center, and wished I had paid more heed to them, Although I had selected the doctor for my shoulder surgery, he had selected to do his surgeries there – it wasn’t my choice, really. If I had gone elsewhere, my finger wouldn’t be permanently damaged from the infiltrated IV that was done there. I did feel compelled to comment on this Yelp site about the surgery center – if only because I caught the surgery nurse not wearing gloves when putting my IV in, and the fact that the management at the hospital was unwilling to do anything about it.

Until there’s a transparent and more accurate way to find about a particular doctor’s talent and expertise, there will continue to be unhappy and frustrated patients and the system will never get any better. This is one of the reasons why I will continue to name the doctors and facilities that I have had personal experience with – good or bad in this blog. These are my own personal experiences, and it has cost me quite a lot in terms of money, time, and undiagnosed symptoms progressing while they’ve chosen to pass along the issue to someone else. By sharing my experiences, it’s my hope perhaps someone else can benefit and have a more positive experience in our dysfunctional medical system.

Last week, Dr. Knopf did call me back, and informed he always believes in giving patients a second chance and asked if we could “start again.” Somehow I got the impression that I was not the first patient he’s had this conversation with. Too bad he made it sound like I was the one at fault. I’m not buying it.