did a doctor wrong you?

It's a start. But for a lot of presenting problems, at least in my specialty, you're dealing with a wide range of possibilities for each of those parameters, which muddies the waters quite a bit.

But (I hope) it's more than that. I was chief of my group for 8 years, so I got to handle all the complaints. I had a couple of docs, and one in particular, who would catch complaint after complaint, and just didn't understand that the fact that they were "right" about the patients problem didn't give them a license to be a dick. The one isn't with our group any more.

Another poster pointed out that failing to communicate is a surrogate marker for arrogance. I think that was pretty much on the money.

MM MD

Doctors are a breed apart. The great ones pretty much work magic imo, like the surgeon who fixed my shattered shoulder. Nice as hell btw, charismatic like a movie star. But I wouldn't put up with an openly arrogant GP.

I think we can/should take gps out of the discussion. there's a huge difference between them and surgeons and er docs. and the fact that we have an er doc right here willing to speak and deflect dicks is a nice opportunity to learn something.

if there is a gp reading, feel free to jump in. i mean no disrespect at all. i love my gp, but it's mostly because i love his bedside manner. the slightest hint of a problem that can't be addressed with a routine prescription and he refers me to a specialist. and that has plenty of value, because i trust his recommendations. but if he was "arrogant" or a "dick" or made me wait too long to see him, i'd be out the door.

If you have a good GP, treasure him/her. They're a dying breed, mostly because of the screwed up way docs are compensated. They don't do much in the way of procedures, which is where the $$ is. I get paid about 3x as much for sewing up a one inch laceration (which I could probably train 99% of the readers here to do in half an hour) as I do for evaluating a 65 year old hypertensive smoking diabetic with chest pain (which is a potential medical disaster)

If they work for a hospital, they have to see x number of patients a day - and x is usually pretty high, so they have to churn thru the list as fast as they can, so if someone comes in who needs a little time they can spend it without worrying about getting a call from some bean counter accusing them of slacking. Tough life, overall.

MM MD

For me, as a patient, it's really not more than that. In a more complicated situation (common for you?), where there are a variety of essentially equal options, then I would expect some quality communication.

But If I've already decided, for whatever reason, to trust you, I stop caring about how well you can explain things or how nice you are.

If you fix me, you are NICE! really,really nice. In fact, I don't know if i've been lucky or it's just something about me, but i find doctors explain more than i need.

I have virtually no idea what i'm seeing when looking at an mri or an xray. but my doctors have always pointed out out the "obvious" to me and i just go ahead and pretend to see what they're seeing. partially to mask my ignorance, and partially to acknowledge their feelings. they're taking the time to show me something and gain my confidence and meanwhile another patient is waiting for their attention.

I don't know. Doctors are in a strange position in our society. I suspect they are frequently not thought of as relatively normal people. They are often revered or hated. And they probably react to that, 'cause, correct me if i'm wrong, but they are just people.

I believe your arrogance is true. You are hijacking a thread and trying to substitute your answers as his. This is why arrogant people are hard to communicate with, it is all about me, me, and me.

http://www.merriam-webster.com/dictionary/arrogant

NO MAT, I can't believe this.

No but I have seen doctors reduce the staff in an OR to tears so that they couldn't do their jobs. I have seen docs make major errors that they covered up or worse put on other staff. I have seen arrogant docs write prescriptions for narcotics give them to the staff and demand they fill them and give them the pills, (ruining nursing careers but not the doctors) I have seen docs use unclean instruments on people when this would not be tolerated in a vets office.

Medicine is production, in the GP office, the GI office, the ER, and the OR. Would you want a Bryan Bosworth removing your gallbladder?

oh my god. You always struck me as anything but arrogant. jesus.

I agree, doctors should just be perfect all the time, and react to and speak to each individual patient in exactly the way that they would prefer to be spoken to in every single one-off interaction, despite what else has been going on that day or whatever situation they find themselves in.

What a bunch of jerks.

Are you a doctor?

On a less sarcastic note, I think that many "high maintanence" patients (and I dont really mean that as an insult) do not realize that not everyone is like them, and not everyone has the same expectations of the doctor-patient relationship as they do. The MAJORITY of patients really dont want you to be deferential to them, they do not want you to try to explain everything in detail. They EXPLICITLY do not want you to try to make anything "their decision." They are overmatched by the decision, and want you to make it for them. It is difficult as a doctor to have to try to guess how exactly each patient would like to be treated from the instant you first meet them, and first impressions can be lasting.

Yes.

She's been with me 11 years, so she might know something. But this thread is teaching me something else. Arrogant is a completely useless word. It's just too subjective and has so many different meanings to so many different people.

I don't think I'll ever use it to describe someone again, nor accept it as a description.

Are you willing to share what type of doctor? I think people can be too hard on doctor's personalities, but I think it matters more in certain specialties than others. I would hope all doctors and staff at a hospice would be extremely nice all the time, for instance.

Surgeon

do you agree with my post #31?

Inpatient psych (where I work), I would put drug-seeking/malingering at 10-20%.

For psychiatric emergency services, maybe closer to 30% malingering. They either want pain meds, or they want a hot meal and a bed for a few days and if they don't get it they're going to kill themselves.

I guess this is something more noticed by other nurses. I doubt the ED nurses would show their arrogance in your presence.

Another thing I've noticed about ED nurses, they love to flirt with the doctors. You would think they were in high school. I was doing a short stint on a med-surg unit 2 yrs ago. While there I worked with 2 nurses who had just transferred from the ER. Couldn't believe the gossip about the ER nurses and their relationships with the doctors. They said they left because the more senior nurse's were on a power trip and were having relationships with the doctors and they were dumping on the less senior nurses. It would explain the high turnover in our ER department! Not saying it's like this at your hospital, but for some reason we hear a lot about it at our hospital through the nurse grapevine

Yes I think thats fairly accurate, I'd say thats the mindset of a typical patient. And its easy to get sort of used to that approach. High maintenance patients have every right to be more demanding, I think that they should be if they want to (its probably how I would be as a patient). I just think they should realize that they are not the norm, and it is not easy to instantly shift gears. I would be thrilled if every single patient took "informed consent" and "patient autonomy" seriously. It would make my life so much easier. My dream conversation with a patient would be "Hey, so these are the options. I assume you've read extensively on them. These are your unique circumstances that impact the decision. I'd be happy to explain whatever you are unclear on. And I'll just wait until you decide what you want to do." That way I have little legal and zero moral/emotional liability. You made a thorough, informed choice, its your health, your decision, your problem. I'll just do my best to help out.

But in reality patients usually just want you to tell them what to do, and when you try to make them take responsibility they get upset, mad, "You're the surgeon just tell me what to do," etc. Then they get super pissed off when something bad happens, because now it is "something you did to me" and not "something I chose to do that had a bad outcome."

Its probably the same reason my wife doesnt ever want to pick the restaurant.

I don't know about this but could you maybe try to make eye contact once in awhile?

all kidding aside, I think your statements are very accurate and it must be incredibly frustrating and disheartening to hear people on the forum (including me) criticizing doctors. There's a real skill to dealing with patients. If a doctor has just seen 2 difficult patients in a row, he may not be in any mood to talk to the 3rd one. That is a problem.

I actually defend 95% of the doctors I ever come in contact with. And I argue with people when they try to put down doctors. I think they do an amazing job under a very heavy load and I'm really impressed with their ability to stay professional with the most difficult obnoxious patients. My hat is off to you.

And I'm not trying to blanket defend all doctors. There are many criteria used to select med school applicants but charm and sociability are low on the list. Similarly there is an insane amount f material and technical skills to master during training and people skills are an actual skill that need developing and it's hard to dedicate time to that. Everyone wants a very friendly charming doctor but how much time that they dedicated to medical knowledge or skill would you truly have preferred they spent on effective communication techniques instead?


But yeah a shocking number of my classmates were straight up social rejects.

I don't remember the source, but I heard/read about a study that showed malpractice suits were not generally correlated with quality of care, but with how big an ahole the doctor is.

Malpractice cases come in three flavors, pretty much.

1) Slam dunk screw ups - amputate wrong leg, leave clamp in patient - those generally settle without going to trial.

2) Complete catastrophic outcomes. Especially if the patient doesn't die, but ends up with a long term disability that will need chronic care. These are tough - the care of the patient might (or might not) have been fine, but the patient pretty much has to sue - as a society we have no mechanism in place to get people like this the help they need otherwise.

3) Everything else. And as you noted, a lot of these cases come down to the doc/NP/PA being perceived as being uncaring. I think a lot of these come down to bad communication/bad social skills on the part of the practitioner.
I suspect these cases are the majority of cases that are filed, or at least the ones that go to trial.

MM MD

Yep it's the number one related factor I think, much more predictive of your chance of being sued than whether you made any sort of mistake or caused any harm. Lolpatients

The other major driving factor is "patient inability to pay". Shouldn't be a surprise but when the patient cannot afford to pay the treatment, the long shot of a malpractice suit becomes much more appealing