When I walked out of my primary care physician’s (PCP’s) office last Thursday I was fuming, “I can’t believe it. There were so many things she didn’t check! How dare she?! I didn’t travel several hours and across multiple state lines to have a sham of a physical!” When I got home I launched into a tirade about how she did this, but not thoroughly enough, and didn’t do this, this, that, and the other thing. I had literally gotten so heated by the end of it that I was sweating.
Three days later I had brought up the visit, yet again, with one my friends and animatedly shared my frustration, “I couldn’t believe that no one checked my BP! I am predisposed! It’s in my chart!” My friend politely interjected, “Did you ask her to take it?”
I paused and mentally replayed the visit in my mind. The answer? No.
It was then I realized that my doctor and I were both at fault for making that a less than productive visit.
How she failed –
Before she started the exam she asked me a series of questions to update my chart. Totally standard. However, she asked the laundry list of questions in rapid-fire succession, which did not provide me with much time to think about my answers or whether they were complete. Furthermore, some questions, like this one, were asked rather indelicately—
PCP: How is your mood? Is it stable? Are you depressed?
This is a loaded question. Actually it is three questions, but how do I completely answer any of them? My mood, I don’t know, it comes up and down given life circumstances. What do you define as “stable” and for how long is that term supposed to apply? Am I depressed this very moment? No, not really. Have I felt that I may have been in the past, yeah, maybe, I’m not sure. Do I feel comfortable having a conversation with you about it right now? Nope, you’re not very welcoming and I have about had all of the vulnerability I can take today.
I would have preferred if she treaded a bit more lightly. Had the tone been conversational rather than an air of I-am-just-trying-to-get-information-down-on-this-paper-so-I-can-go-see-more-interesting-patients I would have been slightly more open to a conversation about it.
And her flippant remark in this instance was completely unnecessary—
PCP: Do you exercise?
Me: Occasionally. I know I should exercise more regularly, but I don’t.
PCP: It’s because you’re skinny; you’re not motivated.
Me: O________O
WOW! Because people are only ever motivated to exercise when they want to lose weight, right?! Yeah, okay. Instead of that remark a better follow-up would have included questions about why I am not exercising, for example: Is it painful when you exercise? Are you too tired? Do you feel like you don’t have time to exercise? Do you have access to a park or another area (that doesn’t require payment/membership) where you can work out? Is it safe to exercise in your neighborhood? She also could have suggested ways to work in physical activity during my workday like taking the stairs or taking a walk during my lunch break.
The physical exam itself was *actually* sub-par. She only checked my mouth, lungs, and breasts (although she only checked them with my arms down at my sides). My temperature, blood pressure, ears, eyes, abdomen, and joints all went unchecked – which I found exceptionally strange because those were all things she checked during my last physical with her.
How I failed –
I didn’t come prepared to discuss any of the mildly abnormal aches, pains, popping sounds, and migraines I had experienced over the last year mostly because I forgot about them. Unless I am feeling the pain when I am at the doctor’s office I completely forget to bring it up with her. To combat this I am thinking of trying to set reminders about things to bring up with my doctor with alarms that go off about 15-20 minutes before the appointment to help jog my memory.
I should have asked questions when I was confused or curious about something instead of just letting the question sit in my mind and remain unanswered until I forget I had the question in the first place.
I should have asserted myself and asked for what I wanted (in reference to the BP check) instead of sitting there after the doctor left and getting angrier by the minute. It wouldn’t be putting her out and it takes no time. It’s my health; we both have to take responsibility for maintaining it.
But saying I should have done these things and doing them are two totally different things. I know why I didn’t do them. It’s usually because the following things are frantically running through my mind:
– I don’t want her to think I am a hypochondriac…
– I don’t want to bother her with unimportant things because she is busy…
– She probably thinks this is a waste of time…
– It’s probably nothing…
While also knowing that I am not a hypochondriac, this isn’t a waste time, and it could be nothing, but it could be something. Furthermore, how can she know that something is wrong and address if I don’t tell her? She is not omniscient.
I think, if anything, this visit reminded me that the person sitting across from me on the rolling stool is a human. There is a lot of power that comes with that M.D. She has undergone extensive training, has years upon years of experience, and is highly regarded among her peers and patients. Regardless, she is still human and is as imperfect as the rest of us. My health is not best served by expecting her to know and do it all, it is best served by the two of us working together; it has to be a partnership.
Maybe we’ll work together a little better next time.
Originally posted May 15, 2014 on my tumblr.
livingLAH 