I Don’t Understand

Dear Dr:

This problem with my GI tract has been going on for two months, and the more I learn, the more frustrated I get with how you have handled my case.

Why did your partner do an EGD instead of an ERCP?  From comments I’ve heard, I’m not the only one asking that question.  I really don’t understand.  The scope was already in place – he could have kept going until he found the problem.  That would have eliminated the need for the subsequent MRCP and the second CT.

Once you decided that I needed a lithotripsy, I don’t understand why you would only refer me to big-city when there’s somebody right there in mid-sized-city who does the procedure.  Referring to a competitor when you can’t provide the needed procedure looks like you want what’s best for the patient.  Conversely, making the patient wait months for treatment because you won’t refer to a competitor looks like you don’t really care if patients are suffering.

I don’t understand why you only told the big-city GI department about CT#1 and not CT#2.  Shouldn’t they know about both of them?  I don’t understand why the referral you wrote flagged me as routine so that they thought they could contact me in their own sweet time instead of treating me promptly.

When you wrote that referral, I’d already been suffering four weeks.  I don’t understand why, when it took three more weeks for big-city to call and set up an appointment even further in the future, and I begged your office to expedite the process or find me a different doctor who could do it sooner, you waited another week to respond.  I don’t understand why your response was to send my paperwork to big-city’s medical school, where it could gather dust for a few more weeks before they called me to set up a routine appointment.

You seem to view the fact that my entire abdomen aches and I can’t eat as routine, not serious, and not worthy of your attention.  Why is that?

Maybe you’re not familiar with any of the doctors in the competing healthcare system, but there is a doctor in mid-sized city who does lithotripsies.  He looked at my CT images and said that I needed to be seen promptly.  He even re-arranged his schedule to fit me in and get the procedure done as soon as possible.  He performed the ERCP/EHL last week.  My pancreatic duct was 80% blocked.  Eighty percent!  Maybe you think that’s routine, but I certainly don’t.

When I saw you in the middle of September, I had no idea this problem would drag on so long that it could affect my family’s plans for Thanksgiving.  What’s so incredibly frustrating is that it didn’t have to be this way.  You could have – should have – handled this very differently.

If you had referred me to your competitor, the procedure would have been done promptly, I’d have returned to you for follow-up, and all this would be in the past.  Instead this is ongoing and I’m not particularly inclined to return to you for follow-up.  Since you wouldn’t act in my best interests in this situation, why would I trust you in the future?

When I go to my family physician for help, I know he’ll listen to me and do what’s needed to get me well. When I go to my rheumatologist, I know she’ll listen to me and do whatever it takes to get me the treatment I need.   When I go to you… well, it’s so sad that the same thing can’t be said for you.