Finding A Doctor

Over at Ask An MD, Doctor D is doing a series on Choosing Doctors.  At the close of his latest installment, he says,

Doctor D would love to hear patients’ perspectives, advice, or horror stories on first doctor’s visits.

The following first-visits happened over a dozen years ago:

My Doctor

My current PCP is wonderful.  Part of the reason I like him is how he responded when his staff screwed up my initial appointment:

Due to a move/job change, my husband and I had to find a new doctor.  I compared our insurance list to the yellow-pages, interviewed whomever answered the phone at a few places that had promising-looking ads, and finally made a selection.  We scheduled back-to-back physicals, the plan being that my husband would take the first appointment and I’d arrive just as he was finishing; my husband would then watch the kids during my appointment (childcare is hard to come by when you’re new in town).  After a two-month wait, the doctor’s office called to confirm my husband’s 9:00 appointment for the following morning.  I said that I could save her the trouble of redialing by confirming my 10:00 appointment, too.

She didn’t have me on the schedule.  A look at their computer showed that my appointment had been cancelled.  And given to somebody else.  I didn’t cancel it, so how did it get cancelled?  Why would someone on their end cancel patient appointments – and not even notify the patient?!*

At that point, there was no way they could schedule a full physical for the following day, but they did squeeze in a quick appointment for a minor issue.  My husband had his appointment, met the doctor, then sat in the waiting room and read books to our kids while I went back for my appointment.

I met the doctor, we chatted a bit, he seemed nice enough, and at the end of the appointment I mentioned that my appointment had been for a physical, but somehow it had gotten cancelled.

He stopped (having barely started toward the door).  He sat back down.  And as if he had all the time in the world, asked, “Was there something you were concerned about?”

I was amazed at how compassionate this doctor seemed.  He sat to listen and didn’t appear at all hurried.  I’d never before had a doctor who seemed to care one way or the other, and in those few seconds went from, “this doctor seems okay” to “this doctor is fantastic!”  No, I didn’t have any medical concerns to discuss; the appointment was over.  Up to that point I’d wondered whether or not we’d made a horrible mistake (nobody wants to be stuck with someone who would make a habit of cancelling appointments on them).  The impression I got at that first appointment has been reinforced time and again in the ensuing years:  this doctor takes time to address his patients’ needs.

Kid’s Doctor

Having been convinced that my kids needed a pediatrician (instead of the family practice doctor we all see now), we found a doctor who seemed to be the choice of every L&D nurse in the city.  It’s hard to come with better recommendations than that, so I scheduled an appointment.  And, to make my life easier, I asked to have the paperwork mailed to me so I could complete it ahead of time.  They thought that sounded great, and asked me to send it back so they could have the kids’ charts set up when we arrived.  Done.

We arrived for our first appointment, but they could not find our charts.  Nobody’s perfect (not even me). I didn’t mind waiting while they figured out what happened to the charts, but they had no intention of looking.  I was told that they had 10,000 patients and couldn’t be expected to keep track of everyone.  So I balanced a clipboard on my pregnant belly and filled out all the papers again – this time while also entertaining two little ones.

Finally we were taken to an exam room and waited.  And waited.  And waited some more.  My baby got hungry, but I didn’t want to be nursing her when the doctor came in.  That meant she was increasingly fussy the longer we waited.  I changed my son’s diaper.  I changed my daughter’s diaper.  I finally nursed her.  Changed diapers again.

We were in the exam room for over two hours before the doctor arrived!  He seemed rushed, but nothing was said about the delay.  At the end of the appointment I asked why we’d been kept waiting for so long.  He’d gone to the hospital to do a circumcision.

Excuse me?  I had seen him in the hallway when we were first taken to the exam room.  He had been in the office at that time.  It was a five minute walk across the street to the hospital, and even if (for some strange reason) the circumcision absolutely had to  be performed on an emergency basis (which I find difficult to believe), a circ does not take two hours.

If they had apologized for losing our paperwork, if they had bothered to pop a head into the room and tell me that the doctor had gone across to the hospital and would be delayed, if, if, if…

I stopped at my husband’s office on our way home and ranted about needing to find a different pediatrician.  He – ever the optimist – pointed out that anyone can have an off day.  I gave them the benefit of the doubt.  At our second appointment, they couldn’t find either child’s chart and wanted me to complete the paperwork a third time!  Again, I heard that they had 10,000 patients and couldn’t be expected to keep track of everyone.  Ummm… Yes.  You are expected to keep track of everyone’s paperwork.  That’s your job.  In an effort to make your job a little easier, you now only need to keep track of 9,998 charts.

New In Town

Before finding/firing the aforementioned pediatrician, we drove back to the kids’ original doctor for their well-child checkups.  It was a long drive, but I really liked him and didn’t relish searching for someone in a new town.  One day, however, I was sitting on the floor with my kids.  My daughter was playing happily behind me, I was facing my son (playing with duplos), and I heard a pop as my daughter started crying.  I turned around, and she was no longer sitting up.  I picked her up to comfort her, but it soon became apparent that there was something wrong.

I phoned our pediatrician’s office.  They said that of course they would work my daughter into the schedule, but I might want to see if there was somebody local who could see her.  <sigh>  I knew that sooner or later we’d have to change.  There was a doctor’s office in a nearby town, so I phoned and explained the situation.

What insurance do you have!  I was upset at having something wrong with my baby.  She was obviously in distress and I had no idea what had happened.  I wanted her seen soon if they could fit her in.  Otherwise, I’d make the ninety-minute drive to the old place.  Either, “I’m sorry we don’t have any space available,” or, “We’d be happy to see her if we take your insurance,” would have been okay, but not the way it was handled (we don’t care about your kid, money is all that matters).

Turns out that they did take my insurance and said they’d work us in, so I bundled up my kids and headed into town.  We were kept in the waiting room until the end of the day.  My baby, who rarely even whimpered under normal circumstances, sobbed for the entire four hours.  They should have told me they couldn’t work us in, but would be willing to see us at the end of the day – then I could have chosen between distance and timeliness.

When the doctor finally came breezing in to see us he was holding a recorder, dictating notes from his previous patient.  He introduced himself, then rushed back out of the room.  Minutes later he returned, said a few sentences, and left again.  Once more he returned, this time to examine my daughter.  He announced that when I’d pulled on her arm, I’d dislocated the elbow.  Maybe it’s dislocated, but I did not pull on her arm.  She was sitting all alone in the middle of the floor. Nobody touched her.  He made the necessary adjustment and did a quick sketch of the elbow joint to explain that a dislocated elbow is called “nursemaid’s elbow” due to the way this injury occurs.  Maybe that’s one way it happens, but that’s not what happened here.  He chose not to pursue it any further, but obviously thought I was lying.

Since that time I’ve talked to a number of people who confirm that my experience there is not at all unusual.  It’s a small town with only one doctor’s office.  Maybe they thought they were doing us a favor by saving us a long drive.  Not realizing that it was their only chance to make a first impression, they blew their audition.  It would have been faster and more pleasant if we’d just made the long drive.  Many of the locals will accept such treatment to avoid driving into the city.  At least now I’d gotten to see how they run the practice.  I knew we’d have to look elsewhere when the time came to find a new doctor.

*Another patient with a similar name died about that time.


One thought on “Finding A Doctor

  1. Pingback: What Works? « ∞ itis

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