The first date with a new doctor should not feel like the morning after a one-night stand. But it did when I met my new gynecologist last week. Indulge me for a moment…
Dear Dr. D,
I am a 60-year-old happily married top executive, wife and mother of two grown daughters. My relationship with my kids and husband is terrific. Well almost always terrific. We all have our moments.
I exercise six-seven days a week…a combination of strength and aerobics. At the recommendation of my naturopathic GP I have avoided wheat, sugar and dairy for nearly 25 years after a health challenge. With his help, these dietary changes and some nutritional supplements, I generally feel healthy and strong.
I have no incontinence issues nor issues with “intimacy” though my episiotomy from my second childbirth has given me some challenges through the years.
How were my pregnancies you ask? Great. No issues. Both easy to get pregnant and vaginal deliveries without any pain medication.
As for the rest of my life, my stress levels run pretty high due to my high-pressured job running a family business. But I work hard to keep them in check and actually recently sold the business. Which was itself extremely stressful both personally and professionally. We are still in transition, but I feel good about it.
I get to choose when I come back to you for my next check-up? 12 or 18 months? Wow…that’s empowerment and some great patient focus. I’ll take 18, thank you.
See you then,
Sarah
Well, Dr. D…You might have known those things about me had you actually spent more than six minutes with me and asked me a single question about who I am and what my gynecological history has been. Or made an effort to meet the human behind the stirrups.
This was our first visit you know. I had to find a new gynecologist after the doctor who treated me for over thirty years and delivered my children retired and transferred his patient records to your practice. I’m sure it was all in the chart that Dr. G passed along before he retired. But I’m guessing you didn’t really read up on it. I wouldn’t expect you to, given the time pressures that doctors are under.
But, since there is limited time for reading charts, I would hope that during our brief time together you might make a little small talk to let me know that you understand that health occurs throughout the body and that you realize you’re treating a person and not just body parts between the navel and the vagina. You might have taken just a moment to actually look me in the eyes and ask me anything about me as a person given that we were entering a new and hopefully long-term relationship in what I consider to be a fairly intimate way. Gynecological exams are rather intimate you know. And gynecological or otherwise, a patient-doctor relationship is a personal one that should be built on human connection not just lab scores.
To my blog readers…I just wanted to share that with you because sadly I know that it occurs far too often. And it’s tragic.
We all know the stresses and pressures that doctors are under to “make their quotas” in an increasingly numbers-focused managed care system. But they got into medicine theoretically because they wanted to help people. Yes PEOPLE. And yet, they look at their computers and ask about symptoms and drugs. Not health and wellness.
While palpating and poking, Dr. D should have taken a few minutes to actually ask about me… ask about if my pregnancies and deliveries had any problems…ask about the quality of my marriage and sex life…or ask about my relationship with my kids or my stress levels. These are all aspects of women’s health, and yet she asked none of that. When I told her that I’ve been taking bio-identical progesterone for over 20 years (after she asked if I was taking any medications) she might have asked why. Hormones are a pretty big thing when it comes to women’s health. But she didn’t.
One thing she actually did ask was if I had had a bone density screening. I said yes, but it was probably over 15 years ago. To which she replied…nothing. She didn’t ask about results, nor did she suggest that I have another. She just asked if I’d had one. Huh? Why bother asking?
This, my friends, is not what a doctor’s visit is supposed to be. She seemed pleasant enough and came with very high recommendations. What I don’t know is if her lack of rapport or curiosity was because she honestly didn’t care or that she was simply so pressured by the guidelines of practice that she felt she didn’t have time…or maybe she was just having a bad day and was distracted thinking about whatever was happening in her own life.
I’m not saying that all doctors are like this…but I am saying that no doctor visit should be like this.
In 2015, Dr. Bernie Siegel, who transformed cancer care with his focus on patient experience, wrote an article that opened with the statement “The present health care crisis is not just related to health care. It is a crisis related to what is happening in our society. We have become depersonalized as a society, invested in technology and not the experience people are having.” He then goes on to say, “I know doctors whose salaries were capped because they talked to patients four minutes longer than the department average.”
This has never been more true than it is today.
The patient-doctor relationship is critical to health on so many levels. As Dr. Siegel learned with his cancer patients, patient outcome is vastly improved when they feel emotionally connected and cared for. On a practical level, your doctor can’t properly treat you if they don’t know and understand the unique complexity of your body’s functioning and that doesn’t occur simply by asking for the list of medications.
I know that finding doctors who take your insurance is not an easy feat. So, if you’ve had experiences like the above, and you can’t switch, make sure you are heard…that your doctor has the richness of perspective before you accept a simplistic prescription. Be sure you have your questions to ask when you go into your appointment and don’t leave unless you fully understand the instructions being provided to you and any items being prescribed.
We are not disjointed body parts…we are amazing, complicated integrated systems. Clearly there are those who missed that day at medical school.
