When my neighbor Kendall went to a well-known surgeon to discuss a tricky elective surgery she was considering, she was appalled at his manner. He answered her questions brusquely (even calling one of her queries “insipid”) and seemed to barely listen to her concerns about the procedure’s risks. After 10 minutes, he abruptly announced that their time was up and left the room.
As Kendall told me the tale, she was angry and confused. “He has a reputation as a great surgeon, but he treated me like trash. Why would he do that? And should I overlook his nasty personality because his work is good…or go elsewhere?”
What really seemed to strike my neighbor as odd was to find a bully in a “helping profession” such as medicine. Yet this is not uncommon, I heard when I contacted Ronald Schouten, MD, JD, an associate professor of psychiatry at Harvard Medical School and coauthor of the new book Almost a Psychopath: Do I (or Does Someone I Know) Have a Problem with Manipulation and Lack of Empathy? In fact, Dr. Schouten told me that he has evaluated a number of physicians, male and female, whose patients complained about their lack of empathy.
What should you do if you’re dealing with such a doctor? First, consider which of the following categories he or she falls into…
The unintentional bully. Least worrisome is the doctor who basically does want to help others but who is unintentionally bullying at times. He may be insensitive…feel overly rushed…get caught up in a sense of his own importance…or be so stressed out from the demands of his practice that he does not always behave appropriately.
What to do: If you trust this doctor and aren’t overly disturbed by his brusqueness or egotism, you’re probably fine sticking with him if you want to.
The true psychopath. This type of person shows a profound lack of empathy, extreme egocentricity and a willingness to engage in immoral and antisocial behavior for his own gain. Psychopaths are rare in medicine but not unheard of. “History reveals that medicine has had its share of con artists, white-collar criminals, sex offenders, even serial killers,” Dr. Schouten said.
What to do: If you have even the slightest inkling that a doctor may fall into this category, clearly you must leave his care immediately…and if you have any evidence (for instance, of sexual misconduct or other criminal behavior), alert the authorities.
The “almost psychopath.” Between those two extremes lies the type of bully that Dr. Schouten calls an almost psychopath. Such people are self-centered, egotistical, controlling, shallow and indifferent to the needs of others. A physician who exhibits such traits may have excellent technical skills yet nonetheless do significant damage—for instance, by manipulating vulnerable patients or by making decisions based on the belief that he is more important than the people he is meant to take care of.
What to do: If you suspect that your doctor is this kind of bully and you live in a large city or near a university hospital, it’s probably easy enough to change doctors. However, in a smaller community with a limited number of physicians, you’ll want to weigh the objectionable traits of your current doctor against the inconvenience of traveling far afield to see someone else. Examples of red flags to watch for include a doctor who…
- Refuses to answer your questions or provide you with information about your condition. (Do be reasonable, though—if you have booked a 15-minute appointment, it’s not fair to arrive with 60 minutes’ worth of questions.)
- Is arrogant—for instance, if you ask how many procedures of a particular type he handles each year and he replies, “Do you know how famous I am for this?”
- Is insensitive to modesty and privacy issues. You deserve a doctor who knocks before entering the room if you have been told to disrobe…warns you of what he is about to do during an exam…and does not leave you in an exposed position.
- Handles you roughly. Yes, some procedures are painful—but you should not sense a lack of regard for your comfort or any unnecessary prodding.
If you experience scenarios such as those above, step one is to discuss your concerns with the doctor. Be frank—“It makes me uncomfortable when you act this way.” Bring a friend or family member along if you want moral support…or write the doctor a letter if that is easier for you. Many physicians recognize that they have been inappropriate once a patient points it out to them, Dr. Schouten said, and they try to mend their ways.
But what if the problem persists? It’s time to say good-bye to the bully and find yourself a doctor who truly has your best interests at heart.