Warning Signs that You Need to "Break Up" with Your Doctor

When I saw this assignment, I just had to jump at it because I have recently had real experience with "breaking up" with my own PCP (Primary Care Physician) after several years of trying to find a good replacement. I finally found a good nurse practitioner that can do home visits, so I finally made the plunge and left my doctor. In addition to that, my mother, who has the same PCP as I do for the past two decades, is also switching from the doctor to the nurse practitioner. All of my reasons are based on my own experience.

Below are just some of the reasons and warning signs of why I broke up with my doctor. There are many more details but it would be a book. A little background on my doctor first.

I won't name the doctor's name out of courtesy. The doctor was my primary care physician. He is an older doctor, currently 76 years old, and he is very stubborn in his ways. If I didn't follow exactly what he said, he would start stalling time on getting my forms filled out, prescriptions filled or general advice. I'm not sure if it was all of his doing or partly due to his staff but, regardless, he should monitor their actions because, after all, they are representing him and, in my opinion, they are a package deal.

I had been going to this doctor since my teens until a few months ago and he was my grandmother's doctor until she passed away in 1993. He was also my mother s primary care physician up until this past week. Everything about our reasons for breaking up with this doctor is still very fresh in my mind, so it's the perfect time to write this article.

Communication

Communication is the most important aspect of a good relationship with a doctor. Let's face it, without good communication, health care is really pointless because doctors need to hear patients describe their pain and discuss it with their doctor, who is supposed to take all of your input and combined it with their medical expertise in order to properly diagnose and treat the problems or, if it is not out their realm of expertise, refer patients to specialists.

My doctor was severely lacking in his communication skills. He would listen to me but it just seemed like he didn't "hear" me and my concerns. It felt like he was basing his treatment on his own opinions with disregard for my concerns. While I understand that doctors are medically trained, I think that is only half of what their job entails. Like I said, I believe that patient input is the other half because most people, like me, know what they feel pain and the general area of where they feel it.

If you can't talk to your doctor, there is little point in staying with him or her.

Bedside Manner

Bedside manner, in my understanding, is how the doctor acts and speaks to his patients, especially when you are sick in bed. I broaden this definition to include all interaction with the patient, in or out of bed, in or out of the office.

Most patients would want a doctor with a great bedside manner, one which is comforting, understanding, honest and not too dark or pessimistic. I don't want the doctor to sugarcoat my ailments but, at the same time, I do expect honesty. I just believe there is a way of not going to either extreme of sugar coating versus honesty -- a way to be honest in a nicer and understanding way.

One of my major irks is that I also want my doctors to act like I am unique, not just a number and feel like we have a one-on-one relationship but my doctor provided a very conformed, homogenous bedside manner. Every time I visited him, it was like déjà vu. He would give his standard greeting and salutations "Good to see you again," along with his smile that looked painful for him to make. After each appointment, I would hear him go into the next room for another patient and hear him say the exact same, canned response, like a robot, which is very disconcerting. I understand that doctors see so many patients that they can lose sight of patients as people and I think this is exactly what my doctor has done over the years -- older and stuck in his old ways.

My doctor acted strange in other ways as well, even when my nurse came on with me during my last appointment. Whenever I would talk to him in person, he would look in my direction, ask a few questions and then just turn his back to me without a word and start scribbling on my chart and writing out a list of prescriptions for the physician's assistant to fill out and only the doctor's signature. I've never seen any other doctor acts this way -- it's just plain weird and rude. Sometimes I wonder what is going on inside his head. Does he think he is better than us because of his medical education? If he's not thinking that, he sure puts on the air of someone with a big ego.

My doctor might be intelligent and educated but is bedside manner is far from acceptable in my opinion.

Adaptability

I think doctors need to have the ability to adapt to new situations, new medicines, new regimens and just plain old modern technology and social etiquette. Times change and so should the treatment of patients, not just with new technology and medicines but also with the way doctors interact with their patients.

My doctor's adaptability seems to be almost nonexistent. I know his bedside manner and overall personality definitely have not adapted to modern times. If doctors are unable to adapt to younger patients, maybe they should just stick to older patients and his regular clientele. He seems to be out of touch with modern times and the social graces of most people under 70 years old.

Being physically disabled, it is rather difficult to get into the doctor's office but they always want to see patients every few months for insurance reasons but they can be a little more lenient. I only complain because I need to take about 5 hours of getting ready, for public transportation and all of the delays that can come with that. Then, when I get to see the doctor, he checks me out for about 10 minutes. 5 hours of time to be seen for 10 minutes seems a bit much. My doctor's office was somewhat lenient to a point but, I know other people who receive 6 months worth of prescriptions so that they do not need to go into the office as much or beg for refills whenever they run out. After a while, the doctor's office would abruptly start refusing refill prescriptions without warning until I make an appointment to see the doctor. That is really a bad thing to do, especially when I depend on the prescriptions. The logical thing would be to say this is your last refill until you see the doctor again, not just completely cut everything off completely because I need the prescription and it takes me a week to plan a doctor visit -- that's over a week of no medication. The doctor should be more willing to adapt to patients' circumstances and situations.

Remember Darwin's theory of survival of the fittest! This actually has a double meaning because, if the doctor cannot adapt to the changing times, he shouldn't survive as our doctor and also we need to be healthy and fit if we are to survive.

Medication

Along with the adaptability I mentioned previously, doctors need to keep up with new medicines. There are a lot more prescription drugs and medicines available these days than there were a decade or more. Doctors need to educate themselves about new medicines that might be better or worse than those regularly prescribed by them for years. I know it is probably easier for doctors to go on prescribing the same medicines year in and year out because they have worked sufficiently over the years, so why try new medicines? There are newer medications with different side effects that might work better than those used 10, 20 or more years ago. It's just common sense logic. Why wouldn't you try new medicines out if they could make the lives of your patients that much better and healthier?

My doctor rarely seemed to discuss newer medications with me unless I mentioned them first or another doctor started me on them first. You would think that getting paid all that money would make him do more legwork and not expect me to do the research and legwork myself. Then, sometimes, when I would mention a new medication, he would be rather flippant in dismissing the drug with a little response without really discussing it with me. Warranted, he is the medical expert, but he too easily dismissed new drugs even though others have and success with them.

Sometimes my doctor's reasons for dismissing certain medications were good decisions but he should discuss them in more detail with patients. However, many times his reasons for not prescribing certain medications prove to be wrong or inaccurate.

Honestly, my disability has no cure and the only thing I depend on my doctor for are his prescriptions for medicine and durable medical equipment. If he can't give me that, he is almost useless to me.

Dependability & Availability

Doctors really need to be dependable and feel like people we can trust with our care. If there is no dependability or trust, there is really no reason to go to the doctor because it's the heart of patient-doctor relationship. You need to depend on the doctor to be there when you need them (within reason of course) and to provide current and accurate medical advice about their diagnoses and treatments. The doctor should also try to stick to the patient's routine treatments until such time as new treatments come out and discuss it with the patient before making changes to their plan of care.

My doctor used to make personal calls to his patients was his practice with smaller but, when his practice and group expanded, he started resorting to having his staff make the calls for him. This is reasonable as long as the staff member is medically trained, such as a medical assistant, but he had his assistant, which is nothing more than a glorified secretary, talk to us about our concerns and basically be like a liaison between me and the doctor. It would take days to reach the assistant plus another few days until she talked to the doctor and get back to us to relay what the doctor said or wrote. Half of the time, the assistant couldn't spell or pronounce the medical terms the doctor or I would be talking about. It makes me feel really safe!

Another way the doctor and his assistant were undependable were in their prescription refills. Take my codeine for example -- one refill he would prescribe one tablet every 6 hours, then one every 8 hours and the last refill said 2 tablets every 6 hours. That really is sporadic and uncalled for because all they needed to do was read my charts and see what my last prescription showed, not to mention that 12 codeine per day would probably put me in a coma! My mother also takes codeine and the doctor prescribed one tablet every 12 hours, then one tablet every 8 hours and then two tablets every 6 hours. She had an MRI done when showed a few bulging spinal discs, which caused her back and leg pain the past few weeks, and wouldn't you know it, the doctor told the assistant to cut it down to one tablet every 8 hours! Just when her pain got worse and it was verified by the MRI results. It's just ridiculous!

Another example of not being dependable is when my mother showed over 75% of the symptoms for iron anemia, such as weight loss, tired legs and eating excessive amounts of ice, the doctor told her that she could lose more weight. I had to tell her to insist on getting a blood test prescription from the doctor and they found her iron levels to be around 33% of what they should be. Only then did the doctor's office take it seriously and rushed an ambulance out to take her to the hospital, where she received two blood transfusions. To make the doctor's advice or a lack of advice even more bizarre, he never told her to get iron supplements or a prescription for them, even though her iron levels were proven to be so low. I had to tell her to buy some OTC iron supplements -- hmm, low iron, iron supplements seems like a no-brainer to me!

I really do not want to suffer in pain and/or emotional stress because my doctor is not dependable and never available. That just makes everything more difficult than it already is.

Ignoring Symptoms

Doctors should watch for recent changes in the patient's health, especially if they correlate to medical symptoms of something serious. Even if the symptoms turn out to be nothing, it is always good to keep on top of it for the sake of preventing serious medical conditions before they become a problem or even fatal. If patients look very different, such as sudden loss of weight or they are more tired than usual, doctors should be on top of it. That is their job after all, is it not?

An example of this is when my mother showed over 75% of the symptoms for iron anemia, such as weight loss, tired legs and eating excessive amounts of ice (pica), the doctor told her that she could lose more weight. I had to tell her to insist on getting a blood test prescription from the doctor and they found her iron levels to be around 33% of what they should be. Only then did the doctor's office take it seriously and rushed an ambulance out to take her to the hospital, where she received two blood transfusions. To make the doctor's advice or a lack of advice even more bizarre, he never told her to get iron supplements or a prescription for them, even though her iron levels were proven to be so low. I had to tell her to buy some OTC iron supplements -- hmm, low iron, iron supplements seems like a no-brainer to me!

A doctor ignoring symptoms is just plain negligent and I should not be doing the doctor's job, especially without being paid!

Timeliness

Timeliness is probably the main thing that doctors and the medical profession are lacking. I understand that we can't expect doctors to be at our every beck and call but there is a certain point that becomes unprofessional and almost disrespectful of the patients.

My doctor is especially notorious for being slow with everything. Ironically, his office has about 20 to 25 staff members and it still takes a ridiculously long time to get anything done by them unless we repeatedly call them throughout the day. And, I also love their voicemail, in which every time we call them, we need to give our name, birth date, Social Security number, phone number in addition to our reason for calling -- you would think they could look everything up on the computer with only one piece of our information, rather than a book!

When I first applied to the state for attendant/nursing care, my doctor and his office took over 5 months of mistakes and time to send the state sufficient medical records on me. Eventually, the state just canceled my application due to lack of proper information. This is just crazy! Really, how long does it take to fill out a few sheets of paper? A few weeks are reasonable but, once you get into months, it is just beyond unprofessional and disrespectful. I gave up working on the application in disgust for a few months before restarting whole process over again. This time I got a local caseworker from the Department of aging to help get everything moving and after a few months, I finally got my attendant/nursing care. I guess doctors are motivated by other medical professionals, so, if your doctor ever excessively stalls time, make sure you have another medical professional with you and see how much faster everything is done.

The above is just one example of dozens and dozens that show the lack of timeliness from my doctor and his office. As I said before, some things take time with doctors but there is a reasonable amount of time that certain things should take. When simple things take weeks and weeks to get done that could be done in a few minutes, it gets beyond ridiculous and it's time to move on to another doctor.

I think my doctor uses his own system of time probably from some alternate universe where its days are equal to months in our universe. It's "Dr. Time!"

Conclusion

Communication, bedside manner, adaptability, medication, dependability & availability and timeliness and the details I give for each warning sign/reason are just the tip of the iceberg for why I decided to break up with my doctor. Each category also outlines what I think are important traits for a doctor to possess and, if the doctor doesn't, he or she is not a good fit for me or most people.

One thing to remember that many "professionals" in the medical field seem to forget is that patients should be able to make their own decisions within the boundaries of safe and healthy medical practices. We, the patients, are the ones who give medical professionals their jobs. We have every right to switch doctors, talk to doctors about our concerns to try to work things out and to see and/or ship copies of our records within a reasonable amount of time (30 days).

Don't be afraid of switching doctors. Don't worry about their feelings because it's your health and your decision. I know it is a lot of work to tell every medical company or other doctors about the new doctor to update their records but, if you feel the doctor repeatedly disregards your concerns and disrespect you and your wishes, there is no point staying with them and it can even be detrimental to your health. Sure, you can sue them for malpractice but any damages to your health are permanent and not worth the money.

If your doctor is unprofessional, like mine, do what I did and break up with your doctor ASAP.