To my Patients

Dear Patient:

I am writing this to set the record straight.  Coming to the doctor is often an awkward thing.  Many people don’t want the spotlight focused on them, and so react unnecessarily to things that happen in the office.  Let me give you some tips that may help the office visits go better in the future.

  1. There are no “stupid reasons” to come in to see me.  People are constantly apologetic for coming in when they are not sure there is something serious going on.  Why should you apologize?  The best-case scenario is that everything is fine and that you are over-reacting.  The worst-case scenario is that something serious is going on and you are sitting at home.  There are things that you just can’t figure out without my help.
  2. Infants don’t need to drink “Sweet Tea.”
  3. You are not “wasting my time.”  I actually enjoy having visits with patients where everything is OK.  I have told many patients that it is my goal to turn as many people as possible into “boring patients.”  That means that everything is OK and I am just touching base with you when you come in to be checked.  On those visits we can talk about your grandchildren or your job.  I actually enjoy doing this.
  4. I am not offended by earwax.  Please don’t apologize if you have any.
  5. You are not crazy.  I have a lot of people who are really anxious about things in their life and they are worried that they are “going crazy.”  There is a huge difference between being “crazy” (psychosis) and struggling in life.  Everyone is struggling in life (no matter how “together” they appear on the outside).  One of the best parts of sitting in my seat is that I have a whole bunch of people opening up to me with their insecurities and anxiety.  I have realized that everyone is just as insecure as I am - and this really makes me feel better in my own struggles.  If you can’t share your anxieties with me, then who can you share them with?  I promise not to make you feel that you are feeling the wrong emotions.
  6. Milk does not curdle in the stomach from a fever.  It always curdles in the stomach due to the fact that the stomach is full of acid.
  7. I am not your mother.  I don’t get “disappointed” in my patients for now following my instructions.  My job is to give you information as to what needs to be done to reach your medical/health goals.  The only way I can be “disappointed” is if I don’t think I did a good enough job.  Plus, I have found that putting patients on a guilt-trip is counter-productive.  It only makes people afraid to come to me for fear that I will give them a tongue-lashing.  You are plenty good at giving your own guilt-trips, so I don’t need to pile on.  I promise.
  8. Green snot does not mean sinus infection.  When I was a kid, I knew that snot is generally green.  It happens with all colds and does not imply you need an antibiotic.
  9. I don’t bring patients into the office because I need the money.  My schedule is full every day.  I have no need to invent reasons for people to come in.  I am at the point in my career as a physician that I don’t need any extra work.  If I think you need to come in, it is for your benefit, not my financial gain.
  10.   We have no control of the temperature in the exam rooms.  The thermostats seem to be there for decoration only.
  11.   It is OK to question me.  I have bad days too, and may not think of things sometimes.  I do my best to be as sharp as possible, but there have been plenty of times over the years when patients have greatly helped me by bringing up things I have missed.  Heck, I think it is OK to question God, and I know He doesn’t make mistakes, so who am I to think I am above questioning?  I actually think that the thing that makes a good doctor is that they don’t care who comes up with the right answer, as long as it is right.
  12.   Don’t add or subtract a degree to the temperature.  Just tell me how you got it and what it was.  Oh yes, and 99 degrees is not a fever.
  13.   If you are coming in for a cholesterol recheck first thing in the morning, please fast.  If we ask you if you have eaten anything, please understand that a donut or a bacon and eggs breakfast does count as food.
  14.   My staff is more important to me than an individual patient.  If you mistreat my staff, I will dismiss you.  Believe me, I have done this.  There are plenty of nice people willing to take your place in line.  They do make mistakes, but are generally working hard.  It is my job as their boss to make sure they are doing a good job, not yours.  If you have a complaint, I am happy to hear it.  Just don’t think I will tolerate treating them poorly.
  15.   I have heard the joke about “the light shining through to the other side” when I look in the ear about ten thousand times.  If you say it because you are nervous, I will still laugh, but only to be polite.
  16.   Never assume “no news is good news.”  As much as I would like to think our system is top-notch, there are things that get missed.  If you don’t hear from me on a test result (after a reasonable length of time), it is OK to call and make sure we got it.
  17.   The Emergency Room is for emergencies.  We have extended office hours with walk-in visits that should accommodate most of your medical needs.  Please don’t use the ER as a back-up clinic.  I don’t usually get much communication about the care they give, and it costs about 10 times more to see them than it does to see me.
  18.   The word is “welt” not “welp.” 
  19.   If I run late for your visit, it is not because I was out golfing or playing computer games.  Usually what happens is that a visit I expected to be short turned out to be long.  I will give every medical problem the time it deserves.  Sometimes that means I run late.  Understand that if you had a medical problem that needed extra time, I would spend that extra time with you as well.  It does absolutely no good to complain when I am running behind.  I am sorry when it happens, but I refuse to put my schedule ahead of the needs of my patients.
  20.   Mrs. Dr. Rob likes to see me on occasion, as do my kids.  If my schedule is full, please understand that I have very competent physicians working with me who can do a fine job helping you.  I have personally hired all of them (given that I am the senior doctor in the group), so I will vouch for their medical and interpersonal skills.

I hope these points will help to make your visits to my office less traumatic.  I am not close to being perfect, but I promise that I do work hard to do my best at being your doctor.  I greatly appreciate the fact that you trust me to do this job - it is truly an honor to be given that trust. 

Hoping for many healthy years to come,

 

Dr. Rob

15 Responses to “To my Patients”

  1. #1 Dinosaur Says:

    Fantastic! Just about everything I’d love to say to the majority of my patients too.

    Are you sure you and I aren’t really twins separated at birth?

  2. Charlie Says:

    Wonderful post!

  3. Medstudentwife Says:

    Thanks for this blog - its exactly what I needed to hear at this point in time :).. you have soothed a bit of my angst about some issues going on right now.

  4. Rob Says:

    I am glad you guys liked it.

    #1Dino: Looking over your blog, I agree with your assessment. I swear I made up the name before I saw your blog. I know you got to the “musings” part before me, but it just shows that great minds…muse alike.

  5. Angel Says:

    Great list!

    Serious question…my “normal” body temp is like 97.5. So what would constitute a fever for a person with a lower body temp? It may be my CFS, but I feel like I’m burning up if my temp goes to 99 or 100 (plus more flu-like feelings, achy, rundown, etc).

  6. Medical Spa MD Says:

    If I could just get the plastic surgeons to be funny…

  7. Rodney Olsen Says:

    Great post.

    I’m about to email it to my doctor.

  8. Chrysalis Angel Says:

    Great post. I’m with Angel up there. My normal body temp. runs lower. I start to feel uncomfortable when I’m running 99.6

  9. Rob Says:

    My approach to people who run low basal temperatures is to call a fever at the same rate as people with a 98.6 temp. Physiologically, the body raises the temp to change the speed of certain chemical reactions as well as decreasing the ideal temperature for the growth of infecting organisms. This does not differ from person to person. I would not dispute that you may subjectively feel worse at 99 than does the average person (for whom that is normal), but I would still not call it a fever unless it was over 100.5.

    Rob

  10. Resident Plastician Says:

    Who says that the Plastic Surgeons aren’t funny? You haven’t been in my practice. ;-)

    Love the blog!

  11. Chrysalis Angel Says:

    Thanks for the Rob. Good to know.

  12. Fat Doctor Says:

    Dropped by to see the new Healthcare Code of Ethics, read this post and am literally laughing my big fat a** off! How I wish I could hand this out to all of my patients. :)

  13. Micheal Says:

    Dr Rob,
    You smile while we sweat, “Bend over (While you put the glove on) and relax.
    I love your view, ummm, position, ummm,
    outlook on the patients feelings.
    Thank you, Micheal

  14. Pediatric Grand Rounds 2.8 » Highlight HEALTH Says:

    […] Seriously amusing … or is it amusingly serious? … Dr. Rob offers some tips that may help future office visits go better in his letter To My Patients. […]

  15. Leigh Says:

    This is one of the best posts I’ve ever read. I wish all doctors’ were as understanding as you.

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