Should I Fire My Doctor?

A day prior to this writing, a man well into his eighth decade came to see me for the first time.  He wanted advice from a gastroenterologist.  So far, this quotidian event is hardly newsworthy.   I asked him, as I ask every patient, if he had ever consulted with a gastroenterologist (GI) previously.  For me, this is a critical inquiry as it often opens a pathway to a reservoir of information.  For instance, if the patient responds that he saw a GI specialist 3 months ago for the same symptoms, but no cause was determined even after extensive testing, then I know that obtaining these records will be critical.

Or, if a patient tells me that he loved his prior GI specialist, but he has to see me because his insurance has changed, then I know that I have be particularly mindful to establish good rapport.

Sometimes, patients change physicians or specialists because they are dissatisfied.  Patients uncommonly volunteer the reason, but I ask them directly why they have sought to make a change.  This is not simply to satisfy my curiosity; it can yield very useful information.   Read through the following sample explanations of why patients have left their gastroenterologists.  I think it will be readily apparent why this information would be very useful to the new physician

• I need a new GI.  My former gastro doc wouldn’t give me any more pain medicine.
• All he did was do one test after another.  I think he was in it for the money.
• She thought the pain was in my head and I know I’m not crazy.
• He was more interested in the computer than he was in me.
• He just didn't seem to care about me.
• She messed up and totally missed my appendicitis!

For my new patient, it was a matter or time.

I am not suggesting, and readers should not infer, that the above reasons are all factually correct.  They are perceptions and it is likely that the prior gastroenterologists would offer different narratives.   My task is not to establish the truth.  The patients stated reasons for abandoning a prior physician help me to understand them better and adjust my approach. 

The septuagenarian who was now before me left his GI physician whom he had been seeing for nearly 30 years. This physician was always running behind and the patient routinely waited an hour for  his appointment.  This increasingly irritated him and persisted even after he voiced his annoyance to the doctor.  I can’t explain why he waited decades to act, but everyone has a breaking point.  So, now he’s mine.  And, you can bet I’ll do my best to see him on time.