http://www.cnn.com/2008/HEALTH/01/23/ep.obnoxious/index.html
my mama always said you catch more flies with honey than vinegar..basically this article says the same thing.
I know I've been dealing with the medical community for well over 20 years now and have always built good relationships with my doctors..and not because I'm a passive patient cause I'm not. I come to my appointments prepared, I treat my dcotors like the professionals they are, I discuss not demand. I ask open ended questions that allow for an exchange not yes or no answers. My favorite question is simply "Why".
Depends on who you're talking too. I think the nurses/PA's love me as I'm kind and considerate of them. I've had a theory for years; ask the nurses etc for help, keep them happy, as they'll keep me alive.
Doctor's on the other hand, are arrogant, uninformed and too busy with 6 minutes per patient to properly evaluate anything that counterdicts 1) what they learned in med school a gazillion years ago or 2) use what they learned in med school to see if possibly you have something else going on than whatever other doctors in your chart think is going on.
This is the same MD that wrote about the 'Googling' patient we had posted a while back. From my perspective, his anger and arrogance shown through his entire article. So, it can't possibly be him, it has to be her, and she's a crappy mother to boot.
One thing I've learned is...go with your gut instinct. If you think you have something...you are probably right.
Now I'm all for doctor shopping.
Pip
I've gotta tell you, my doctors are great. I've had more trouble with nurses in the hospital. When I had my first c-section, I had to BEG for post-op pain meds. When I had my appendix out, I got chastised by the nurse for NOT using the post-op morphine pump and asking for Vicodin and Coca-cola instead (this had been cleared with the surgeon beforehand and WRITTEN IN THE CHART). I didn't need or want morphine.I'm not an obnoxious patient, although I haven't been in a situation where I would think that anything beyond being friendly and patient was called for. I would probably be annoyed if my doc only gave me 6 minutes and rushed me through and didn't want to take the time to explain things to me, but that hasn't been the case. My doctor seems to have all the time in the world for me (and I would assume his other patients) and has never seemd to even be a little bit distracted.
I don't have a whole lot of doctor experience though. Before RA, it was rare that I'd even get a cold. Not really around the medical community too much.
Yikes Jasmine. Sounds like that hospital staff could use a bit ofthe doctor from the previous article was quoted but he was hardly the main part of the article.
Going to a doctor with a pre conceived idea of what the only treatment you will accept might drive that opinion that every doctor is "arrogant and uninformed"
Lorster,
I agree that people should not be in pain. On the other side of the pain issue, have you ever taken care of a patient who said their pain was 10, but they were laughing and walking around? I think that is where some nurses get jaded. My motto is: It isn't my job to determine if they actually have pain or not. If they request it and have it available, I give it. I have also had "seasoned" nurses be really "slow" giving men pain meds because they (the nurses) think they are "babies" for showing pain. Most of the nursing care I've received over the years has been great... but I am still haunted by the memories of that horror after the c-section. I was at the mercy of those two witches. Immense pain; couldn't see my baby or family; I've never felt so trapped or alone. EVER.
I have wonderful doctors. My PCP and RD...I can't say enough good about them. However, I have problems with the RD's office staff. If it wasn't that my RD was so top notch...I would be looking for a new one just because of his office staff. We are at the point of saying something to our RD when we see him next on the 30th after 2 years of dealing with their snottiness. Buckeye - I can only go with my experiences. My rheumy and incompetent GP (there, I said it - she misdiagnosed my baby's vitiligo, refused to run ALL thyroid tests when I was getting sick, refused to send me to an endocrine doc etc.) knew what I 'thought' (infection) was going on and ignored it - even when I brought my 6' 2" hubby to help me manage them. Yes, I was freaked on getting this diagnosis - so, you'd think these idiots would be more helpful and understanding of the emotional issues of being diagnosed with this garbage. But they don't want to deal with it... so 'here, have a AD'. They wanted me on the standard meds for RA. Period. I balked at Plaq. Now, I think that's not so bad of a med...but at the time...no way. I needed my eyes. I still would have problems agreeing to Plaq emotionally. So I researched and decided Minocin was an acceptable risk...and if it didn't work, I'd still have the option to go to other meds. Now, knowing I thought 'infection' and knowing I didn't want Plaq did they suggest an approved ACR DMARD; Mino? NO. But, when I went in to the rheumy with the book and printed out studies...not only did he not read them, he knew all about it already. My hubby, expecting a fight because of the other meetings with MD's at the various departments at the Great U - said 'she want's to start with Minocin". What did the Rheumy say? "Well, it's better than any medicine I could give you?" Oh, yeah? Then why the hoops? Why the multiple appointments? Why not bring it up when I'm talking about 'infection', 'bacteria' and for God's Sake, "AZT"? For me, I'm darn glad I chose AP. Let me tell you, at the end I was stupified by the pain. I don't know how much longer I could have held out for Mino - and that thought scares me to death. Pip Gramma, I'm not trying to get on your case or anything, BUT I agree with the nurse. (Maybe not her delivery). Her responsbility is the patient. She was trying to make sure that Arielle had the same pain control at home as she did in the hospital. As you know, PO meds don't always work as well as IV. Just because she has a different way of doing things doesn't make it wrong. I think it was nice of her to make sure Arielle wasn't in pain. the other option was her not giving a sh*t about your daughter OR her pain.
Think about it. Doesn't everybody see a GP, eye doctor, dentist, Urgent Care occasionally? Women see OB/GYNs. PT/OT would count, too. Unless it is everywhere you go, every time, it is probably at least an issue from both sides, not just the patient. Once you have a bad experience, though, I think it does put a strain on everything going forward. My daughter has had so many bad experiences with blood draws, even at children's hospitals and ped's offices. They can never get a vein, and stick her and stick her. She cooperates, stays still, but does cry. I try so hard to stay calm, because I need to, to keep her calm. I do a good job of that, it is like an out of body experience - which MORE than once at DIFFERENT locations has been shattered by the nurse PRAYING OUT LOUD before she will stick my daughter. How am I supposed to stay calm when a medical professional has to ask the lord's help ALOUD before doing their job????? It's a blood draw. A blood draw. Actually, I'm going to try the new ASS technique I learned on Ugly Betty with the next MD I meet. I'll report back. LOL This is a recap - Betty begin the interview (she is very uncomfortable, and wants to call the book something else). He tells her, “Men want to get laid. I want to help them.” His technique is: “Approach, Subdue, Score!” Betty says, “ASS? Clever. I smell a Pulitzer!” He explains that the nest way to break the ice with a woman is to insult her. Betty asks if he really believes that women fall for that. The whole episode is that women DO fall for that. I'm just betting MD's will too. Everybody should Torrent this episode. Seriously, I think it'll work with MD's. LOL Pip I am sure that right now my doctor think I am obnoxious. I have been in a lot of pain. I have pain medication that doesn't help much. I called the rheumy first, who said call your primary, called him, he said call your rheumy. So in other words I got nothing because neither wanted to take responsibility. http://womensbioethics.blogspot.com/2008/01/are-you-obnoxiou s-patient.html There are some good responses to this question at the above site. I am a well informed patient. When I arrive for an appt. I am prepared with notes and questions in the order of their importance to me at that time. I expect the physician (irregardless of specialty) to be knowledgable enough to competently address my questions in language that I can understand. I don't like to think of myself as obnoxious although I'd guess some docs probably think I am. I can be tactfully demanding (ha) if I don't feel that my questions are being answered ; if I feel that I'm being passed around i.e. "thats a question for your ________doc (when they could very well take the extra minute to answer), or worst of all, if I sense that my questions are being answered in rote response as though I'm just another sheep in a huge, non-descript flock, in which case I'll say things like, "I'm sorry, doctor, but I'm having difficulty understanding your explanation". "Is there another way you could explain that to me?". At this point, he/she is usually furtively doing the wristwatch glance (hint hint--tick tock) in sync with the eyeball roll, but will usually accomodate me. I've had doctors tell me how much they appreciated the conciseness of my reported history, symptoms, questions, etc. so I think obnoxious is a relative term. I personally find some physicians to be rather obnoxious. K. I'm a knowlegable patient, otoh my sister is an obnoxious yet knowledgeable patient. there are drs who simply refuse to have her as a patient here. I've bragged a lot about my drs, but I'm convinced that telling them in the beginning that I'm looking for a partnership in my health care means a lot. Thats not to say I havent had a few nasty experiences with drs including when I was first diagnosed with cardiomyopathy and the freaking dr said , "well theres nothing I can do." uh 2 weeks later I was in critical condition and if he had just given me lasix, coreg and cozaar all that mess could have been avoided and I wouldnt have been facing a heart transplant. and one nurse.. I had an IV get blocked my arm was red and swollen.. I TOLD her it was occludded and this moron to see if it was just inked up grabbed the tubing from 2 feet above my arm and bounced my arm around with it.. shook it like you shake out a rug.. I screamed and told her get the f... away from me and get someone else. and she said well I have to call your dr then and its midnight. I told her then CALL him and make sure you tell him what you did.. I cant imagine such a thing I've started laughing when they something silly in regards to my AP. Does that count as obnoxious? Pip /
Well, it's not mean laughing...just 'get a clue' laughing. I don't even mean to do it...they say something silly (like my dentist telling me he wouldn't take antibiotics for the rest of his life - when he has a sister with MS!!!) and I'm thinking "you ninny...try this pain for a week and you'll be on God Knows What to Cut it Out". I've started laughing when they something silly in regards to my AP. Does that count as obnoxious? Pip[/QUOTE] Without a single doubt! *LOL* yeah, baby. Glad that's cleared up
Then they finally understand. This kills me. Ped rheum has some form he wants filled out every time. Early on, they handed me a stack of papers at check-in, and I asked if I needed to fill any of it out. "The nurse will tell you." She said no. Then he came in and wanted to know why it hadn't been filled out. Next time, I filled it out, but he never looked at it. Next time, I was filling it out when they called us, and the nurse held off on taking us back until I finished. The whole back page is "Heart problems? Difficulty swallowing?" Etc. A thousand "no" answers. He came in and took the form, and you know how busy and time-constrained they are, right? He starts asking me each question, one by one. "Has she had any difficulty swallowing?" "No." After about fifteen, and knowing I have TONS of things I need to ask about before we are out of time, I blurted out, "I PUT 'NO' ON ALL OF THEM! See?" He smiled at that, and we moved on. Another time, they forgot to give me the form, and he filled it out for me LOL! I go to every doctor with courtesy and respect. I fill out all their forms, pay their fees, do what I am told. I in return expect courtesy and respect, a correct diagnosis, and proper treatment. I have decided the psychology of the bad medical doctors I have encountered, because my great doctors don't practice this method. I go in, explain my symptoms, we talk, they do an exam and say, okay lets test for ______________________. Then it all comes back normal. Because they didnt guess right the first time. It hurts their ego, they feel they are getting an "F" on a test because their first answer wasnt it. So they throw up their hands and say you are making it up. A real doctor says okay, its not that, so lets try this next. Thank goodness I have finally slowly painfully have built a working team of great doctors. Maybe you found a great team. I guess we are all still on the journey to find our perfect team. I just want them to treat me as the intelligent person I am--not the 2:00-2:15-- co-pay--get her in and get her out. On the paperwork they hand out--my drs office doesn't do that--but the x-ray people do. I could not understand why I am telling the X-ray Dept my life history when the doctor ordered the x-rays. The questions include gyn questions which I did not answer as they were x-rays hands and feet and I figure my female organs didn't have much to do with my hands and feet!!!!!!!!!! I put big N/As all other the form! Supposedly it is all entered in central medical library--so they would have all of this anyway. I really think it is "busy work" to shut the people up while they are waiting their turn. My drs offices just ask--"Any changes?" I inform them when the insurance might change, etc. otherwise they are good.
We did have an interesting experience with a nurse when Arielle was being discharged from the hospital. Our PCP had her on a PCA (the pump with the pain meds in it where you can push the button every 15 mins. or whatever your doc sets it at plus you get a basal dose of pain meds) and our PCP leaves us on the PCA until we are discharged so we are as comfy as possible for the ride home and for some time after we get home. Well, he comes in to see Ellie and says you look so much better you can go home (this is about 1230PM. Here PCA pump started beeping because it was empty. Call for the nurse and no one comes right away so the doc disconnects it from her IV (her IV catheter is still in place) and takes the beeping pump with him to the RN station. He did not have a band aid with him or otherwise he would have totally removed her IV. So at this point, Ellie can get dressed so she does. Doc is at RN station and writes out her scripts (pred and percocet) and discharge order and instructions. We ring for the RN once again. Finally about 20 minutes later she comes in. We tell her...ready to go please take out the IV. Well, she REFUSES to do it. Ellie and I just look at each other like what the heck?? She refused to do it until Ellie was put on oral pain meds and monitored for some time to make sure she was ok and the pain wasn't coming back. Now mind you, my doc doesn't do it that way...we know he doesn't (from my previous experience and what he said to us when he said he was discharging Ellie)...so ELLIE in a not so nice tone of voice tells her...that it is HER doctor...that is NOT the way he does it....SHE is the patient...and she wants to go home NOW. RN says...sorry but I will not let you go yet. I am calling the doctor and demanding different orders. By this time...me, Danny, and Ellie are pretty ticked off. It is now 130pm. So we sit and steam. Danny says screw this...goes down to the RN station and gets the tech to take out the IV. Tech comes to the room refuses to do it. ARGH. Because she says..the RN will be pissed because she is waiting for the doc to call back. Whatev. I'm standing in the doorway of Ellie's room just ticked off. A tech walks by that I know from my previous stay in the hospital and asks me why I look so upset. So I tell her. SHE walks in the room and removes the IV for us. At that point Danny is like YAY...I'm going to take the stuff to the car...pull the car up...you get the RN in here to do discharge instructions and give you her scripts. I say ummm OK. He leaves. I get RN from RN station. RN comes into room because obviously my doc has called back and said do it his way lol. So RN proceeds to give Ellie her discharge instructions. Talks to her like she is 3 years old. Ellie getting angry once more. I pull out from my jacket pocket my bottle of pain meds (methadone) because I am due for meds. Ellie says to me...Mom is that your methadone because you are due for it. RN looks at me...looks at Ellie...says to Ellie...DOES YOUR MOM GIVE YOU METHADONE AT HOME?? The RN had this real serious look on her face when she said that. Before I could even snap off to this RN...Ellie beat me to it!!!! My mom would NEVER do that...we TOLD you ALREADY my mom has SEVERE RA and she NEEDS those pain meds. How DARE you accuse my mom of such a thing!!! well...YOU GO ELLIE!!! LOL. RN shut her trap real quick and discharge instructions were finished pretty quickly after that. All in all the time it took to get my baby discharged from the hospital...2.5 FREAKING HOURS!!! In the elevator going down to the car there was some woman in it holding a clipboard dressed very nicely. She could tell me and Ellie were pretty pissed off and she asked what was wrong and I told her about the RN. She said sorry we were treated that way and she hopes Ellie gets better. The next day we get a call from an admin of the hospital asking us how Ellie was and how we were treated while she was there. Danny told her what happened. The admin was familiar with the particular nurse already (so that leads us to believe we weren't the first ones with complaints) and the admin told Danny that the RN will never again work in the hospital (she was from an agency). So at least something got done about that RN!!
I really feel that if you are an obnoxious patient that you won't get the care that you deserve because you have ticked off your care providers. If that RN that was discharging Ellie didn't decide that she was going to second guess my doctor and do what she wanted and not what the doctor and the patient wanted there would have been no problem.
I do arrive at appointments well-versed in my "condition", in current standards-of-care and alternative therapies. I do voice my opinions and I do make educated and well-informed requests. I do make some demands and I do am less than receptive of that all-too-familiar "I know best" attitude of many practitioners, whatever the initials behind their names.
I too am looking for partnerships and I am lucky to say that at this moment in time I have a "team" responsive to who I am, how I am, and why I am. However, it was easier to recruit to the team than it was to keep the team focused on MY needs.
In my defense allow me to say that I have had the same PCP for more than twenty years and that the rheumatoligist that I am currently seeing took over my care, and my obnoxiousness from a retiring physician without hesitation.
Perception~~~it is ALL based on perception.
See, Happ, I wouldn't look at what you've described as you being obnoxious. I mean, unless you're really rude in the way you present your data, needs and expectations. But I can't really see that. I don't think that being non obnoxious equals being an uniformed doormat.Well...obnoxious is most often defined as "protest" or "disapproval". Thus I suppose that like many discussions the first thing that needs to be done is to define terms.
Ahh. Well maybe I just don't know the true definition of the word. When I think obnoxious, I think loud, rude, hostile, abrasive. It's very very negative.obnoxious
obnoxious
Copyright ArthritisInsight.com