10 Things Your Primary Care Doctor Does That Should Worry You

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Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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Many of my patients express frustrations with our offices or previous doctors they’ve come across—and they have the same concerns over and over. After 17 years as a physician and learning from folks what drives them crazy, I have a list of things doctors do that should make you run for the hills.

  1. The waiting game. Dr X leaves you waiting more than 45 minutes once you’re in the room (often in a flimsy gown) on more than one occasion without an explanation or even a quick apology. Easy ways for a busy doctor to handle this are walking in and saying, “I’m sorry to keep you waiting,” or having the nurse let you know, “Dr X is running 30 minutes late today,” so you can grab a coffee or a magazine. It’s about expectation and the recognition that your time is important.
  2. After-hours. Dr X’s office provides no way for you to reach a HUMAN VOICE after-hours or on the weekends if you have a medical issue that requires attention. When you meet a doctor ask them: “What will I do if I run into trouble after 5 pm or on the weekends?”
  3. Do as I say, not as I do. Dr X smells like cigarette smoke. I have great respect for what a hard habit tobacco is to kick, but you can’t smell like cigarettes when you are going to counsel your patients about modifying their risk factors for stroke and heart disease. Your doc should cut it out during the clinic day at the very least.
  4. Lack of touch. Dr X doesn’t touch or examine you. Now, it’s not always necessary, but if you have a specific complaint (shortness of breath, knee pain, sore throat) and your primary care doctor doesn’t look, touch, or listen to the affected area, that’s not right. I may be old school but the answer so often lies in the physical exam.
  5. The money talk. Dr X doesn’t offer or discuss generic or cheaper options for your brand name prescription drugs. Many of you come to me paying high out-of-pocket costs for your medications and are always surprised to hear there are cheaper (and just as effective) options. If you feel uncomfortable discussing the cost of your meds with your doctor, or don’t feel you have the relationship to do so, move on.
  6. Empathy-less. If you are tearful when talking about feelings of sadness or depression, or discussing a painful life event (the recent loss of a parent, etc) and you notice Dr X appears uncomfortable and tries to change the subject, this is bad news. Run for the hills.
  7. Me me me me. Dr X talks about themselves during your visit. One study showed that during 30% of primary care visits the doctor spent more time talking about themselves than they did the patient. This visit is about YOU and we are already limited in what we can do in 15 to 20 minutes.
  8. Deal with it. Dr X says, “That’s just part of getting old” when you have a complaint, but offers no plan. It’s true: arthritis, visual changes, decreased hearing, and sun damaged skin are among the fun things that go along with getting old—but we can still come up with a plan to deal with them and alter their course.
  9. Rushing. Dr X delivers bad news (a new cancer diagnosis, loss of a pregnancy, a positive STD test) with language that is short, sharp, rushed, and without emotion. Some news will change a person’s life forever and they will always remember that moment . . . a cold delivery is painful and unacceptable.
  10. Acknowledging the unknown. Dr X can’t say, “I don’t know what that is, but let’s make sure it’s not something worrisome.” Often a patient has a pain, skin lesion, or weird symptom that occurs only when they are doing such and such activity and I don’t know WHAT it is. But it’s your doc’s job to admit that, and say they will do their best to monitor it and rule out worrisome things.

What am I missing?

Dr O.

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