Wednesday, June 6, 2012
Finding a good doctor and winning points with the in-laws
My in-laws are in town for my daughter's graduation. When I came home yesterday I was greeted with a big smile and vigorous handshake from my father-in-law. "I just want to thank you," he said, standing up from his chair, "for finding us a good doctor. The one you found for us is wonderful."
My wife smiled at me warmly. I just earned myself big points. Yay!
Her parents and mine are both in their 80s and are overall in remarkably good health. When I called my father after he had a minor surgery over the summer, my mother told me he had a ladder and was "on a bee hunt." It's a blessing to have them around, especially having them healthy.
My parents have a wonderful primary care physician, which takes a whole lot of pressure off of me to do family doctoring, and puts my mind at ease. I've only personally contacted him once when my dad had a prolonged time of vague fatigue and body aches. I try not to use the "I'm a doctor, so I am second-guessing you" card that I've had some patients' children pull. I called his doctor more as a son who wanted a clear story about what was going on than as a physician with thoughts on the situation.
"I first want to say that I am very grateful my parents have gotten such good care from you," I said at the start of the conversation. "It's nice to not have to wonder if they are getting good care."
He was very grateful. I would be if someone said that to me, and I really meant it.
"About his current situation," I continued, I don't want to sound like one of those meddling doctor children who want to second-guess their parent's doctor ..."
"You've already blown that one," he interrupted, clearly pulling my chain. My kind of guy.
I went on to discuss what has been done, adding some things that had occurred to me, specifically of a condition called polymyalgia rheumatica, which I see with some regularity in my office. He listened to me, and I made sure he knew that he had no extra obligation to listen to my thoughts because I am a doctor. We finished the conversation with a few more jokes and I hung up with increased confidence as well as gratefulness that my parents had very good medical care.
A few weeks, after my suggested diagnosis came to be true, my dad informed me that his doctor told him, "Your son made the diagnosis; he deserves the credit." I earned major points from my parents on that one, but their doctor clearly got high score in my book.
My wife's parents haven't been as fortunate with a primary care physician. Their care has been done a la carte only when they had problems, and that done with very little explanation. Being from the generation that doesn't question their doctor or demand explanations, the extended family was largely in the dark about their medical care. This meant that my brother-in-law (an internist) and I ended up having to figure out, suggest, and occasionally meddle to get them the care we thought was appropriate.
A few hospitalizations over the past few years and some mystery medical diagnoses brought the situation to crisis earlier this year. When we went to visit them in the spring, I was given a charge from the family: find them a good primary care doctor. Given that I am in Georgia and they are in Oklahoma, this was not the easiest task. I got some names from a fellow blogger (thanks, John), but the best lead was that of a physician who doesn't accept insurance, charging an hourly rate that made me gasp. It didn't seem to be a good match, as my in-laws wouldn't be thrilled to pay $200 for a viral illness.
Out of leads, I went to the only other source I could think of: Google. My search quickly led me to physician rating sites. I had recently hired a roofer and plumber via Angie's list (with good results on the roofer, and bad on the plumber - as I previously mentioned), so this seemed worth trying. One doctor seemed good, but his med school graduation year was in the 70s, so I doubted he'd be around long. Another physician seemed OK until I read some of the reviews by patients who complained of wait times and that they didn't feel listened to.
I eventually happened upon a physician with my training (internal medicine and pediatrics) who had trained at a good program and who was young, but not too young. There are very few who get through a med/peds training at a tough program who are not motivated and thorough. I called, and the office treated me very well, even though I didn't mention I was a physician (I wanted a true idea of the office's user-friendliness). I got her an appointment, sent my mother-in-law the information, and left it at that.
I was thrilled and relieved when I heard their opinion about their doctor. He had spent time with them, had listened to what they had to say, and made them feel like they were no longer in limbo. He would take care of her and figure out what is going on. That's a big deal for me, as I don't like having to do detective work and second-guess other doctors. I don't like doing it as a primary care physician for my own patients, much less as a dutifully son-in-law. Yes, this doctor too won major points in my book.
The jury is still out, as they have only had one visit, but everything points toward a winner. I find it interesting being on the other end of the transaction of finding a good doctor. In this circumstance I was a health care consumer looking for what I needed. The tools I used were the usual: personal recommendations, Google, physician rating sites, and a call to the office. I had a slight advantage knowing the quality of the program this physician trained at, but it was still took a fair bit of luck.
To both of these physicians, my parents' primary care physician in New York and my in-laws' new primary care physician in Oklahoma, I give my deepest thanks. I know how easy it is to cut corners, to get tired, and to be worn out by our system. I know that it's easier to not take the extra time to explain, making sure you are heard. I know that it's more profitable to see extra patients and spend less time with each of them. Thank you for doing the right thing.
And thanks for all of those points!
After taking a year-long hiatus from blogging, Rob Lamberts, MD, ACP Member, returned with "volume 2" of his personal musings about medicine, life, armadillos and Sasquatch at More Musings (of a Distractible Kind), where this post originally appeared.
Contact ACP Internist
Send comments to ACP Internist staff at email@example.com.
- QD: News Every Day--Internists get median of $1,00...
- Reglan and tardive dyskinesia: medical malpractice...
- Ethics rounds
- QD: News Every Day--Cancer rates rise by 75% even ...
- Recommended care, says who?
- New oxygen requirement overruled without a reason
- QD: News Every Day--One year later, work hour limi...
- Learning from Massachusetts
- Prayer as placebo
- QD: News Every Day--Two-thirds of internists affec...
Members of the American College of Physicians contribute posts from their own sites to ACP Internistand ACP Hospitalist. Contributors include:
Albert Fuchs, MD, FACP, graduated from the University of California, Los Angeles School of Medicine, where he also did his internal medicine training. Certified by the American Board of Internal Medicine, Dr. Fuchs spent three years as a full-time faculty member at UCLA School of Medicine before opening his private practice in Beverly Hills in 2000.
And Thus, It Begins
Amanda Xi, ACP Medical Student Member, is a first-year medical student at the OUWB School of Medicine, charter class of 2015, in Rochester, Mich., from which she which chronicles her journey through medical training from day 1 of medical school.
Zackary Berger, MD, ACP Member, is a primary care doctor and general internist in the Division of General Internal Medicine at Johns Hopkins. His research interests include doctor-patient communication, bioethics, and systematic reviews.
Controversies in Hospital
Run by three ACP Fellows, this blog ponders vexing issues in infection prevention and control, inside and outside the hospital. Daniel J Diekema, MD, FACP, practices infectious diseases, clinical microbiology, and hospital epidemiology in Iowa City, Iowa, splitting time between seeing patients with infectious diseases, diagnosing infections in the microbiology laboratory, and trying to prevent infections in the hospital. Michael B. Edmond, MD, FACP, is a hospital epidemiologist in Richmond, Va., with a focus on understanding why infections occur in the hospital and ways to prevent these infections, and sees patients in the inpatient and outpatient settings. Eli N. Perencevich, MD, ACP Member, is an infectious disease physician and epidemiologist in Iowa City, Iowa, who studies methods to halt the spread of resistant bacteria in our hospitals (including novel ways to get everyone to wash their hands).
db's Medical Rants
Robert M. Centor, MD, FACP, contributes short essays contemplating medicine and the health care system.
Juliet K. Mavromatis, MD, FACP, provides a conversation about health topics for patients and health professionals.
Dr. Mintz' Blog
Matthew Mintz, MD, FACP, has practiced internal medicine for more than a decade and is an Associate Professor of Medicine at an academic medical center on the East Coast. His time is split between teaching medical students and residents, and caring for patients.
Toni Brayer, MD, FACP, blogs about the rapid changes in science, medicine, health and healing in the 21st century.
Vineet Arora, MD, FACP, is Associate Program Director for the Internal Medicine Residency and Assistant Dean of Scholarship & Discovery at the Pritzker School of Medicine for the University of Chicago. Her education and research focus is on resident duty hours, patient handoffs, medical professionalism, and quality of hospital care. She is also an academic hospitalist.
John H. Schumann, MD, FACP, provides transparency on the workings of medical practice and the complexities of hospital care, illuminates the emotional and cognitive aspects of caregiving and decision-making from the perspective of an active primary care physician, and offers behind-the-scenes portraits of hospital sanctums and the people who inhabit them.
Ryan Madanick, MD, ACP Member, is a gastroenterologist at the University of North Carolina School of Medicine, and the Program Director for the GI & Hepatology Fellowship Program. He specializes in diseases of the esophagus, with a strong interest in the diagnosis and treatment of patients who have difficult-to-manage esophageal problems such as refractory GERD, heartburn, and chest pain.
Mike Aref, MD, PhD, FACP, is an academic hospitalist with an interest in basic and clinical science and education, with interests in noninvasive monitoring and diagnostic testing using novel bedside imaging modalities, diagnostic reasoning, medical informatics, new medical education modalities, pre-code/code management, palliative care, patient-physician communication, quality improvement, and quantitative biomedical imaging.
William Hersh, MD, FACP, Professor and Chair, Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, posts his thoughts on various topics related to biomedical and health informatics.
David Katz, MD
David L. Katz, MD, MPH, FACP, is an internationally renowned authority on nutrition, weight management, and the prevention of chronic disease, and an internationally recognized leader in integrative medicine and patient-centered care.
Richard Just, MD, ACP Member, has 36 years in clinical practice of hematology and medical oncology. His blog is a joint publication with Gregg Masters, MPH.
Kevin Pho, MD, ACP Member, offers one of the Web's definitive sites for influential health commentary.
Michael Kirsch, MD, FACP, addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.
Elaine Schattner, MD, FACP, shares her ideas on education, ethics in medicine, health care news and culture. Her views on medicine are informed by her past experiences in caring for patients, as a researcher in cancer immunology, and as a patient who's had breast cancer.
Mired in MedEd
Alexander M. Djuricich, MD, FACP, is the Associate Dean for Continuing Medical Education (CME), and a Program Director in Medicine-Pediatrics at the Indiana University School of Medicine in Indianapolis, where he blogs about medical education.
Rob Lamberts, MD, ACP Member, a med-peds and general practice internist, returns with "volume 2" of his personal musings about medicine, life, armadillos and Sasquatch at More Musings (of a Distractible Kind).
David M. Sack, MD, FACP, practices general gastroenterology at a small community hospital in Connecticut. His blog is a series of musings on medicine, medical care, the health care system and medical ethics, in no particular order.
Reflections of a Grady
Kimberly Manning, MD, FACP, reflects on the personal side of being a doctor in a community hospital in Atlanta.
The Blog of Paul Sufka
Paul Sufka, MD, ACP Member, is a board certified rheumatologist in St. Paul, Minn. He was a chief resident in internal medicine with the University of Minnesota and then completed his fellowship training in rheumatology in June 2011 at the University of Minnesota Department of Rheumatology. His interests include the use of technology in medicine.
Technology in (Medical)
Neil Mehta, MBBS, MS, FACP, is interested in use of technology in education, social media and networking, practice management and evidence-based medicine tools, personal information and knowledge management.
Peter A. Lipson,
Peter A. Lipson, MD, ACP Member, is a practicing internist and teaching physician in Southeast Michigan. The blog, which has been around in various forms since 2007, offers musings on the intersection of science, medicine, and culture.
Why is American Health Care So Expensive?
Janice Boughton, MD, FACP, practiced internal medicine for 20 years before adopting a career in hospital and primary care medicine as a locum tenens physician. She lives in Idaho when not traveling.
World's Best Site
Daniel Ginsberg, MD, FACP, is an internal medicine physician who has avidly applied computers to medicine since 1986, when he first wrote medically oriented computer programs. He is in practice in Tacoma, Washington.
Other blogs of note:
American Journal of
Also known as the Green Journal, the American Journal of Medicine publishes original clinical articles of interest to physicians in internal medicine and its subspecialities, both in academia and community-based practice.
A collaborative medical blog started by Neil Shapiro, MD, ACP Member, associate program director at New York University Medical Center's internal medicine residency program. Faculty, residents and students contribute case studies, mystery quizzes, news, commentary and more.
Michael Benjamin, MD, ACP member, doesn't accept industry money so he can create an independent, clinician-reviewed space on the Internet for physicians to report and comment on the medical news of the day.
The Public Library of Science's open access materials include a blog.
One of the most popular anonymous blogs written by an emergency room physician.