Is my doctor incompetent or do I have multiple conditions?

July 20, 2010 7:37 PM

Is my doctor incompetant? I thought it was a UTI, he thinks it's a fungal infection, oh and also herpes and chlamydia depending on when you ask him. What gives? (slight amount of gross).

I experienced painful urination and redness around the urethra, and urge to urinate more so than normal. My girlfriend occasionally gets UTIs and visited her doctor who confirmed that was what she was suffering from. I visited a new doctor since I had just recently moved to this part of town.

The doctor decided it was a fungal infection and prescribed clotrimazole and said to apply to penis and urethra, twice a day for a week. He examined a urine sample and remarked that there was no bacteria however there were "pus cells, so is likely to be fungal".

Two days later, excruciating pain, burning, blistering, cracking, oozing, swelling of foreskin. Gross.

Contacted doctor, who asks for a new urine sample and tells me to stop using cream. Next time I visit him he examines me and says that I clearly am having an allergic reaction and it's also the first condition is probably chlamydia now. He also observes the blisters from the reaction to the clotrimazole, he swabs them and remarks they look like herpes and gives me a 10 day course of medication for that.

Before me and my SO started having unprotected sex we both had STI checks (3 weeks ago) and both are clear, she has since retested as clear. But my doctor seems to be on some warpath to treat me for every STI that a 24 year old male could have. I told my doctor about my girlfriends doctors diagnosis, and he suggested that she come and visit him and brushed off that it was merely a UTI. (She's had her three day antibiotic and is now fine).


Am I right to feel like my doctor is incompetent? Is he?

What can I do about the reaction? And does anyone know what this infection sounds like?

posted by anonymous to health & fitness (12 answers total)

You need to seek a second opinion as soon as possible. I am not a doctor, but I am a dude, and if I looked down and experienced "ZOMG CRUCIAL APPENDAGE HURTS AND/OR LOOKS FUNNY" I would be wearing the buttons off the phone trying to get in to see another doctor.
posted by Inspector.Gadget at 7:42 PM on July 20, 2010

I second that emotion...find another doctor, ASAP.
posted by bolognius maximus at 7:46 PM on July 20, 2010

No one on the internet can tell you what you have. HOWEVER, without running few cultures, neither can your doctor (not for SURE, at least)! And from everything you've written, it sounds like he's done a lot more "take a glance, whip out prescription pad" than "perform an valid differential diagnosis on your wang". It doesn't matter whether the dude has valid reasoning or not (for my money, he sounds kind of... lax); if you're not comfortable with this approach, get thee to another MD (or, if you're desperate, a Minute Clinic).
posted by julthumbscrew at 7:49 PM on July 20, 2010

Your doctor sounds dangerously off.

See someone else, get better, then consider reporting him to the relevant authorities.
posted by drjimmy11 at 7:50 PM on July 20, 2010

Your doctor is incompetent. If nothing else, he gave you a 10-day course of medication for herpes and didn't discuss long-term management strategies?
posted by cabingirl at 7:54 PM on July 20, 2010

how would anyone on the Internet know? Go get a second opinion from another doctor.
posted by anniecat at 8:14 PM on July 20, 2010

Time for a new doctor! Seeing a urologist is always a good option if you are having issues with your junk, or just a new primary care doctor if your insurance requires that first. In my experience of showing up with an exciting infection down there, they should be doing all kinds of cultures and tests so as to actually figure out what you have, not just guessing based on symptoms.

To repeat: go see a new doctor ASAP. Don't wait, and don't waste time with your current doctor.
posted by Forktine at 8:15 PM on July 20, 2010

If you were tested for STI's by this same doctor several weeks ago and came up clear, but now he thinks you have chlamydia and/or herpes, that seems a little fishy to me (unless there's something I don't know about STI tests?). Especially if you told him that your girlfriend has been having UTI issues which have been diagnosed and successfully treated by her doctor.

If my above assumptions are all true (your doctor knows you just recently tested negative for the STI's in question and knows about your girlfriend's recent UTI's), it's time to get a new doctor.

That said, I once had a UTI that migrated up to infect my kidneys. When I was in the ER getting that dealt with, the doctors asked me every reproductive health question imaginable and didn't rule anything out till they'd run far more tests than seemed absolutely necessary. Though it doesn't sound from your question that this is the tack your doctor is taking.
posted by Sara C. at 8:17 PM on July 20, 2010

He sounds awful. I suffered a lot in my twenties because I thought they all knew what they were doing and I just followed whatever they said. Then I wised up and if a doctor doesn't answer questions, doesn't explain things to me, doesn't listen to me, or take me seriously, I don't wait around, I fire him. A good doctor will do all those things.

Even if this were a fungus, he needs to know exactly which it is to give effective medication and they have lab tests for that, so "looks like" is not good enough. If it is a UTI as you suspected to begin with and which I'm not convinced he has ruled out, while he's been messing around with this and that, he's left you in danger of the damned thing becoming a kidney infection and that's wretched.

It's worth the effort to find a good doctor who demonstrates good patient care. When you do, return the courtesy, be a good patient and follow their advice. But first, they have to ante up a performance you can respect.
posted by Anitanola at 9:04 PM on July 20, 2010 [4 favorites]

For the time being, I would skip looking for another GP and get straight to somebody with extensive experience in this kind of thing. Forktine suggested a urologist; you could also check around for free/cheap STD testing from your local public health department, Planned Parenthood, etc. I have a huge amount of respect of primary care doctors as a group, but if there's any question at all about the diagnosis, go see somebody who deals with Body Part X day in and day out.
posted by McBearclaw at 9:48 PM on July 20, 2010 [1 favorite]

Good grief! Get a second opinion. Hell, get a third or fourth or more opinions. It's time to start shopping for a physician (think of it as a long-term investment in your heath & happiness).

The obvious choice for that second opinion would be your SO's doctor -- whatever's going on affects both of you, after all, and generally more information is better, etc.

Non-obvious choices: urologist, dermatologist, allergist..

On preview: What McBearclaw said.
posted by Tuesday After Lunch at 10:06 PM on July 20, 2010

I went through something similar earlier this year. Answering from my phone so I can't post the link, but look at my Ask history and you'll see it. Neither of us had any STDs but it took a week and 3 doctors, plus antibiotics and painkillers, to be sure. I tried the emergency room, urologist and GP and all had differing opinions until the tests came back a week later.
posted by Unicorn on the cob at 12:47 PM on July 21, 2010