Ask Miss (Bedside) Manners

September 30, 2005 4:47 AM

How do you know when it's time to change doctors? If your doctor says things that worry you, or you feel s/he doesn't listen to you, is that a good reason to look for a new one? Alternatively: how can you (or even should you?) approach your doctor about his/her bedside manner?

Here's the thing: I am experiencing a set of distressing symptoms of as-yet unknown cause. My doctor has started the diagnostic ball rolling with a series of tests, all upcoming. So far, so good, can't ask for more on that front. The problem is his bedside manner. I feel like he doesn't really listen to me or hear what I am saying, like he doesn't have time to actually sit down and talk/listen to me during an appointment, and he sometimes discusses things in ways which I find offputting. He seemed surprised and almost disbelieving when I told him I have regular menstrual periods (he asked if I "still" have them, and when I said yes, said "regular ones?" in a seemingly skeptical way), as if someone of my greatly advanced age should have hit menopause by now (I'm 37) - the symptoms I am having are seemingly unrelated to reproductive health. I have lost a fair amount of the weight I need to lose (I'm overweight, not morbidly obese), and he seems extremely focused on my success with this, at (it seems to me) the expense of the other health problems I am having (maybe he's just surprised to have a compliant patient?) - perhaps the menstrual period questions were related to my weight loss, but he didn't mention it. The symptoms I am having are very worrying to me, and rather than reassuring me that we're going to work hard to find out what's going on, or telling me something which lets me know that he understands that I'm worried, he praises me about my weight loss and tells me how great he thinks I'm doing (yeah doc, except for that little "feeling like a bag of crap most of the time" thing, and now, thanks to your "gosh, someone of your apparent age hasn't hit menopause yet" thing, I feel old to boot! Thanks!). Don't get me wrong, I am proud of what I have achieved so far and I do truly appreciate the positive reinforcement, but right now my concerns lie elsewhere and I'm feeling uncomfortable with my doctor on top of feeling uncomfortable about what might be wrong with me. He asks me questions but doesn't seem to listen to my answers, he always seems in a rush to be somewhere else, he's always doing three things at once (taking notes, writing lab requisitions, ostensibly listening to me), he seems less than approachable and I just feel like I want treatment that's more...personal. It's not that I expect him to be my therapist and work on making me feel happy, obviously I care most about his competence at getting to the bottom of my health problems, but I'd like to feel less like I'm getting in his way by being there, and less like the only thing that REALLY matters is that I've lost some weight (important as that is).

I am stressed, sensitive, emotional and worried right now, I know this affects my perception of things. I also don't really want to switch doctors now that I've started investigating possible causes for my symptoms with this doctor, but I am definitely feeling uncomfortable with my doctor's bedside manner, I almost feel as though I should just look for a female doctor to be my PCP in future, or at least a doctor who'll approach reproductive health in a less worrying/more sensitive manner (you mean I look old enough to be going through menopause? Or you didn't look at my age? What? - this is just the one example that sticks out among many). I try to be a reasonable person, and I would like to continue that - what should I do? How should/can I approach my doctor about this?

posted by anonymous to health & fitness (13 comments total)

It sounds like it's definitely time to change doctors. If you're at all uncomfortable, you deserve to find someone who doesn't make you feel that way.

Honestly, as a woman, I feel a lot more comfortable with female doctors than I do with male doctors in general - especially for discussing reproductive health issues.
posted by tastybrains at 5:02 AM on September 30, 2005

I'd look for a female doctor, but with the caveat that even some women physicians lack empathy for their patients. Remember: your doctor is employed by you to care for you. You, not the MD, should be in charge.
posted by Carol Anne at 5:22 AM on September 30, 2005

Because I have had similar experiences a number of times with male doctors (feeling as though I wasn't being taken seriously, or listened to thoroughly), I only see female doctors for primary care, gynecology, and, when it's feasible, other specialties. My understanding is that this is a common complaint among women.

This is not to say, of course, that all male doctors are uncaring jerks... But I don't have the time or inclination to doctor-hop and I feel like my chances of being comfortable are better with a female MD.
posted by amro at 5:43 AM on September 30, 2005

I just changed doctors for the precise reason that my doctor's bedside manner was terrible and she had no attention to detail regarding my case. I think that the minute you are not happy, it's time to change doctors. It's not a friendship, it's a professional customer/client relationship and your goal is not only to get the best possible medical treatment but also to feel that your needs are being met. Do it.
posted by spicynuts at 5:48 AM on September 30, 2005

I agree that it's time to change doctors, though I don't agree that the gender of your doctor makes much of a difference. I recently had a perplexing gynecological issue; my female OB/GYN behaved exactly like your doctor, only half-listening to me and always rushing elsewhere. I tried very hard, on multiple visits, to describe my symptoms to the best of my ability; no matter what I said, she never "got it." Finally, I got a recommendation from a family member for another doctor -- a man, this time. He spent 5 minutes really listening to what I had to say, and knew immediately what was wrong.

The moral of the story is that it's important to find an experienced doctor who listens well, regardless of gender. I'd always been hesitant to ask around about doctor's before, but the advice I got from friends and family was invaluable.

I don't know what your symptoms are, but if you have decent insurance coverage I'd recommend asking around and going ahead immediately to see a specialist. Switching PCP's is all well and good, but a qualified internist might be what you really need.
posted by junkbox at 6:08 AM on September 30, 2005

Bedside manner aside, a doctor who is unclear as to the typical age for onset of menopause is scary. C'mon, that's basics.
posted by desuetude at 6:12 AM on September 30, 2005

I don't think it's a male vs female doctor issue. Most doctors these days, regardless of gender, want to get patients in and out as fast as they can. I have switched OB/GYNs twice now because I felt the last two were not taking the time and listening to me like they should be... and they were all female. My mom has struggled with the same problems with her PCP and specialists. She's finally found 2 doctors, both male, that will take the time to listen to her.

So, in short, yes I do think you should switch doctors if you're uncomfortable. Personally, I'm not inclined to be as open and forthcoming about my symptoms with a doctor I do not feel comfortable with. Like junkbox said, the best way to find a doctor that listens is to ask people you know.
posted by geeky at 6:19 AM on September 30, 2005

Absolutely change. Would you go to a restaurant where you had gotten such blah service in the past? Hire an architect who didn't listen to your desires and needs?

There's plenty of good doctors out there and no reason to suffer through an unacceptable encounter more than once. Your doc might be great... to someone else. Find the one that's great for you.

It's a pain in the ass but what other person do you hire in your life to service an item you intend to use till the day you die? This is the one area you never ever want to skimp or settle on.
posted by phearlez at 7:02 AM on September 30, 2005 [1 favorite]

(Apologies to our resident doctors, who I'm sure are competent and understanding, with good listening skills.)

Doctors are tradespeople, like plumbers and auto mechanics. You hired them, and you can fire them.

On preview, what phearlez said. Perfectly.
posted by unrepentanthippie at 8:07 AM on September 30, 2005

Most general practice physicians allot 10 minutes to each patient for a standard appointment. If you feel like they're not listening to you or taking the time to understand you, it's probably because they're not, and they've got five other patients sitting in exam rooms waiting for them to come by and do their doctor thing.

I see a nurse practitioner now for GYN and other things, and it's the best experience I've had. The standard appointment is 30 minutes long, so you get more time to talk and listen, if that's what you want. Ask around and see if your clinic has nurse practitioners on staff.
posted by bonheur at 8:40 AM on September 30, 2005

I would change doctors. Several years ago I went through something similar - I knew something was wrong (I know my own body), but I couldn't figure out what was going on. I went through several doctors before finally finding one who believed me and was willing to do some tests.

By the way, several of the crappy doctors were women and the one who finally helped me was a man. In my book, it's all about finding a doctor who makes you feel comfortable.

Good luck!
posted by Serena at 9:25 AM on September 30, 2005

I've fired several doctors (it always feels great to say I fired them, the truth is I just went to other docs). In your situation I'd recommend you go get yourself a second opinion right away, but not necessarily fire your doctor yet. You've already got a set of diagnostics coming up. You might as well get the data and one interpretation of them. And, if he's doing a good job let's give him a chance to mend his bad bed-side manner ways.

In the mean time, ask your friends or co-workers for a recommendation of a good doc in the area you need. Ask any other doctor you trust, or any other medical professional for a recommendation as well. You could also ask your poor-bedside-manner-man for who he thinks is good in the field.

Once you find a good recommendation, go try out the new doc. See how they feel. You're not married to the doc you got, you can two-time with no ethical concerns :-). If you like them better, tell your current doc "You're Fired!" (or, just never go back).

As to dealing with your current doctor:
* Next time you make an appointment, ask the scheduler to book you a longer appointment. If they don't comply, insist. If they need a reason, tell them it's for a full physical and ask to talk to the nurse about your next appointment.

* If necessary (If you need to 'make it a physical), explain to the nurse that you're not getting enough attention for the problem at hand in 10 min and you feel that you need a longer appt to discuss the issues at length with Dr. Bad-Beside.

* Before the appointment set aside an hour to write down all your concerns and questions. After 10 minutes (that's all it will probably take) spend the next 20 editing it down into cogent questions and a list. At the bottom write "Bedside manner". Spend the next 30 minutes doing something nice for yourself.
I know it sounds dumb, but it always works for me. Make sure to take it with you, along with a pen to mark off what you've talked about. Doctors freak me out, I always forget to ask something unless I write a list.

* At the appointment when Dr Bad-Attitude says "What seems to be the problem" say: "I'm very concerned about these symptoms we've talked about before. I'm not concerned about [weightloss, whatever else]. I'm so worried about it at this point that the worry itself is a problem. I need you to focus on these issues and help me understand what's going on, what we can do about it, and what this means for me long term" (or something like that). If he doesn't say "Ok, I understand" you may have to repeat yourself several times. Try "Do you understand what I mean?" if you're not getting anywhere.

* Go down your laundry list with him, in order of biggest concern to least, excepting Beside manner which should be discussed last.

* Take notes during your talk.

* When you've got satisfactory answers to your questions, it's time to think about beside manner.

IF during your longer appointment he was attentive and more helpful:
-- Tell him that you appreciate his attention and focus, and that that's what you need in the future to continue to feel like you're being treated well.
-- See him again, see if things get better.

IF he continues to have bad beside manner
-- Tell him that you're not happy with the kind of attention you're receiving for your issues. Get specific if you can. Ask him "What can we do to make sure I get the kind of treatment I need?". If you get more guff, make the Donald Trump hand motion, say "You're Fired!" , and get the office staff to send you copies of your medical records. Find somebody else.

OR If he continues to have bad beside manners
-- Take your stuff, get your records, and go. You don't owe the doc an explanation. He'll get the message soon enough.

OR Tell him that despite your efforts, you're still unhappy with his manner, and that he needs to improve if he wants to keep patients.. Then leave.

OR whatever feels best.

Sorry, hope that doesn't sound pedantic. These are mostly my fantasy of how to do this. Truthfully, I've fired several doctors over the years and basically I found a different doc and never called the bad one back.

Also: hightened focus on physical complaints is a common symptom of anxiety. It's worth paying extra attention to your mental health if you're noticing all kinds of things going wrong. Probably this doesn't apply in your case, but it's worth asking the question.

Best of luck, crappy doctors are a bad situation, I sincerely hope you find a good one. If you're in Seattle, feel free to drop me some mail, I've got a good recommendation for a GP in the area. Email address is in my profile.
posted by daver at 9:32 AM on September 30, 2005

I went to nurse-midwives for all my gynecological care. They were fantastic and had great bedside manner. Nurse-midwives do well-woman care too, not just prenatal/delivery/postnatal. If they come across things they can't handle they refer you up to someone else that can, and I've found myself to be comfortable with their referrals. I did all my annuals through them and only saw a GP/PCP as needed.

I would change doctors if I wasn't comfortable. I would tend to pick a woman, myself, but I've had female doctors that didn't have great bedside manner, so obviously it's not a given. I would also tend to pick a younger doctor, with the idea that they are probably not burnt-out, phoning it in, or set in their ways yet, and are more up-to-date with medical advances. That's also not a given, of course.

You might want to point out your concerns to this doctor first, or you might want to wait until some diagnostics have been run; and if the bedside manner doesn't improve, don't hesitate to take your records and results and go elsewhere.
posted by Melinika at 12:04 PM on September 30, 2005