How do you know it's time to switch doctors?

[Anonymous]

Technical skills are what matters most fora surgeon.

Do other DOCTORS recommend her?Did you ask her stats (like outcomes? Complication rates ? Most importantly: How frequently does she perform this procedure??)

For an ongoing doctor (like an internist), I would never tolerate someone who does not leave time for my questions, or explain their recommendations.

[Anonymous]

Anonymous wrote:Doc here- first of all, yes, if you don’t click with her and don’t trust that she does her job well then absolutely shop around. It’s your health and your life!

Second of all, when I document, there is an option for a template for almost every kind of encounter. If a kid has strep throat I click the template , add some details, delete some others, and lock the encounter. Otherwise I’d be documenting for 6 hours every evening after I left work. So yeah I’m sure a lot of those charts say I educated the family on a million types of infection control when I didn’t (although technically, legally, I did, by handing them the discharge paper that includes a million infection control suggestions). Does that make me a bad doctor? That’s up to you. I’m just trying to see patients and practice solid medicine, I’m not trying to write a novel for every standard patient encounter just so insurance companies will grudgingly agree to pay for your visit. But some people wouldn’t like that the chart is clearly sort of standardized, and that’s fine, my feelings aren’t hurt.

It's not about hurting your feelings or not. You should come up with a new shortcut if the shortcut you're using ends up putting false information into people's charts. For one thing, your causing people to lose valid disability claims with your practice. I have doctors who include a "review of systems" at the end of the encounter note but didn't actually ask me about any of those symptoms. I write them back and note that they didn't ask, and if they had, my answers would have been xyz, and I ask them to correct it.

[Anonymous]

I recently needed surgery and disliked the first two surgeons I met with. Everyone kept telling me I didn't need to like them and that surgeons are usually jerks. I met with a third surgeon and really liked and trusted her. It ended up mattering a lot when I unexpectedly needed to stay in the hospital for several days, and she managed things really well. I don't trust that the others would have been as good.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Is it just "vibes"? You don't click? Do they have to do something like screw up a procedure, overbook and keep you waiting, talk down to you/ignore your concerns?

Where do you draw that line? Does it differ by specialty?

For me, if I don't vibe with a counselor or therapist, I tend to move on. GPs could go either way; I probably stay longer than might be best just because it's a familiar face in a familiar environment I'm used to. My Gyn is chronically late, but the practice is a baby factory so I assume c-sections muck up the scheduling.

Right now, I need a surgeon and I don't click with the one I picked. She's got great reviews, and is okay in-office, but she pads my chart with allegations that we discussed things I know we didn't and it makes her hard to trust. That said, we don't need to get along. I need her to perform the surgery so I can move on with my life.

So I'm trying to suss out when I need to go shopping for a second opinion, and when it's okay to just say 'eh, we wouldn't be friends but they're good at their job'. Suggestions welcomed, but try not to be a dick. I spent the day in the ER and I'm already pretty stressed out. Thanks!

Interesting, two of my doctors also write a lot of stuff in my portal notes that were never discussed.
One uses AI for the notes, the other does not.

It's happened at most visits lately. Not happy.

You should have them correct the notes. Every time.

[Anonymous]

Anonymous wrote:My husband is a doctor and I'm a research scientist. For us it's not about bedside manner or "clicking". It's about making the right medical decisions. I've had very few bad doctors in my life, ones who actively did something wrong, or omitted doing something that should have been obvious.

What's more common are doctors who miss going in the right direction the first time around, because the patient unintentionally leads them astray with their reported set of symptoms, or because they hyperfocus on one cause and forget to do all the right checks for any other. That is very common. Are they bad doctors? Depends how far they go in the wrong direction, I suppose. But they're also human and fallible.

My husband is a very good diagnostician in his specialty but has a poor bedside manner. He wants to find what's wrong and treat it, not hold your hand and give you the tissue box.

Lovely that you, his wife, think he's a good doctor. His patients likely think bedside manner IS part of being a good doctor. (But they will take what they can get, because a lot of doctors have very poor bedside manner.)

[Anonymous]

Anonymous wrote:

Anonymous wrote:I had a general practitioner give me a gynecological exam as part of my annual physicaland did not give me warning before sticking a finger in my butt. I was alarmed, but I was only about 25 and was unsure if that was normal. It did not feel right. I looked up reviews after that, and the majority were extremely positive as she was a well regarded doctor in the northern Virginia area, but digging deeper there were a handful that had experiences like mine. That really made me question what she was doing. I never went back.

That's... not normal, is it?

No, I don’t think it’s normal.
That very same thing happened to me once, when I was around 22, and it was very upsetting. Male doctor that I’d never seen before, no warning at all. Left and never went back. Felt violated.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I had a general practitioner give me a gynecological exam as part of my annual physicaland did not give me warning before sticking a finger in my butt. I was alarmed, but I was only about 25 and was unsure if that was normal. It did not feel right. I looked up reviews after that, and the majority were extremely positive as she was a well regarded doctor in the northern Virginia area, but digging deeper there were a handful that had experiences like mine. That really made me question what she was doing. I never went back.

That's... not normal, is it?

No, I don’t think it’s normal.
That very same thing happened to me once, when I was around 22, and it was very upsetting. Male doctor that I’d never seen before, no warning at all. Left and never went back. Felt violated.

Did he offer an explanation?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My doctor wouldn’t treat my psoriasis in any way that made it better. I told her the tubes of ointment she prescribed smelled awful and didn’t work and stained my clothes and sheets and she kept prescribing them. I finally told her I thought it needed to be treated from the inside, out. Rather than the outside, in. More ointments.

So I left. Went to a different doctor. Got on Tremfya and now nobody can tell I have it.

PP's husband would coldly explain that he knows better and would charge you $400.

It's always the nastiest people who need the most love, attention, and gentle care. Probably because they're even meaner to themselves than they are to random, strangers, etc. I hope you heal, PP.

Describing frightened overwhelmed people suffering from a health crisis as “the nastiest people” says a ton about the way many doctors think.

“Shut up and do as I say - you’re just a payment on my new Audi - I’ve got other patients to see! No questions - don’t you know I went to med school?”

You're a bully on the internet. If you're suffering from a health crisis, I hope you get the help you need. I also hope you stop spewing your nastiness all over this thread, trying to derail with comments about $400 charges and audi payments. Heal your trauma so you don't dump it on a thread where the OP specifically asked that people keep it civil. You're a mess, and this thread isn't about you/your mess.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I had a general practitioner give me a gynecological exam as part of my annual physicaland did not give me warning before sticking a finger in my butt. I was alarmed, but I was only about 25 and was unsure if that was normal. It did not feel right. I looked up reviews after that, and the majority were extremely positive as she was a well regarded doctor in the northern Virginia area, but digging deeper there were a handful that had experiences like mine. That really made me question what she was doing. I never went back.

That's... not normal, is it?

No, I don’t think it’s normal.
That very same thing happened to me once, when I was around 22, and it was very upsetting. Male doctor that I’d never seen before, no warning at all. Left and never went back. Felt violated.

Did he offer an explanation?

I was the person who first detailed this issue and I was too shocked and embarrassed to ask. I questioned my own discomfort, thinking no way would a female doctor do that if it wasn’t ok.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Is it just "vibes"? You don't click? Do they have to do something like screw up a procedure, overbook and keep you waiting, talk down to you/ignore your concerns?

Where do you draw that line? Does it differ by specialty?

For me, if I don't vibe with a counselor or therapist, I tend to move on. GPs could go either way; I probably stay longer than might be best just because it's a familiar face in a familiar environment I'm used to. My Gyn is chronically late, but the practice is a baby factory so I assume c-sections muck up the scheduling.

Right now, I need a surgeon and I don't click with the one I picked. She's got great reviews, and is okay in-office, but she pads my chart with allegations that we discussed things I know we didn't and it makes her hard to trust. That said, we don't need to get along. I need her to perform the surgery so I can move on with my life.

So I'm trying to suss out when I need to go shopping for a second opinion, and when it's okay to just say 'eh, we wouldn't be friends but they're good at their job'. Suggestions welcomed, but try not to be a dick. I spent the day in the ER and I'm already pretty stressed out. Thanks!

Interesting, two of my doctors also write a lot of stuff in my portal notes that were never discussed.
One uses AI for the notes, the other does not.

It's happened at most visits lately. Not happy.

You should have them correct the notes. Every time.

I'm OP. Thanks for pushing this. I wrote to my doctor (again) to address the discrepancies in my chart. Ultimately, I think it's a dealbreaker for me. She may be a great surgeon, but the lack of integrity makes it impossible for me to trust her. It's one thing when I'm awake and alert and can counter the false narratives. But if I'm under general, the only way for me to know what happened to me during surgery is trusting that she will make an accurate record of what went on. If she can't do that for general office procedures and simple things like a biopsy, well, that's a whole statement about her integrity.

Whether she had an assistant write it up, or AI, or whatever, she signed her name to that mess. I'll give her the opportunity to explain why, but I'm pretty sure there's nothing she can say at this point that will restore my trust, and it matters to me.

[Anonymous]

Anonymous wrote:Doc here- first of all, yes, if you don’t click with her and don’t trust that she does her job well then absolutely shop around. It’s your health and your life!

Second of all, when I document, there is an option for a template for almost every kind of encounter. If a kid has strep throat I click the template , add some details, delete some others, and lock the encounter. Otherwise I’d be documenting for 6 hours every evening after I left work. So yeah I’m sure a lot of those charts say I educated the family on a million types of infection control when I didn’t (although technically, legally, I did, by handing them the discharge paper that includes a million infection control suggestions). Does that make me a bad doctor? That’s up to you. I’m just trying to see patients and practice solid medicine, I’m not trying to write a novel for every standard patient encounter just so insurance companies will grudgingly agree to pay for your visit. But some people wouldn’t like that the chart is clearly sort of standardized, and that’s fine, my feelings aren’t hurt.

Yes, I was going to say this. Based on my experiences, I think that certain symptoms/conditions are attached to others, so if a doctor selects an STD, for example, it will auto select "sexually active". Or if you are taking spironolactone for hair loss, it may autoselect that you have high blood pressure because that is spironolactone's actual purpose.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My doctor wouldn’t treat my psoriasis in any way that made it better. I told her the tubes of ointment she prescribed smelled awful and didn’t work and stained my clothes and sheets and she kept prescribing them. I finally told her I thought it needed to be treated from the inside, out. Rather than the outside, in. More ointments.

So I left. Went to a different doctor. Got on Tremfya and now nobody can tell I have it.

PP's husband would coldly explain that he knows better and would charge you $400.

It's always the nastiest people who need the most love, attention, and gentle care. Probably because they're even meaner to themselves than they are to random, strangers, etc. I hope you heal, PP.

Describing frightened overwhelmed people suffering from a health crisis as “the nastiest people” says a ton about the way many doctors think.

“Shut up and do as I say - you’re just a payment on my new Audi - I’ve got other patients to see! No questions - don’t you know I went to med school?”

You're a bully on the internet. If you're suffering from a health crisis, I hope you get the help you need. I also hope you stop spewing your nastiness all over this thread, trying to derail with comments about $400 charges and audi payments. Heal your trauma so you don't dump it on a thread where the OP specifically asked that people keep it civil. You're a mess, and this thread isn't about you/your mess.

DP but you are overreacting.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Doc here- first of all, yes, if you don’t click with her and don’t trust that she does her job well then absolutely shop around. It’s your health and your life!

Second of all, when I document, there is an option for a template for almost every kind of encounter. If a kid has strep throat I click the template , add some details, delete some others, and lock the encounter. Otherwise I’d be documenting for 6 hours every evening after I left work. So yeah I’m sure a lot of those charts say I educated the family on a million types of infection control when I didn’t (although technically, legally, I did, by handing them the discharge paper that includes a million infection control suggestions). Does that make me a bad doctor? That’s up to you. I’m just trying to see patients and practice solid medicine, I’m not trying to write a novel for every standard patient encounter just so insurance companies will grudgingly agree to pay for your visit. But some people wouldn’t like that the chart is clearly sort of standardized, and that’s fine, my feelings aren’t hurt.

OP here. Thanks for this. Yeah, I kinda figured there's a ticky box and/or a preset form. And I know insurance is shite and getting them to pay out is a massive hassle. Helps to hear it again though.

I think she's alright. I just need her to fix my defect so I can go back to living my life. I don't think there's anything she can write or omit in the clinical notes that would keep her from being liable from any negligent or intentional bad outcome. I think I'm just autistic and dealing with a feelings thing happening in a clinical setting.

Ain't comfy though. It would be nice if my doctors had adequate time to explain things so I understand, with clinical notes to match so I can go back and review and reference. If only the system weren't so broken...

I totally get it (PP here). We used to have scribes that typed out everything I told you. I and the patients both loved it. But of course, too expensive for the practice so now we just have pre-set templates. My own practice of medicine hasn’t changed but the note the patient reads afterwords has. I agree it’s hard for people to circle back around and re-read things that were hard to digest in the exam room (because many patients are stressed in the exam room and don’t remember things clearly!) but, again, unless I’m able to see way fewer patients every day, I can’t document all that.

Paper notes back in the 90s were like 2 lines long for this reason.

My brother is a surgeon and his hospital is testing out AI scribes who listen and type up his notes for him. Then all he has to do is review and clean them up at the end of the day. He says for the most part, the scribe is accurate and he has very little cleaning up to do at the end of the day, and this allows him to spend more time talking to his patients. Maybe consider that?

[Anonymous]

My wife and I had a primary care provider who was terrible. He did his own blood draws and charged them as appointments, rather than just send us to the lab. He tried to put me on statins without trying lifestyle modification on his assumption that my high cholesterol was genetic - after refusing statins I changed my diet and brought it down significantly, and my new doctor confirmed to me that his approach was not standard. He told me over the phone that I had prediabetes only to then tell me in the office that he was 99% sure that I didn't--he offered to give me a prescription to help me with anxiety because I seemed nervous during that prediabetes appointment. He called my wife and told her to come into the office immediately to discuss her MRI results, and refused to tell her whether there was any malignancy, only to sit her down in his office the next day (after an obviously sleepless night) and tell her that she didn't have cancer and just needed to change a prescription. That last one was the final straw, and we both went to get new doctors--recommended by a really good specialist our original doctor had sent us to.

In general, it seems to me that if you can get a new patient appointment within the next week or two with a primary care provider, he or she is probably not too good. Specialists are obviously different.

[Anonymous]

Anonymous wrote:My wife and I had a primary care provider who was terrible. He did his own blood draws and charged them as appointments, rather than just send us to the lab. He tried to put me on statins without trying lifestyle modification on his assumption that my high cholesterol was genetic - after refusing statins I changed my diet and brought it down significantly, and my new doctor confirmed to me that his approach was not standard. He told me over the phone that I had prediabetes only to then tell me in the office that he was 99% sure that I didn't--he offered to give me a prescription to help me with anxiety because I seemed nervous during that prediabetes appointment. He called my wife and told her to come into the office immediately to discuss her MRI results, and refused to tell her whether there was any malignancy, only to sit her down in his office the next day (after an obviously sleepless night) and tell her that she didn't have cancer and just needed to change a prescription. That last one was the final straw, and we both went to get new doctors--recommended by a really good specialist our original doctor had sent us to.

In general, it seems to me that if you can get a new patient appointment within the next week or two with a primary care provider, he or she is probably not too good. Specialists are obviously different.

Wow. That sounds nightmarish! Yes, there are definitely some doctors who are on a serious powertrip, pathologically so. YIKES!