How Doctors Treat Us (Video at the End)

I've had a lot of contact with physicians recently. It's been about a month since my mountain biking accident, where I broke 5 ribs. I saw a nurse at the Winter Park Resort clinic; two different doctors and twice as many nurses at Harmony Urgent Care, numerous X-ray techs, and, yesterday, a doctor at my normal family doctor's office -- though not my regular doctor. I made the appointment on short notice; you get whoever is available.

This is how I would rate them all, on a scale of 1-10:

Winter Park Nurse - 8

Urgent Care Doc, round 1 - 8

Urgent Care nurses, round 1 - 9

Urgent Care X-ray tech, round 1 - 7

Urgent Care Doc, round 2 - 9

Urgent Care Nurses, round 2 - 10

Urgent Care X-ray tech, round 2 - 9

Doctor's Office Doc - 3

Doctor's Office Nurse - 7

X-Ray Tech, Round 3 - 7

All pretty average, non-notable encounters with health care professionals, except where I've highlighted those who were on the opposite ends of the scale. All of these appointments have me thinking a lot about what makes a good doctor. What's good doctoring? We go to health care professionals for care -- how do they care for us? How do we know that they care about us?

Let's review out highest and lowest scorers in an attempt to answer this question.

When Docs Get It Right - Our High-Scorers

The two doctors at the urgent care were very much alike. They were both male, in their 60s, and grey-haired. If I were asked to tell them apart from each other in a line-up today, I'm not sure I could. They wore the traditional doctor's costume -- white lab coats with their names embroidered over the breast pocket. Old School. I imagine that they could have easily been jaded about their profession and certainly about the people who come into their clinic. I imagine they've seen all of Fort Collins' hypochondriac's and drug-seekers on a regular basis.

But they were kind, understanding, and compassionate. They took the time to listen to my descriptions of my accident and symptoms, and they didn't interrupt too often. Unusual for this day and age, neither of them carried laptop computers. or even pens and paper. Just stethoscopes slung around their necks. They weren't there to take notes -- they were there to take care of their patient.

The process at the urgent care enabled this doctor/patient interaction. A nurses' assistant first took me back to the exam space and took all of my vital signs. Then a Physician's Assistant came in and took my history, went over the medical records on file. He took pen and paper notes and had printouts to refer to. I assume that the doctors received all of this information to review before he saw me. Even more important, they didn't have to spend their time with me on these details. They could devote themselves to patient care. Their examinations were hands-on and thorough.

When Doctoring Goes Wrong

My recovery has been an up and down progress, but I've been feeling a bit better recently. Until a few nights ago when things went downhill and stayed down. So I called my regular doc's office and asked for an appointment. Seeing my regular doc on such short notice is out of the question, so I took whatever was available. I like this practice. I've been there for a few years and have never had a bad experience, until yesterday.

Much like the urgent care, the nurse who escorted me to the exam room took all of my vitals and asked for the basics of why I was there. The doc arrived a few minutes later. We sat in chairs at first. She had a laptop, which I've come to expect, even gotten used to -- every doctor at this practice carries one into appointments.

What was different this time was how much attention the doctor paid to the laptop and how little she paid to me. I went through the full history of my injury, from accident to the moment the pain again turned severe. I gestured. I used my hands to point specifically to where the pain was -- and where it had moved to -- and the entire time I was talking she was looking at her laptop screen.

Not typing and glancing occasionally at her laptop screen.

Not making eye contact with me when she asked questions and then looking down as she typed.

She almost never looked up at all.

I became acutely aware of her behavior because it seemed to unusual.

She was transcribing, not listening.

I made more eye contact with the man who accompanied her -- a guy going medical coding -- than I did with her. I was hoping her was observing her to grade her. He seemed to notice her lack of attention to me as well.

Her physical examination was cursory and impersonal. her stethoscope never touched my skin, and she never actually felt my rips. Even though I had told her, more than once, that lying on my back caused the most pain and that my breathing felt different and even sounded different in that position. A few cursory presses on my abdomen and she was done. I didn't even get a good helping hand for the very painful process of sitting up.

I left angry, disappointed and most of all, feeling quite ignored.

The Answer?

Te doctor-patient relationship is just that -- a relationship, and how a doctor relates to a patient sets the tone for everything that follows.

This doctor, I believe, does have the answer, and I wish my physician yesterday had seen this video or at least been taught some critical people skills. Take 18 minutes to watch: