Showing posts with label Crazy Patients. Show all posts
Showing posts with label Crazy Patients. Show all posts

Apr 21, 2010

How NOT To Thank A Doctor!

Last post I said there's really no wrong way to thank a doctor. While that is usually the case there is one very wrong way to thank a doctor...


Doctor D's number one rule for thanking doctors:
Don't be creepy!


The only way that you can mess up a thank you is to make it creepy. And by creepy I mean very, very inappropriate. Most patients don't need to worry about coming across this way because they have no twisted ulterior motives. I don't think anyone could be this creepy by accident:
  • Showing up at Doctor D's doorstep at 1:00 am to thank him.
Stalkerish and not cool.

  • Saying, "Okay Doctor D, now that you've saved my life I am bound to be your personal slave for life!"
It might have been okay if the patient was joking, but when said seriously it's just a little too much gratitude for Doctor D to handle!

  • Telling Doctor D how awesome he is right before you ask for a prescription for high-dose narcotics.
Maybe the gratitude was heart-felt, but when combined with a request for controlled substances Doctor D can't help but suspect he's being manipulated.

  • Making a very obvious attempt to feel up Doctor D while thanking him.
Yeah that got her discharged from the practice, and it almost got her an ass-whoopin' from Lady D!

Now most of the patients that read this blog don't have that psycho-killer vibe and therefore expressing gratitude like this never occurred to you. But if you do happen to be a bit on the creepy side a good rule of thumb to remember: if an action has ever gotten you a restraining order it probably isn't a good way to thank your doctor.
So "No Creepiness" is the only absolute don't of Doctor-thanking that D can think of. Does anybody know anymore no-no's for thanking doctors? Anyone have great stories about creepy gratitude?

Doctor D will be back soon with some tips on the right way to thank an MD in your life!

Apr 5, 2010

Doctored to Death?

What is a Doctor Junkie?

A
commenter on the Medical Mafia post brought up the subject of doctor-junkies, and readers seemed fascinated by the idea.

Yes, doctor-junkies are real and they are everywhere!

Just as Doctorphobia is hazardous to your health, Doctorphilia can be equally disastrous.

Any regular reader of AskAnMD is aware that while MDs are useful, we can also be dangerous. An addiction to doctor-visiting will lead to lots of risky tests and medicines you don't need. Too much doctoring can take you to an early grave and make you miserable on your way there.


Who are these Doctor-Junkies?
Doctor-Junkie: (n) -a person who believes that every uncomfortable or unusual physical sensation must be evaluated by a doctor.
While most hypochondriacs are doctor-junkies, not all junkies are hypochondriacs. Some doctor-junkies aren't paranoid they have a horrible illness, but just feel every little thing must be "checked out."

Dangerous Doctorphilia is often an inherited condition. Doctor-junkies start out as those kids whose parents rush them to a doctor every time they sneeze or scrape their knee:
Once a mother brought her child to Doctor D's ER because the toddler had made an especially loud sigh. "A sigh?" I asked. "Yes, like this" and she made a sighing sound "so I just wanted you to check his lungs." Doctor D assured mom that we all sigh on a regular basis, but perhaps this sigh was louder because of her child's frustration that he had a mother with nothing better to do than gauge the volume of his sighs. She demanded a Chest X-ray just to make sure. Then Doctor D let out a loud sigh of his own.
You would think after a childhood spent in ER and clinic waiting rooms that someone would want to escape the world of needles and medicines, but the junkie is hooked by the time they reach adulthood. Any runny nose or sore muscle and the doctor-junkie gets that overpowering urge to visit somebody in a white coat quick. The doctor-junkie isn't satisfied with just an exam and reassurance, "No doc, I've been waiting a long time to see you so give me the good stufflab tests, X-rays, and lots of pills!"

To the doctor-junkie no symptom is too mild or too brief: every physical discomfort needs blood work and prescription medicine ASAP. If you doctor's office is on lunch break then junkies call an ambulance for that mild sense of nausea!

In addition to wasting billions of dollars, all those visits likely shorten the lives of the junkies. Radiation from imaging studies leads to cancers. Lab studies eventually uncover benign abnormalities that junkies need fixed. Junkies get some really nasty side effects from meds, because they've often been prescribed every medicine in the pharmacy.

Rather than forcing the junkie at rock bottom to change his ways, being harmed by healthcare has the opposite effect: a doctor-junkie who is sick from over-doctoring feels the compulsive need for more and more and more.


Who is to blame for this epidemic of Doctorphilia?

Doctors!

Yup, it's us. We have the stuff that junkies crave, and docs give out unnecessary care like candy till we get everybody hooked.

Why shouldn't we? Docs get paid to see people whether they are really sick or not. A proper exam followed by educating a concerned patient is difficult and time-consuming, while ordering tests and writing prescriptions is just so quick and easy. Doing unnecessary care and writing unnecessary prescriptions keeps patients happy with us because they feel they are getting something done.

Plus, it's nice to feel needed.
I know a doctor who shall remain nameless that gives antibiotics to every single person with a runny nose. Now almost all runny noses are caused by mild viruses that cannot be cured by any medicine. Dr. Zpack gives everybody a useless antibiotic and they all assume that the medicine worked when the symptoms resolve on their own. His patients are apparently unaware that human beings have immune systems. Dr. Zpack's junkie patients love him because he always "cures" their infection, and it's good business for him because half his visits are simple colds he can easily "fix" with one prescription. When Dr. Zpack's office is closed his patients panic and rush to the ER at the first cough. He's a nice old doc, but who knows how many superbugs and dangerous reactions have originated with Dr. Zpack's prescription pad?
The fact that doctors give out unnecessary care immediately legitimizes it. Patients accept that it must be safe and necessary if doctors order it. Some patients casually dabble in being over-doctored, but some susceptible patients fall over the edge into full-fledged addiction.


The Addiction Gets Ugly:
It's a win-win situation for the dealer and the junkie until something goes wrong: The junkie gets too demanding or overdoses on unnecessary care resulting in an iatrogenic injury. Then Dr. Dealer freaks out and cuts off the junkie cold turkey.

Doctor D has seen it too many times: panicked patients in withdrawal from over-doctoring pitching fits in the ER that they have to wait an hour to be seen for their runny nose.


Recovery:
Coming to Doctor D's office (or his blog) is like detox for doctor-junkies. Appropriate medical care is often a shock to the doctor-junkie's system. Doctor D has to explain to recovering junkies that the human body is actually capable of healing itself. Who knew?
Fortunately Doctor D has a 12 step program for the Doctor-Junkie epidemic. Tune in next week for my prescription for curing the over-doctored!
What do you think? Have you or loved one ever suffered from Dangerous Doctorphilia? How did you recover? Do you blame MDs for this problem?

Did you miss Doctor D? Where were you when you first heard the word iatrogenic? What other irreverent medical topics should this blog tackle?

As always, Doctor D loves to hear your thoughts and stories in the comments!

Dec 11, 2009

Is The Patient Crazy—Or The Doctor? (Friday Links)

Doctor D found a great blog by a patient with lots of physical maladies who used to be reporter for the Associated Press. Now she is "Sick Momma" and blogs on her life as a chronically ill mother and wife. As D was enjoying her blog and came across this post about some conditions he'd never heard of.

Apparently Sick Momma believes that many doctors suffer from a mental disorder which causes us to attribute symptoms we don't understand to a patient's mental state. Whatever!
Patients expressing unfamiliar complaints to their physicians often induce the "It's All In Your Head" (AIYH) or the "That's Impossible" response in doctors suffering from these behavioral problems and personality disorders.

Physicians fixated upon the metaphysical belief system of "If we don't know about it, then it doesn't exist" are suffering from a mental defect or psychological condition known as "Doctors with Unexplained Medical Beliefs": D.U.M.B.
Excuse me? I'm the doctor, so I'll decide what is a disorder and what isn't!

And I've never heard of these "behavioral disorders," which leads me to suspect they don't exist! Since I have no idea what put these crazy ideas in Sick Momma's mind, I shall diagnose her as depressed and put her on Prozac. I shall continue to add psychoactive medications until she learns not to challenge my god-complex!


***
Actually this is an interesting problem: What should be done about symptoms that make no sense? Lots of patients and doctors end up these situations.

The doc is thinking, "This doesn't sound like any disease I know about. All these symptoms are subjective sensations. Maybe it all is in this patient's head?"

The patient is thinking, "This doctor doesn't know what is causing my symptoms! What an ignorant doctor! If my doctor has never heard about this it must be something rare and horrible!"

It is a tricky impasse. Each can't help but have these impressions sometimes. We all want to prove we aren't ignorant or crazy, but then again we all want to be agreeable. Often these situations end up with either unnecessary antidepressants, unnecessary testing, or both.


We need better ways of discussing strange symptoms. Hence, in next week's reader question Doctor D shall provide some answers! (or perhaps some humble suggestions)
Until then, what do you think? Has a doctor ever told you your symptoms were all in your head? Have any of you healthcare providers ever had a patient who had nutty symptoms? Doctor D would love to hear your stories!