Given a choice between technical skills and minimal interpersonal competence...wait a second. Why on earth does it have to be a choice?
Condolences. And very glad your reading skills are more sophisticated than his.
"So how's that creeping death coming along?"
Sorry to hear it, amigo. [wiggles fingers at screen] Good renal mojo to ogged! Good renal mojo to ogged!
No worries, folks--it really is clear that new doc was wrong and everything's fine (I have a call in to the surgeon anyway). It was just so sloppy and inconsiderate.
Maybe this will cheer you up.
I saw that on your site and I've already sent it to people; so cool.
Hmm, reading comprehension indeed.
Yay for ogged's kidneys! My good mojo worked!
The link in five is just incredibly awesome.
Once I had a funky boob thing that mighta been cancer or maybe not (it wasn't), and the oncologist I saw had a similar bedside manner. Just, like, you're a specimen on the table, or something. And somehow being told "he's an excellent oncologist, though" really doesn't help, does it?
Aw, jeez. You know, damned if it'd do any good, but I'd write a letter to Doctor Numbnuts and copy your surgeon, hitting the technical point that he misinterpreted the chart in a manner that might under other circumstances have affected a treatment decision, and the social point that his error was emotionally distressing in that it misrepresented your risk of cancer going forward. A doc who acts like that is going to hurt someone, and is going to get sued for it, and if throwing a scare into him could prevent either bad outcome it's the best thing for everyone.
(Actually, I'm lying. I'd think about writing such a letter and then not do it. But I think it is a good idea.)
I've always thought you had funky boobs, B.
Well, yes, but that's distinct from *a* funky boob thing, which is a whole other issue.
13: I would be too lazy to write a letter, but I would talk to his colleagues about it, which I've done before (hence "he's a really good oncologist" attempt at reassurance).
Sue! Do they have negligient-infliction-of-emotional-distress in CA? Doesn't matter -- sue anyway!
Okay to settle for cash before trial, but at least you can make the whole experience a positive.
Funky boob, funky boob
Get off my back
I'm sorry, Ogged. Sometimes I hate doctors and I have to take a deep breath and carefully remember the few who have been competent and kind. I think LB is onto somethign with the letter. .. .leave a paper trail for letter, and maybe shake him up a bit so he reforms. But I suppose you have to balance that with how much you're stuck with him also.
/Sends More Renal Mojo!
What an unnecessary stressor, Ogged. Sucks.
re: 13
If you are not going to see Doctor Numbnuts again (and why would you), I think 13 is a good idea. Maybe someone down the road will benefit from your having pointed out that he was a tota lass in a way that may have been no big deal to him, but that was (at least for a short time) a big deal for you.
Is there some law of nature that specialists have to be complete imbeciles w/r/t empathy, interpersonal skills, and so on?
Also, if you like the link in 5, you might also enjoy Kid Beyond. Silly stage name, but he's a good guy.
I love "Trash the Dumb Oncologist Day." Warms my cockles. (The tumors in which were found to be benign...two days before I died.)
Reminds me of the cardiac specialist who wandered in to my hospital room, announced that my heart was just dandy [not a source of that weird chest pain], but that my X-rays showed a bilateral hilar adenopathy. 'It's probably lymphoma', he tossed over his shoulder as he left the room...
Oh my god, Ogged, I could feel my blood pressure skyrocketing just reading that. I can't imagine how that must have felt. You're not allowed to get cancer again, dammit!
And I want to cockpunch your doctor.
oggedbat! oggedbat!
Idealist gets it exactly right.
Ugh. Who knew there were so many such docs? I had a doc once who very casually arranged a referral, and only on his way out the door bothered to mention that he was making the referral because he'd detected this lump, see, and wanted to make sure it wasn't malignant.
"Have a good weekend," he smiled and walked away.
Turned out to be nothing, but yeah, maybe bedside manner should be part of the first year med school curriculum?
I wonder if there's some unnatural selection going on during pre-med. In the old days, before docs could actually influence many events, their main job was reassurance. Now that medicine has all those tests to do and interpret, I'll bet the selections are biased more towards the same sort of personality you find often in high-tech jobs.
28 seems obviously correct.
In order to get through the classes to become a doctor, you have to absorb an almost inconceivable amount of scientific information, and that's after you manage to pass the MCAT and get in. I know people who went for PhDs in biological fields because they didn't want to bother spending 6 months memorizing irrelevant material just so they could do well on the MCAT.
This is why I support just about every effort to give nurse practitioners more power to diagnose people and deal with patients. I don't see any way to prevent specialists from being social-skill-free tech nerds, though, given the amount of information they have to process.
(my 29 does not address the issue of reading comprehension; there's no excuse for your oncologist to have screwed that up)
"It doesn't make any difference to how we proceed?"
Disgusting. Infuriating. Stupid.
It never ceases to amaze me...
28, 29: Which also implies that part of what we need to do as patients is to not get too worried about docs with limited or unusual social skills. E.g. breast doc to wife, brightly: "Congratulations, you're now officially high risk." From her, somehow, it kind of worked.
This is why I support just about every effort to give nurse practitioners more power to diagnose people and deal with patients.
Deal with patients, yes. Diagnosis? I dunno about that. All this super-science stuff came in right after WW2, and that's when the selection of people started to shift to techies who could handle it. Nice, sympathetic, kind, and all that are fine with me but only as long as they get the diagnosis and treatment right. I really can do without friendly and sympathetic blunders.
33
"I really can do without friendly and sympathetic blunders."
33 assumes an NP would (a) attempt to replace a specialist, which is not what they're about; and (b) necessarily blunder, albeit it in a friendly way.
Personally, I could really do without any and all blunders, but if I had to have them, why not make 'em friendly.
30 "I don't see any way to prevent specialists from being social-skill-free tech nerds, though, given the amount of information they have to process."
Why -- specialized technical skills are somehow incompatible with social skills? I have a good friend who is a rather skilled specialist, and a really compassionate and sensitive guy to boot. It's not impossible. And given the studies I seem to recall that bedside manner is as important as whether the doctor actually screwed up in determining which docs wind up getting sued, there's kind of some incentive out there to develop those social skills...
I'm not going to put down NPs, I've worked with them often enough in L&D and know they can be perfectly competent. That was about twenty years ago and it now seems as if anything more complicated than a head cold gets referred to a specialist. I can see the medical benefits in having an ankle specialist and a wrist specialist but I don't think it's going to make for a lasting human connection. I'll settle for good credentials and few lawsuits.
This is, of course, the fault of our not having a civilized healthcare provision in this country. Which means you should hate on the opponents of that, ogged -- your doctor is but an innocent victim! Well, a bit of a jerk for failing to transcend the pressures his job puts on him, but then aren't we all.
I would write a letter to the Chief of Oncology explaining that this physician could not even read a simple pathology report and attach the report. I would also get a copy of what he wrote down in your new chart. He sounds like a quak. No way would I trust my life with someone like that.
I work in a medical school and have a fair amount of contact with medical students, and I have to say, it's really not encouraging. You can see where this kind of shit comes from pretty early on. They are not, on average, a very thoughtful lot.
Yeah. The 'you cannot get into med school without a 4.0' standard is not a good one. I think my sister's interpersonal skills are predicted by the fact that she did very erratically undergrad, and then waitressed and cut up dead bodies for a couple of years before med school -- not the standard "I am so driven" track.
I hope you don't have to go back to that awful doctor again. Ugh!
I think I'm going to ask that another doctor take it from here.
13 & 35: The argument about bedside manner and not getting sued is summed up for laypeople in Malcolm Gladwell's book Blink. (Pages 40-43, or thereabouts according to Amazon's lovely Online Reader.)
Doctors who talk down to their patients will get sued. The academic research really is that simple: surgeons who had never been sued spent about three minutes longer with each patient than those who had been sued did, and the ones who had been sued took on a dominating tone in the discussion. Patients don't like it, and when something goes wrong, the doctor who has been a jerk is the one who lands in court.
Gladwell writes, "What comes up again and again in malpractice cases is that patients say they were rushed or ignored or treated poorly. 'People just don't sue doctors they like,' is how Alice Burkin, a leading medical malpractice lawyer, puts it. 'In all the years I've been in this busines, I've never had a patient walk in and say, "I really like this doctor, and I feel terrible about it, but I want to sue him." We've had people coming in saying they want to sue some specialist, and we'll say, "We don't think that doctor was negligent. We think it's your primary care doctor who was at fault." And the client will say, "I don't care what she did. I love her, and I'm not suing her."'" (pp. 40-41)