If you ask them they will of course tell you they care. They are probably right, but what they don't tell you is that they just don't have the time or they don't want to spend the time to ensure that you have all the information you need to make an important medical care decision. They don't realize that good communication cures people too. I have yet to find one doctor who has an active presence on social media to interact with patients. Many have web portals but doctors don't use it. It is very frustrating dealing with these doctors today when that is how many of us communicate. Many doctors are scared to use social media since it would make it easier for their patients to reach them. This has cost me---and many others--- a lot of money with purchasing expensive medications and getting unnecessary medical procedures.
Not having the necessary up-to-date information to make an important medical decision makes me angry since I am not a medical expert. I have not gone to medical school to understand the complexities of a human body and how it behaves with different medications. You would expect doctors to explain it to you in a simple manner so you can use various points of references to make an important medical decision. The doctors today leave it to you to figure it all out and make a decision.
My Recent Experience
You probably have a similar story. My purpose of this post is not to criticize doctors' medical competence, but to show that it is also equally important they are competent in communicating to patients so the patients know what's best for them.
I have had a back problem since the late 90s. My back pain flared up last year, and I tried to avoid getting a surgery, but after consulting with several doctors, and my wife, I decided to get a back surgery. The reason I opted for surgery is because I wanted to have a better quality of life, such as able to take a long walk in the park, which I am unable to do right now.
On the day of the surgery, I saw the doctor briefly before the surgery, but did not see him after the surgery. The doctor's secretary scheduled an appointment to see the doctor in two weeks after the surgery.
Here is a little thing my doctor could have done that would have made me feel real good, but I guess I have a very high expectations of doctors.
I was asking myself, why couldn't the doctor call me the next day and have a quick word with me and then follow-up a week later. I don't know if this is how all doctors practice medicine, but if they do, I can see why people hate doctors. They don't go out of their way to show they care. A phone call would not have taken more than few minutes, but it would have meant so much to me that the doctor cared about how I was feeling and recovering after the surgery when you are in pain and feel isolated.
When you bring this up with doctors they will blame it on Obamacare, Medicare, insurance companies, lawyers, paper work, etc. I have never had one doctor ever tell me how good he felt for healing a patient. Many have lost their calling on why they became doctors in the first place. I understand that there are issues, but we all have issues. Overall, doctors do quite well. My advice to doctors is to enjoy your job and stop complaining.
Here is another thing that ticks me off about doctors in how they communicate with patients.
When I visited the doctor two weeks after the surgery, I said to him that I did not get the relief I was expecting in my leg after the surgery. Instead of explaining the pros and cons of the back surgery, he blamed me for waiting too long. I was taken back. I said to the doctor, "Isn't a surgery the last resort?" I explained to him that "I was advised by other doctors to seek alternative treatments instead of rushing into getting a surgery since it is fraught with risks and may not work." He changed the subject quickly and said that it will take longer since my disc was calcified and asked me to go through physical therapy and see him in two months.
Doctors have to know how to explain things before the surgery, the day of the surgery and after the surgery, so the patients are satisfied that the doctor is consistent throughout the entire medical process. I know it is a long and arduous path to become a doctor, but they also need to learn how to communicate effectively with patients. Being a good doctor is not enough. They also have to learn to make an extra effort to ensure that the patients are clear with he information they need to make an informed decision. They don't think that it is their responsibility.
Whose Responsibility Is It Then?
The other problem is that doctors are so specialized such that they all can be right in their way, yet not that helpful to you. The question is who can you turn to mediate this? The problems patients have is quite complicated. For example, with my back problem, I had to consult with several specialists, such as physiatrist, pain specialist, surgeons, physical therapist, and others. How do I know what is the best way to fix the problem with all the information that is out there. Unless you have all the time in the world, you need a case manager who can bring all these disciplines and then come up with a course of action through consulting with you. This does not exist right now. Unless this is available, the care is going to both ineffective and costly. If you do it on your own, you are at the mercy of trusting that the doctors has your best interest in mind by his putting himself in your shoes. According to research, putting in someones shoes does not work. A doctor who is not experiencing back pain can't put himself in your shoes no matter how long he has been practicing medicine. What works is asking you directly. How likely do you think that is going to happen today?
We tend to trust doctors but we have to know where they are coming from (as far as their specialty is concerned) and this is very difficult for patients to know. You have to be very careful when dealing with specialists since they tend to operate in the following mode: "When all you have is hammer, everything looks like a nail."
After my surgery, I started my physical therapy. My physical therapist took the time and explained everything to me and answered all my questions without my feeling I was being rushed. He and his staff are always there to answer all my questions.
During one physical therapy session I started chatting with a woman who was there for her back therapy. She had an injection and it didn't provide much relief. Her doctor wanted her to get another injection. She decided against it. Instead she opted for physical therapy and informed me that it made a big difference with her pain.
This got me thinking that why didn't my doctor recommend my getting physical therapy after getting an injection and even after getting the second injection. Why didn't the two surgeons I saw didn't recommend getting physical therapy for 8 weeks and then only consider surgery if I saw no improvement. What I am doing after surgery could have been done before the surgery, but no doctor explained or even recommended this option. It is too late for me, but I would highly recommend you look for the long game in getting better instead of quick fixes.
If you have a back pain, first go through extensive physical therapy and do some of the exercises at home. If that does not work, then get an injection and do more therapy. Keep doing exercises at home for some time and if the pain is still hard to take, then only consider surgery, but do your research. Doctors are not going to be of much help. You have to become the doctor of your body; don't outsource that to anyone, including doctors.
You have to do your research as Rudolph Giuliani, former mayor of New York city, points out in his book "Leadership" after he was diagnosed with prostate cancer. He writes,"I learned as much as I could about the disease in general and prostate cancer specifically---so that I could understand what I was being told and could form my own opinions and see whose advice best reflected my own approach to recovery." Later he goes on to say that you have to gain some expertise on a subject like prostate cancer not only because it is important, but you will be able to make an informed decision and not swayed by others. He emphasizes this by using a subheading of a chapter, "Don't Leave It To Experts."
What About The Future Of Medical Care?
The future of medicine is not quick fixes, but long term care through technology such as wearable devices and long term personal care such as physical therapy. Technology and long term care will provide better care, reduce the cost and produce better outcomes. Also, patients are going to be empowered to make an informed medical care decisions rather than resort to short term quick fixes that are not only expensive but often don't produce good outcomes. Medical care is changing for good.
In the HBR article "Personalized Technology Will Upend the Doctor-Patient Relationship" the authors write that medical care is going to adopt two models in the future: goldminers and bartenders. They write that "Goldminers, who dig deep in one major area, and Bartenders, who offer customized and convenient options to address routine needs."
In this model the gold miners will only get involved when you have high confidence that you have diagnosed the problem. The bartenders will use many of the emerging technologies to treat and manage patients and will have sufficient data to justify sending patients to gold miners. By not following this model leads to making decisions that are not optimal for the patients and increases cost and deliver inadequate care due to inefficiencies. The big change that is going to take place is that doctors may not play a pivotal role in medical decisions. Eric Topol of Scripps Health is quoted as saying in the article that “The digitization of human beings will make a parody out of ‘doctor knows best.’ ”
Another area where technology and better procedures have produced better outcomes without increase in cost is treating heart attacks, according to NYT article "A Sea Change in Treating Heart Attacks." The way hospitals have improved outcomes is to cut down time. They way they do it is by having paramedics send electrocardiogram readings from ambulance to emergency rooms and have the team assembled with a single call and are ready to treat the patient when he arrives at the hospital.
With technology and newer models, the care is going to change for good. Medicine is too complicated to be left to doctors or even patients to make a decision. The information collected over a longer term is going to be more helpful in diagnosing and treating patients. Patients will have to learn to work with bartenders like nurse advocates, physical therapists, psychologists and others before rushing to gold miners directly. I think some of the emerging medical care models will make a big difference in the overall quality of care, reduction in cost and better experience for patients as well as care givers.