Give advice to future pre-meds

[Lucy the Valiant]

I would also like to add that for doctors who work with children - your words and actions may have far more significant effects than you may realize (both for good and for bad), especially if you don't have children of your own yet. You are a Very Important Person to many children, so use that influence well in what you say and how you react.

 

 

[happypamama]

 

Always wash your hands before examining the patient. Always explain what you are going to do before doing.

 

 

And especially with children, ask for permission before doing an exam, especially anything at all sensitive. And warm the stethoscope.

[Jaybee]

My father was a family physician for 40 years. He said that 90% of his job was listening. He had a broad fan base. :)

 

For me personally, I like a doctor who listens first (though I realize that 15 min. increments don't always allow for much of that). I also like a doctor who explains; he/she explains what they are doing, why they are recommending a certain protocol (especially if it is over a different protocol), etc. I like a doctor who is teachable and who is always learning. (Sometimes that learning is from your patients and their experiences.)

 

Nurses are important. Treat them well and with respect. They are a part of your team, and should be treated as such. (You can learn from them as well.)

[Jean in Newcastle]

As someone with multiple problems, I've had the following frustration.  The doctor asks me what I'm there for.  Well?  Which problem do you want?  Sometimes I don't know exactly what I'm there for other than I still don't feel well and because I don't know how to triage myself, it's sort of hard to pick the most important problem to discuss.  Or I will start to list symptoms and sometimes the doctor will roll his/ her eyes at some things that are "normal".  OK - I don't want to waste the doctor's time but I don't know if all these symptoms are normal or not which is partly why I'm there.  Or in my litany of symptoms he will pick out a few as being "not in his specialty".  Again - I don't know what symptoms go with which specialist.  What I appreciate are those doctors who listen, do not belittle me, help me to categorize things better if necessary and says "we'll tackle these" but "I'd like you to go to XYZ specialist for these other problems."  Actually, what I'd really really like is a doctor who works as part of a team.  My primary now is doing this specifically at my request - I asked him to be the clearinghouse for all my problems and to actually send me on to those who can help me and he does.  (Which you would think is part of the definition of a primary but somehow isn't.)  Now I wish he'd also communicate with those other doctors directly instead of everyone making me communicate what the ENT said or the neurologist said etc. because I'm afraid that I'm going to get it wrong, but for some reason that seems to be impossible.  

[kbutton]

As someone with multiple problems, I've had the following frustration.  The doctor asks me what I'm there for.  Well?  Which problem do you want?  Sometimes I don't know exactly what I'm there for other than I still don't feel well and because I don't know how to triage myself, it's sort of hard to pick the most important problem to discuss.  Or I will start to list symptoms and sometimes the doctor will roll his/ her eyes at some things that are "normal".  OK - I don't want to waste the doctor's time but I don't know if all these symptoms are normal or not which is partly why I'm there.  Or in my litany of symptoms he will pick out a few as being "not in his specialty".  Again - I don't know what symptoms go with which specialist.  What I appreciate are those doctors who listen, do not belittle me, help me to categorize things better if necessary and says "we'll tackle these" but "I'd like you to go to XYZ specialist for these other problems."  Actually, what I'd really really like is a doctor who works as part of a team.  My primary now is doing this specifically at my request - I asked him to be the clearinghouse for all my problems and to actually send me on to those who can help me and he does.  (Which you would think is part of the definition of a primary but somehow isn't.)  Now I wish he'd also communicate with those other doctors directly instead of everyone making me communicate what the ENT said or the neurologist said etc. because I'm afraid that I'm going to get it wrong, but for some reason that seems to be impossible.  

 

Well said. 

[Beaniemom]

As someone with multiple problems, I've had the following frustration. The doctor asks me what I'm there for. Well? Which problem do you want? Sometimes I don't know exactly what I'm there for other than I still don't feel well and because I don't know how to triage myself, it's sort of hard to pick the most important problem to discuss. Or I will start to list symptoms and sometimes the doctor will roll his/ her eyes at some things that are "normal". OK - I don't want to waste the doctor's time but I don't know if all these symptoms are normal or not which is partly why I'm there. Or in my litany of symptoms he will pick out a few as being "not in his specialty". Again - I don't know what symptoms go with which specialist. What I appreciate are those doctors who listen, do not belittle me, help me to categorize things better if necessary and says "we'll tackle these" but "I'd like you to go to XYZ specialist for these other problems." Actually, what I'd really really like is a doctor who works as part of a team. My primary now is doing this specifically at my request - I asked him to be the clearinghouse for all my problems and to actually send me on to those who can help me and he does. (Which you would think is part of the definition of a primary but somehow isn't.) Now I wish he'd also communicate with those other doctors directly instead of everyone making me communicate what the ENT said or the neurologist said etc. because I'm afraid that I'm going to get it wrong, but for some reason that seems to be impossible.

In some of the parent support groups we have discussed having a "medical home" where all information would be coordinated. Not sure anyone has been able to make it work but I agree it would be wonderful when you have to see 3 different specialists.

[MrsBasil]

Listening is good.  I've about given up on having a regular doctor and just go to whatever walk in clinic will take my kids.  The last 3 doctors I've seen or taken my kids to are up, writing, not making eye contact, and trying to walk out the door while I'm still trying to ask questions about the issues I made the appointment for.

 

Eye contact is good.  I am uncomfortable when the doctor stares at the wall, his computer, or anywhere but me while I'm talking.  It's rude and I feel like they are not even listening to what I'm saying.

 

Pay attention to patient waiting time.  We had a pediatrician who was routinely 45 minutes late to every appointment.  Had.  I understand emergencies, but every time is an issue needing a solution.

 

When diagnosing someone with something serious, like ohh early onset Alzheimer's, a little compassion goes a long way.  Talking to the other people in the room like the patient isn't even there is just awful for the patient too.

[Reefgazer]

1.  I would like doctors to listen to their patients when they express their wishes clearly, even if they don't take the doctor's advice.  I had a few doctors treat me as if I was ridiculous and an idiot who didn't understand the issue at hand when I rejected their recommendations.  I understood the implications, and chose a different option than the one recommended. 

 

2.  I also appreciate a doctor saying point blank that they don't know something about a medical issue when they indeed don't know.  I don't expect them to be God, and appreciate truthfulness.

 

3.  I really get pissy when all my possible options and benefits/drawbacks aren't laid out for me, and when only the doctor's preferred one option is offered.  Then I have to go back and research options on my own, and that makes me distrust the doctor and his/her agenda for not being completely upfront with me.  Yeah, that was related to point #1.

[creekland]

I promise - middle son will catch up sometime today.  Yesterday he was busy playing "college student back at home" and went to a Hobbit marathon with younger brother and mutual friends.  This started at 10am - meaning shortly after I got them up.  ;)  Then my mom came for her holiday visit, so we spent yesterday evening enjoying presents, etc.

 

I love the advice given, though it has made me wonder just a little how much we (myself included) expect total perfection from our doctors rather than dismissing some personality issues as we do with other professions.  It's a tough line.  Fortunately, my guy has terrific people skills. (Yes son, I do feel that about you.   :D  Do NOT let that get corrupted by any system! )

[Lolly]

Do not allow air fresheners to be used in the waiting room and restrooms. I know they can get stinky. If you do insist on using them, be nice to the asthmatic, allergic person who has to go sit in their car to wait out the waiting area time. Call them on their cell when their turn comes up. Also, please refrain from using heavy perfumes on your person. Do not allow your staff to wear them either. 

 

If you have an emergency come up and wait times will be extended, please let your waiting patients know what is going on. I find waiting much easier if I have an idea what is going on and how long the wait might be. I had an ob-gyn who would have the nurse announce when things would be extended in the waiting area. They also gave patients the option of rescheduling at that time. (I believe he must have kept plenty of slots open for this purpose.) Same doctor would give personal calls to high risk patients at night occasionally. I asked him about that practice, and he said that he found that patients who spoke with him were less likely to make emergency calls to him or have problems during the night. His calls, made on his schedule, saved him time and put the patients so much at ease that they were less likely to have difficulties. I can tell you that as a patient, it really did make you feel like you were being taken care of and safe. 

 

[Ottakee]

I

 

I love the advice given, though it has made me wonder just a little how much we (myself included) expect total perfection from our doctors rather than dismissing some personality issues as we do with other professions.  It's a tough line.  Fortunately, my guy has terrific people skills. (Yes son, I do feel that about you.   :D  Do NOT let that get corrupted by any system! )

We do see a few doctors that are harder to deal with, much less people skills, etc. but they are TOP in their specialty field and for that issue, we wanted the TOP NOTCH doctor.  I would not put up with that for a primary care doctor that we need to build a long term relationship with but say I needed emergency heart surgery.  I don't care at that moment about any personality issues, etc., I would just want the best surgeon available.

 

It is often said in neurology (where many doctors we have seen are foreign and speak with a very heavy accent) that they have a nurse to be their bedside manner and help translate for them.  If you need brain surgery though, they are tops.

[creekland]

Creekland's son here, once again.  This time it's my mother who is out and about.  She's probably busy saving the pandas in Australia... or maybe she's helping advise a friend concerning his son's financial aid.   

 

Thank you all again for your advice and insights!  As noted, I'm definitely seeing some common themes of needs: Strong communication skills, a willingness to admit where knowledge is lacking, patient empathy and respect, and many others.  As before, I will do my best to internalize these and share them with my fellow premeds.

 

 

DISCLAIMER: I know there are no pandas in Australia.  As a premed I'm required to know these things.  :coolgleamA:  My mom will be so proud of my homeschooling knowledge!

 

[prairiewindmomma]

1. Wash your hands in front of the patient.

2. Listen well.

3. Ask good questions: current meds, recent visits to other doctors, what's going on at home---in addition to the symptoms they are presenting.  You may discover that their neck pain is related to nursing a baby or lifting their spouse in and out of a wheelchair....and you can make connections you wouldn't otherwise.

4. Don't be afraid to refer out, especially if the patient wants to.

5. Be humble. 

6. Hire good office staff. A nurse who can manage triage calls, assure worrywart patients, and keep tabs on the front staff people is worth his/her weight in gold.  An office manager who is fair and compassionate helps keep your lights on if you are in private practice. A competent, professional front end receptionist gives the first impression of your practice.

7. Have a holistic knowledge base. It was an ophthalmologist who caught our daughter's brain tumor; an endocrinologist who referred me to a rheumatologist, a perinatologist who discovered vascular issues in an unrelated scan, and so on.

8. On the flip side, don't be afraid to super specialize. Creating a patient niche allows you to become very good at what you do, and people are willing to travel for good practitioners. I drive 5 hours to see one specialist alone---I want the guy who sees 20 patients with my issue rather than maybe one in a lifetime.

 

ETA: I will never forget that my oncologist cried with me on the day my daughter was formally diagnosed with terminal cancer, or the doctors who sent personal handwritten notes after she died. Don't forget to be human. 

[creekland]

ETA: I will never forget that my oncologist cried with me on the day my daughter was formally diagnosed with terminal cancer, or the doctors who sent personal handwritten notes after she died. Don't forget to be human. 

 

:grouphug:

[kroe1]

After reading all these posts, I think your son should learn to be a superhero instead. There is no way one can learn how to do all these things for all people in 7 minutes. (Each patient is allotted 15 minutes but the other 8 is spent making the computerized chart, filling out insurance papers, or arguing with the insurance or Medicaid provider. In other words, I do not see how it is possible to meet anyone's needs in such a time crunch. Perhaps your son should figure out how to get insurance companies and government out of medicine then there would be no time crunch.

[creekland]

After reading all these posts, I think your son should learn to be a superhero instead. There is no way one can learn how to do all these things for all people in 7 minutes. (Each patient is allotted 15 minutes but the other 8 is spent making the computerized chart, filling out insurance papers, or arguing with the insurance or Medicaid provider. In other words, I do not see how it is possible to meet anyone's needs in such a time crunch. Perhaps your son should figure out how to get insurance companies and government out of medicine then there would be no time crunch.

 

I've been thinking the same thing about superhero.  It has given me new appreciation for the doctors in my life though.

 

And it's made me thankful we are with health share and have NO issues with insurance and gov't.  All but one office I've been to has thanked me for this choice.  Whenever I read any insurance thread, I'm reminded of why!

[creekland]

ps  I'm so relieved to know my guy remembers there are no (wild) pandas in Australia.  Homeschooling wasn't a bust after all.   :lol:

[Angie in VA]

Someone said handwashing in front of the patient, and ITA. Our pediatrician washes her hands as soon as she enters the room and then again at the end of the examination. I know she goes to another exam room and washes them again, but I like it. (And her!)

 

I also like carpet-free offices/exam rooms/ waiting rooms. Again, my pediatrician ripped out the carpet years ago. Bravo!

 

Both a veterinarian and a pediatrician told me that psychology classes helped them the most in their careers. They went into those fields b/c they love animals and children respectively, but it's the grown-ups who bring them in who they have to deal w/ the most. ;)

 

Rumor has it that students have one semester of nutrition in med school. True? If your education is lacking in nutrition, then shore it up on your own. Try not to sell your soul to Big Pharma. Yes, when I need meds, I need them and want them and am thankful for them, but sitting in the waiting room w/ those pharma babes makes me crazy. 

 

 I like an open-minded doctor who can embrace an integrative approach, but this is not for everyone. I look long and hard to find docs who have this approach, so heads up: there is a demand for it!

 

Have a good system in place for receiving faxed info. Once when I asked at an appointment what the Rx would be (how many and what dose of the pills to take) and then received different instructions from the pharmacy, and faxed a question to the doctor along w/ blood work I'd done for a different doc, my fax was placed is in this doc's bin. Only problem? That doc only came in 1-2 days a week, so she didn't see it until the next week.I called the pharmacy and was told that is what the doc wrote. I called the office the day I got the RX and the nurse told me to just take what the Rx said. Nine days later I got a voice mail from that doc's office stating I was taking TWICE the dosage I should be.

 

I did everything right to make sure it was correct. I felt awful. I was driving over an hour away with children in my car. I got the voice mail message two days after it was left for me. Not that office's fault, but they left a message at one place. They didn't call my home or my emergency contact to make sure I stopped the overdosing. Nope, I happened to miss a voicemail and got it 2 days later, so I was on double the dose for 9 days. Insanity. 

 

 

[creekland]

Last chance... the lad leaves on Friday and will likely compile things this Wednesday.  

 

He doesn't actually get on my account other than this thread - not that I'm aware of anyway! ;)