Doctor Doctor Give Me The News


I recently saw the Big Deal Lupus Doctor in town.  My Regular Rheumatologist referred me as my flare up this summer was particularly stubborn and not responding to the course of treatment I was on.

The current plan involves infusion therapy and  Imuran.  The jury is still out on whether or not I’m clinically improving.  Regardless, I don’t feel well.  I’ve been running a fever for two days.  My hair continues to fall out.  I’m getting hives on my face and a rash (looking a lot like the one I just had) is beginning to appear on my legs.  At this point I’m concerned enough to call Regular Doctor to discuss these changes.  We spoke on the phone and now I’m frustrated and disappointed with how the conversation went.

First, I had to leave a message, which is standard protocol, especially in a large practice with 7 physicians.  I tell the operator I’m having some symptoms and wish to discuss this with my doctor.

Then, I get a call back from the doctor’s Snotty Bridge Troll.  She tells me to call the Big Shot Doctor because I’m under his care now and he needs to know if I’m having problems.  I tell the Troll that Regular Doctor wrote the prescription for Imuran, ordered the infusions and has been following me for two years.  I’d appreciate a call back when it’s convenient.

About 20 minutes later Regular Doctor calls and listens to what I have to say.  She tells me that my symptoms could be anything … lupus, medication, who knows what … and I need to call Big Shot Doctor.  And even though she prescribed the Imuran and IVIG, she’s deferring to BSD now when it comes to treating me.


Did I just get dumped?

Lupus has been called the Great Imitator with good reason.  Hives, fever, hair loss, anemia, rash, lethargy … these are warning signs for people who are immunosuppressed and have lupus.  What kind of doctor tells a worried patient to call somebody else?

I work for a very busy doctor.  In fact, I’ve been managing his medical practice for 16 years.  We see a lot of very sick people who sometimes need a little TLC.  When they call us for help we take a few minutes to listen and find the very best way to meet their needs.  If a patient must see another specialist or surgeon, we set up that appointment for them.  We make sure their insurance will cover their laboratory or radiology studies.  Our doctor basically “quarterbacks” their treatment to insure continuity of care.  If it’s in the best interest of our patient to segue from our practice to another, more specialized physician, our doctor discusses this with them with sensitivity and honesty.   Nobody needs to remind us that sick patients often have difficulty hearing bad news, getting their prescriptions filled, arranging for transportation, and understanding their medical bills.  We’re there to help them get through the tough times.

I’m going to ask the Big Shot Doctor to be my primary rheumatologist.  If he can’t, then I’ll find another doctor.  It’s hard enough to deal with lupus when you’re not feeling well.  It’s worse when the doctor and the medical practice you’re working with appears indifferent when you ask for their help.

Shame on them.

10/9/08    Here’s an update to this post:

I called the BSD’s office and left a message.  The BSD’s rheumatology fellow, Dr. O, called me right back and was so very kind and helpful.

Me:        My rheumatologist told me to call you if I’m having problems.  Do you remember me?  (snif, snif)

Dr. O:    Of course I do!  You’re not feeling well?  How can I help?

Me:        (I tell her my tale of woe.) What do you suggest?

Dr. O:    First, I want you to know that we will be more than happy treat you here.  Let’s lower your Imuran dose by 50 mg and see if that helps slow down or stop your hair loss. I’d like to run some blood tests also. I’ll call you back with those results ASAP and we’ll talk about what the next step will be.

Me: Thank you so much! I’m relieved to know there’s a plan on board.

Dr. O: Call me any time you have a question or a concern. Just leave me a voicemail!

Whew! A little compassion can make all the difference!


2 responses »

  1. I used to work for a Doctor. He was always so busy that he’d frequently be 1-2 hours behind schedule. Many patients would complain about this, but the simple truth is that he was always late due to giving each and every patient the TLC they needed. That is why his number of patients is still growing rapidly to this day. No one wants to go to a doctor that blows you off for any reason. It’s poor practice and poor people skills.

    I hope your “BSD” will take you and give you his full attention when asked for it. Good, well, anything, is hard to find these days.

    Point well taken! Helps validate that I’m not a ninny who whines too much. 🙂

  2. It’s amazing that a doctor’s ego would get in the way of care and compassion. If your first doctor is that fragile it’s time for them to get out of medical practice. I can assure you t hat you weren’t the first patient to be treated that way and you won’t be the last until all their patients abandon ship like rats on the Titanic. I hope that your first doctor goes back for some sensitivity training.

    On the other hand kudos to the Big Time Doc. You were listened to, believed and most importantly respected. I’d switch my care in a heartbeat.

    Keep on truckin’

    Thanks Greg!!

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