My Dismissive Rheumie

[Crabcakes]

During my first visit the other day, After getting blown off, I did tellt he doc I had done a great deal of reading on autoimmune diseases. He said "Oh really" Did you see MY name all over the place?". I honestly answered NO, but just now I did a search and OMG:

"Dr. Dismissive is board certified in internal medicine and rheumatology. Dr. Dismissive has been a recipient of multiple awards for research and academic excellence during his career. He also achieved the highest honor of "Fellow of the Year" for outstanding performance and dedication to patient care upon graduation. He has published journal articles and is a co-author in the "Sjogren's Syndrome Handbook". He continues to reach out to the community via public speaking through the Arthritis Foundation. His dedication to teaching the future physicians of the valley is ongoing, with his affiliation to Midwestern University and the University of Arizona Medical schools. Dr. Dismissive has been an integral part of the Dismissive Arthritis Care family since 2004 and continues his excellent care"

Incredible. Maybe I caught him on a bad day?

[Scottietottie]

Hi Crabcakes 

My father was a surgeon, a general surgeon, no high flier. He bemoaned the fact that only A Grade students seemed to be taken on do do medicine because he argued that A Grade students were the high fliers and were far more suited to reseach and writing papers thatn they were for face to face interaction with patients. Maybe he was right.

Take care - Scottie 

[stillsguy]

Perhaps u did catch him on a bad day crabcakes, doctors r after all only human and subject to the same delays at coffee counters, ejits in traffic and notices from tax departments as the rest of us. He may/ may not b worth a secpnd first impression; thats' up to ur instinct, ur craw to decide... These guys depend on your referral letter and if it hinted something negative about u it was a waste of your time and money...

I dont give it a second thot, to fire a doctor. And i collect all communications between all docs and primaries, experience has taught me eternal vigilance is the safest road to longevity. I once had the cream of the crop of nephrologists go to sleep on me after a primary decided he was the better specialist. It eventually resulted in (amongsr other things) kidney failure...

Those were the days I always gave them second chances, now I review their notes and judge them accordingly.

Whose bum is it after all?

[Epson]

Crabs,

A lot of doctors are jerks, if you don't like him find another.  My old Rhumie was probably a good doctor, but dismissed every thing I told him and had an inability to communicate with his patients.  I found a young lady to replace him and I feel she is just as knowledgeable as the old doctor, but she is not afraid to listen and explain anything you have a question about, she is also easy on the eyes, that doesn't hurt either.

[Patze]

Okay Epson, we have to keep the board clean now!   Hey, who says the new ones are worse than the old ones?  And yes, I'm glad to see that this one will listen to you and is taking you seriously. 

The first rheumy I had really listened to me (just wish the doctor stayed in the area), the second one, well, lets just say he seems to be permanently in a lousy mood (a few decent days in between to shake things up), and right back to the usual diet of "I'm the doctor, and this is what I believe", end of story.  I have noticed that he's lightening up with me somewhat though, so I'll hang in there for a bit more.

Take care -

Patze

[Crabcakes]

Stillsguy, are you saying that the referring doc would write something negative? Hmmm. That is an interesting and potentially litigious situation. Well, I have Tricare, and my primary did not write a letter of referral... I just go through Referral Management. Nothing was sent to the rheumie, and he did not have any of my labs, or anything! In fact, all he had in his hand was the sheet I filled out in the aiting room to go by. I took a copy of my labs but he barely glanced at the first page only. He did not make copies for my chart at his office.

SOme may think I am being too hard, but I paid a $12 co-pay and who knows how much he collected from TriCare for my 3-4 minute visit. I will be fair and give him one more visit.

I've been thinking a lot about the doc's routine. How boring is it to go from room to room with mostly routine stuff. Then a PILE of neverending  paperwork, and visits to the hospital. I had always wanted to go to medical school, but the work sounds less than appealing to me now.

[TerriJ]

Crabcakes,

Maybe, even though this rheumy has high flying credentials, he is not the doctor for you?  I go to a nearby teaching hospital and am assigned to a "rheumatology fellow" for their residency duration.  I would see a different rheumy each time right after my exam with the fellow.  I really liked the last rheumy a lot!  He was awesome.  The others I have seen I didn't like as well.  Now I am going to schedule my appts.  based on when the most recent rheumy that I liked is in the dept.  All of the rheumys I've seen have super credentials and are professors specializing in AI's and rheumatology.  Would I get the same care from each of them?  I don't think so.  I'm kind of yammering on and on here, but you probably get what I'm saying?

Anyway,  these diseases are tough to deal with.  I say go to who is a good fit for you.

Terri

[Pisces24]

I go to a teaching hopsital too. The immunologist there was very smart and ran the test for SJS.  He is well thought of by the other doctors I've been seeing there.  I just think at a teaching hospital, if you are training new doctors , you have to have the patience and "personality" to do that.  Also you have to show by example.

Believe me not everyone can teach!  I am sure if the dr doesn't meet the 'teaching criteria' he/she is not kept teaching.  I get the "learner", then the dr with the "learner" and sometimes even another one. They WANT TO learn and teach so I feel confident going to them there. I get all my questions answered. If they don't know they discuss how to find out in front of me - granted they use big words - but hey I am not getting a pat on the head and a cookie.   

I would definitely recommend going to a teaching hospital. And this is from someone who went two years from duh dr to duh dr prior to that.  If you don't feel you have a good relationship with the dr, go to another one.
I had one once though that was very very "stiff" & smart BUT he listened to me, answered my questions, etc and except for his very abrupt bluntness (which might be a good thing to some ) he was a great dr to me. So I could overlook what I considered his 1 flaw. You just need to take everything into consideration and decide yourself.

[TerriJ]

Pisces,

I like the teaching hospital that I go to and am glad my endocrinologist referred me there.  I enjoy the "fellows" or rheumatology interns.  They have been great.  It's been kind of neat to get to meet various professor/teachers at my appts. who are the rheumatology experts.  Now I know the one that fits me best!  I guess that's the unique opportunity about going to a teaching hospital.  I don't get to keep the same intern, but I can stick with the same rheumy!!  Cool!

Terri

[lynnmarie219]

Crabcakes,

I agree that you have to find a doctor that is the best fit for you......and as has been noted here that doesn't always mean the one with the highest degrees and the most amount of research completed! Do what you feel is best...you know in your heart if you  like a doctor or not......but I'm with you on the part of giving someone a second chance....because we all have "off" days.......but if those "off" days become the norm...then its time to look for a new doc!   

I also go to a teaching hospital/medical center and I like it too! When they have students and interns in and fellows who assist the doctor...I feel I learn so much more because they explain everything as they go along where they might not do that if they were just doing a routine exam.

[Patze]

I too go to a teaching hospital to see an endo there, as I haven't had a lot of luck finding a decent one around here.  I'm looking for another endo as we speak because I want to try another protocol, the T4 only hasn't worked well for me.

I too like that the doctors at the teaching centers explain things better than any single/multiple physician practice I've been to in any specialty (it doesn't seem to matter).  I don't particularly like the "fellows" much as most of the ones I've dealt with where straight out of their internship/residency.  If they had practiced first, I probably would like them more.


Patze