Wildcard number 2 – New Doctors

I am participating in RABlog week. Today I chose wildcard number 2 for my prompt:

New doctors – Ideas for breaking in new doctors, how to begin the process of establishing viable collaborative patient/doctor relationships. What do you do in those days leading up to the new doctor visit?

Best way to break in a new Doctor?

I think the best way to break in a new doctor is not to do it.   I  have terrific doctors, many of them; but each time I get a new one I have to start at the beginning.  Despite my doctors all having access to my medical file, I have to answer the same four questions whenever I see any doctor.

• What is your A1C,
• When was the last time you saw your endocrinologist,
• What is Rituxan
• Are you taking pain medication.

When I see a new doctor, I often have to help them ask the four questions.  But I know that in order to treat me, any doctor needs to know this basic information.   If they do not have it or do not care about these four things then I cannot work with them.  Because if they do not care they may prescribe medication that will run counter to my overall treatment goals.   So I start right at the beginning with any new doctor.

Frustrations abound:

The most frustrating part is when they assume I have type 2 Diabetes.  It is frustrating because I know when they see a 60 year old person with diabetes they almost automatically assume the person is a type 2.  This stereotyping drives me nuts.  So each new doctor gets the story.  I was 17, I was at Disney World, yada, yada yada.  Then we move on to RA.  Yes, I have RA, yes I have Ankylosing Spondylitis yes it sucks, yes I have had the blood test for AS.  Yes Rituxan is a good medication for me,  and yes it is my 6^th biologic.  It is enough to make you crazy to tell this story over and over, especially when you have to take 2-4 minutes of a 10 minute visit to tell it.

But, as frustrating as it is I must do it.  I have to impress each doctor first that I know what I am talking about, second that I am not a chronic complainer (whatever the complaint might be today) and finally that I am a responsible patient.

Despite the importance of this oral history, it is not how I judge the effectiveness of a new doctor.  I still have an acid test to tell if we can work together.

Will they laugh?

Because if they do not laugh during the first appointment I have little regard for anything they will say.  I know that is a non-medical way to judge the effectiveness of a new doctor, but it is my main way.   Any person (doctor or not) who cannot laugh both at the calamity of my medical situation and their little part in treating it, is not a person I can continue seeing for the long term.

Why is laughter so important?   It builds trust and human connection. I am not just a case, I am a human.  I insist I be treated like a human.  I insist that we acknowledge the comedy that is my collection of conditions.  I insist they see me as more than a widget.  Laughter helps me know they can see me as human.  So the first thing I do when I see a new doctor?  I laugh.  I laugh at myself, at my medical issues or the complexity of the situation.  But my laughter is about more than just a good time.  My laughter is a gauge, can we continue to work together.  Because anyone who thinks this is anything but a group grope to improve my health is fooling themselves, and frankly I do not have time for a person who cannot understand that.

rick

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