Doctor Distrust

Our well-worn portrait of America features a steam engine chugging laboriously across the Great Plains while a sepia-tinged family farmer in overalls and a baseball player in a baggy uniform both wipe sweat from their brows and dirt from their hands. This snapshot of America in a bygone era also shows a white-haired physician, the guy we considered our best friend. Stethoscope around his neck and bag in hand, he guarded the health of our children and our parents and all of us in between.

Today, we have a hard time just getting in to see our family physician, and when we do, the doctor is often rushed and uninterested in anything other than what brought us in to the office. The docs of yesterday knew our families. Today they are barely aware that we have families.

We need to see our doctors. We wait. This afternoon, maybe? We will try to squeeze you in next week. We are told the doc will call at five.  The phone does not ring. We are assured the prescription will be called in to the drugstore.  It still is not there. Many physicians no longer accept insurance. They have to wait too long to get paid. These docs do not even want to bill us. For many it is cash or credit card while we’re in the office.

Young doctors invariably graduate from medical school in debt. These professionals face years of residencies and fellowships that pay very little.  Then they want to have lives of their own. Most marry, have families, and are faced with even more financial obligations. You can’t really blame them for wanting to make a decent living, but at what cost?

Future physicians work under increasing pressure and spend long hours on the hospital floors. They begin to see patients as charts, not people; a collection of symptoms, not human beings. Internships and residencies are practically paramilitary operations, with these young doctors just trying to survive.

However, I have no patience for those who blame the system for the fact that physicians can seem so cold and uncaring.  Don’t tell me managed care or financial pressures are to blame when my friend’s doctor chastised her for referring to an item about her condition in a newspaper:  “If you are going to get your medicine from ‘The Wall Street Journal,’ you don’t need me.”

I learned I had multiple sclerosis during a phone call with a neurologist.  Apparently, a life-changing diagnosis did not merit a personal visit. When a cancer patient profiled in one of my books received his diagnosis, it was from a radiologist who realized the guy did not have a clue.  The primary physician had not bothered to pass along the bad news.

I am not suggesting that every practicing physician in America treats patients badly or is ignoring their emotional needs.  Some are there for us, come hell or high water.  But there is too much anger at the medical profession to conclude that all is right.

If you are disappointed in your doctor, say goodbye, ask for your records, and move on.

Richard M. Cohen was diagnosed with multiple sclerosis in 1973. His online column is published every two weeks.