Tuesday, March 18, 2008

Definition of a Patient: Customer

It was in 1999 when there was that first hint that something just was not right. Whether that hint was related to the Parkinson’s Disease or the Degenerative Disc Disease is a question that will probably never have an answer. Until 1999 the only real medical related problems I ever experienced were pregnancy related.

In the long run, the cause of those initial symptoms is not important. The lessons that I have learned throughout the last nine years are priceless. The lessons did not come without a price. The price of those lessons included frustration, distrust, lack of medical support, insufficient answers, etc. It appeared to be a very slow learning process.

I believe that many of us are under the impression that when we visit a doctor, he / she will be able and willing to provide us with the answers we are searching for. I know that I had blind faith in doctors for many years. After all, they have spent many years in college and training, so they must know exactly what they are doing when it comes to their profession. Additionally, within the scope of my blind faith, I firmly believed that all doctors truly care about their patients. I was incorrect with respect to all of the above.

Here is the reality of what I now believe through my experiences with the medical community. The practice of medicine is just how it sounds. Although there are thousands of known conditions that have identifiable diagnosis criteria, there are numerous conditions that do not. Therefore, often a patient may have to go from doctor to doctor, trying various treatments, or be told there is nothing physically wrong, until just the right doctor makes just the right observations that leads to a diagnosis. This is unfortunate, but it happens quite often.

I began to realize that the internet held information that patients twenty years ago would have been unable to access without spending hours, days, or weeks inside of a library. Additionally, the internet is quick, and a person can easily find symptoms for most medical conditions without having to be a computer expert or a member of the medical profession. Aside from my husband’s observation and recognition of my symptoms, I would say that the internet was my greatest tool before, during, and after the diagnosis process.

Each time I was sent to a different specialist to rule out a specific condition, I would research that condition on the internet to learn as much as possible about that condition. Additionally, I would also research other conditions that were known to be similar or mimic the condition I was being assessed for. By doing this I had the ability to ask the appropriate questions and also know when a doctor was telling me things that were in contrast to known facts. I was very surprised to find that some doctors will tell a patient something that is not correct, because they presume that the patient does not know or understand the facts.

Although I have previously mentioned the internet and self education, I feel that it is important for patients to know that it is okay to tell a doctor that they disagree with something the doctor says. It is important that the patient be able to back up any disagreement with known facts, rather than just relying on what the patient may have once heard or someone may have once mentioned to him / her.

When a patient does disagree with something a doctor says I have found that there may be one of two basic reactions on the part of the doctor. If the doctor is truly interested in a proper diagnosis and has not made a rush to judgment based on non-factual issues, then the doctor will be open to discussing the disagreement. On the other hand, if the doctor has already decided that the physical symptoms are mental health related or the doctor is just plain arrogant, a patient may receive a rude or condescending response upon stating the disagreement. I have received both types of responses. I have also been cut off in the middle of explaining my position and rushed out of the office.

Before I began to realize that it is okay to disagree with a doctor, I wasted a lot of time going back and forth to doctors who had no real interest in finding the real cause of my problems. I lacked the courage and questioned my right to just walk away from a doctor, who is supposed to know how and want to help me. I had not come to the realization that I did not owe these doctors anything, but in fact, it was they who owed me something. I was a customer seeking out a service. I am a paying customer who should expect to receive the appropriate service that I am paying for. Once I realized this, seeing a doctor is not any different than hiring an electrician, plumber, or hair stylist. They provide a service that the customer pays for, and if they do not perform to the customer’s standards, then their services are no longer necessary.

When I seek the services of a doctor, I now go into an appointment with certain expectations. If those expectations are not met, I do not return to that doctor. Additionally, I do not recommend that doctor to friends, family, or anyone else who may be seeking out a new doctor. Although this may not mean much to the doctor, I believe that somewhere down the line, certain doctors do find that they become the choice of last resort. I personally believe that word of mouth is the best advertising for any business, and word of mouth can also deter patients from seeking the services of those doctors who have not quite figured out that the patient / customer is the most important asset they have.

In the last few years I have had conversations with other patients who will often say that they will give the doctor another chance. Often, they have already given a specific doctor multiple chances, just by paying for the doctor’s services through previous appointments. Sometimes, patients will often keep giving chances to a doctor, because it is very difficult to seek out the services of a new doctor. I finally decided that if by the second visit a doctor is not providing me with the services that I am paying for and expect to receive, that doctor is terminated / fired. If it takes going to two, three, or ten more doctors until I find one that knows how to properly provide service and genuinely cares about my health, then that is exactly what I do. It is absolutely a difficult route to choose. However, the benefits far outweigh the negatives. That is the reason why I have a select group of doctors that I see today, not because they are covered by my insurance or for any other reason, except that I choose to have them as my doctors. They all meet and exceed my expectations that I have for those professionals who play an instrumental role in my current and future health.

Just as I have the choice of which stylist I allow to cover my gray and cut my hair, I also have the choice of which doctors I allow to play a role in my health. Since my health is a much more important aspect in my life than how nice my hair may look, I obviously have certain expectations that a physician must meet that far exceed those that I would expect from a stylist. Just as I am the client / customer of my chosen hair stylist, I am also a client / customer of my physician. For this reason, I should be more willing to terminate my relationship with a physician than with my stylist. This concept has probably been the most important concept that I have learned. Simply stated, the patient is the customer; the doctor is the service provider. When I pay for any service, I expect to get my money’s worth.


Diane J Standiford said...

Hear hear! I demand good service or I go elsewhere, but I do live in Seattle, a city FULL of doctors and hospitals. You ARE the consumer, and you DO have rights.

Patient With A Plan said...

It took me a while to understand this concept. My husband is actually the one who helped me see the light.

Mary said...

You are so right! I am ULTRA picky about doctors, not just my own, but for the rest of my family as well. You just have to be if you want "good service."

Unknown said...

Good for you! I just learned that concept the hard way. Thanks for spreading the word.


Patient With A Plan said...

I give my husband credit for enlightening me on this topic. I now research any new potential doctor extensively for myself and my husband. Our family members are the most important people in our lives, and a good doc will know this and treat our loved ones accordingly.

Patient With A Plan said...


I too learned through the school of hard knocks. It is a shame, because it should not have to be that way.