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Congratulations. You have added yourself to the list of doctors I would not recommend to anyone. I doubt that you care, given your attitude at my last appointment, but I'm going to go over some of the reasons for my decision, just in case there is still a decent human being somewhere inside you.
I do have to admit, this has been coming for some time, as over the last few months I have become more and more aware of the way you treat your staff. The arrogance and abusiveness with which you treat your staff - in the presence of patients, no less - actually made me feel guilty for continuing to rely on you for medical care, because I felt that by continuing to rely on you as my doctor, I was in some way sanctioning your treatment of your staff. To make matters worse, you were abusing your staff for things they did in attempts to make the lives of your patients less stressful, or for mistakes that you accused the staff of making which, as I have learned through experience, you were more than likely the one who made the mistake yourself. I say "as I have learned through experience," because over the months I have been with you, there have been many small mistakes that I tolerated because I was happy simply to have a doctor I could (I thought) rely on, and complaining about those mistakes (referrals that never arrived at the specialists, which your own staff could find no record of you ordering until they searched through your notes, prescriptions arbitrarily changed or canceled without any notice to the patient, abusive insults toward the staff of my health insurance provider, and the list goes on) would have only served to increase the stress of dealing with you, as well as large mistakes (last month, for instance, when you provided me with a prescription for one of my regular medications, but did not bother to write down a quantity on the prescription, so my pharmacy was unable to fill it until I returned to your office where one of your staff had to correct your error) that have negatively affected my health.
My monthly appointment with you for this month, though, was the last straw. Let's start at the top, shall we?
Item the First: Willful Ignorance
When I arrived for my appointment, I was handed a brief questionnaire, less than a full page in length, and told I needed to complete it for my appointment. Even though it was obviously one of those worthless pseudo-scientific "depression screening" questionnaires, I completed it, and made notations on the paper as to the fact that every positive answer I gave (lack of energy, inability to perform some tasks, etc.) was due to being in pain. Seriously, have you ever had to live with your entire body experiencing a baseline pain level that is roughly equivalent to being held down and beaten with cricket bats? That's what I have to live with, every day, and that's my pain level with the benefit of morphine. Without the morphine, my baseline pain level is quite a bit higher. Naturally, when your pain is that intense, you tend to be somewhat restricted in what you're able to do.When you arrived in the exam room for my appointment, you opened the discussion by declaring that my score on the questionnaire demonstrated that I was "in the deep, deep red" for depression, and that I needed immediate treatment. When I pointed out that I had clarified the answers on the paper, which you were holding in your hand, so I could see that it was the paper I had written my answers and my notations on, you first demanded to know what I was talking about, as if you were incapable of seeing what I had written on the paper, and then declared that my notations didn't matter, all that mattered was the score.
Item the Second: Absolute Control
I requested a referral to an endocrinologist. It seemed reasonable and appropriate, because I have several problems that are best treated by someone who specializes in endocrine medicine. Aside from diabetes and hypogonadism, I also have a history of parathyroid problems, as well as symptoms that could be associated with other endocrine problems, which you have dismissed as either unimportant or hypochondria, but which could easily be ruled out by simple tests which you have rejected. Then again, you haven't even bothered to do the routine A1C tests the American Diabetes Association recommends, while demanding that I adhere to a dietary standard that bears no relationship to the American Diabetes Association recommendations, so I shouldn't be surprised.Your response to my request was threefold:
- You stated that you do not do referrals - ever - for conditions that you are able to control yourself. You stated that you do not relinquish control unless you have no other choice.
- You berated me for taking an active interest in my health care. You claimed that every appointment, I come in with a list of demands for you to fulfill, and that you were tired of putting up with my monthly demands.
- You reiterated that you demand total control over my health care, and that you can not work as my doctor unless I relinquish total control over my health care to you.
Item the Third: Attacks on my insurance carrier
You continued your rant, now turning your attention on my insurance coverage:- Declarations that my prescriptions and diabetic testing supplies would not be provided by my insurance company, which I pointed out was in direct opposition to what I had been told by my insurance company,
- Insults directed toward the staff of my health insurance company, declaring them to be a bunch of minimum-wage idiots who don't know their head from a hole in the ground, and definitely don't know what their own company covers, because you, the doctor, have vastly superior knowledge of what their company covers than they, who are merely the staff of the company that provides the coverage
- Insults directed toward me, because I have the temerity to believe that when my insurance company tells me that it covers a certain item or a certain medication, then it covers it.
Item the Fourth: Personal Attacks
Apparently, attacking my insurance coverage wasn't enough, because then you turned personal.- You declared that I was an arrogant, ignorant git who thinks he knows better than you, the doctor, with your vastly superior knowledge of my specific condition, granted by your degree in general medicine, despite the fact that you have not been forced to live with my condition 24/7 for over 20 years and have not had to research this one specific condition in order to find hope that there may be treatments or care options that might help it for those 20 years. In short, you declared that because you have a degree in medicine, and thus have general knowledge of a wide variety of conditions, your knowledge of my health is vastly superior to mine, despite the fact that I have spent the last 20 years becoming intimately familiar with this one single condition, without having the luxury of being able to broaden my knowledge into other conditions. That's like telling me that the guy who just got a shiny new degree in aircraft maintenance knows more about the engines of a 747 than the guy with no degree, but who's spent his entire working life doing nothing but working on 747 engines.
- And then you moved on to declare that I was deliberately sabotaging my own health care, because I had the temerity to ask why you would want me to do a particular thing, or why you would change my prescriptions without any notice, or why you would change my treatment from one that was mostly successful to one that has been nothing but a failure since the day you implemented it.
- That apparently really got you worked up, because you spent several minutes berating me for being a failure at your diabetic treatment regimen (despite the fact that neither your diet nor your insulin regimen are among those the American Diabetic Association recommends), and declaring that my health problems were entirely my fault, because I am the only patient you have who isn't perfectly happy and successful with your treatment.
