The good doctor

I have been fortunate to have had many good doctors throughout my lifetime. Then again, I’ve seen a LOT more doctors than most people my age, for a great deal more conditions and problems than the average 44-year-old has, so perhaps it’s just a numbers game and the odds are in my favor. But I know when I get a good one, and for me, what distinguishes a great doctor from an ok doctor; and let’s face it, some are just downright bad. If you are seeing a bad doctor, you should stop it. There are many other good ones out there, fighting the good fight.

I started my SEEING ALL THE DOCTORS phase when I was still in college. I got very sick, and nobody could quite nail down what was wrong with me. This is part of the problem with being in a small town – generally speaking, many small town doctors are not up on the latest studies, techniques and developments (though some are), and while they’re fine for routine care, if you have a specialized or unusual problem, you’re better off heading to a major hospital system in a larger city. It wasn’t until I started going to a doctor in Cleveland that they correctly diagnosed and began to treat my Ulcerative Colitis, which began a five-year journey of horrible illness, culminating in a complicated set of surgeries that finally set me on a better path forward for a healthy life. I saw two or three doctors in my small town before going to the doctor in Cleveland. They were, alternately, perfunctory, irritated, bored, stumped or otherwise relatively disinterested in pursuing a fix, and more interested in throwing medicines at me. When I saw the GI in Cleveland, he sat me down and wanted me to tell him the whole story of when things started and what had happened, what I had been dealing with and what was going on with me now. I remember being in tears at one point during my story, and I could see the doctor visibly struggling himself to hold back tears. It touched me. He committed to getting me better, and over the next five years, was open to anything and everything that would GET ME WELL. His prime motivation was my wellness, and he encouraged me to learn what I could and co-manage my own care alongside him. I read journal articles on my condition, which we discussed at my appointments. He got me into new drug trials and tried experiments that were just coming out on people with my condition, such as in-hospital, intravenous cyclosporine (an anti-rejection drug given to transplant patients), but also encouraged me to try alternative therapies as long as he knew what was happening. I went through acupuncture, biofeedback, therapy, tried Chinese herbal medicines, a macrobiotic diet, everything. When I didn’t have health insurance, he didn’t charge me. He gave me boxes of medicine out of his cabinets when I couldn’t afford prescriptions. By the time we reached the end of my five-year journey and I consented to surgery, I really knew we had tried everything there was to try. I found out later he had to pay a hefty fine to his practice for referring me out of network to the best surgeon for the job, knowing how key the surgeon’s skill was to the success rate post-operatively, long-term, for the patient, but the referral was important to me, and for my insurance to consider paying for it. The surgery marked the end of my time as his patient, and truly that was the best thing of all – for me to no longer need to see him was his ultimate goal, and I am forever grateful.

Since then I’ve seen literally dozens of various kinds of general practitioners, specialists and other surgeons for everything from bunion surgery to gallbladder removal. When considering where to have my gallbladder out, I called doctors at all three of the major medical institutions in Cleveland – MetroHealth, the Cleveland Clinic and UH. The UH doctor’s office never called me back, and when I followed up, they told me it would be more than two months before I could see someone for a consult. I needed my gallbladder out immediately, I did not have that kind of time. I went to see the surgeon at the Clinic, who was 20 minutes late to the appointment, spent less than 5 minutes with me, and clearly couldn’t have cared less about me as a patient. When I went to see the surgeon at Metro, he turned over my appointment paper and drew me a diagram of my internal organs and discussed what his attempt would be. We discussed the challenges of laparoscopy given my abbreviated internal plumbing from previous abdominal surgeries, and the challenges that the scar tissue in my abdomen could create. We discussed my questions and past problems with anethesia, and his tactics to aggressively manage post-op nausea. Needless to say, I had my surgery at Metro.

My primary care physician is at Metro, and I have been seeing her for many years now. I had my annual physical yesterday and though she was squeezing me in between other appointments, she took a great deal of time with me. She sat and listened to me and asked me questions about ongoing problems, like the problems I’ve been dealing with for almost three years now with my knees. She asked other questions that prompted me to tell her things I would have otherwise forgotten, like my recent hearing test and the unhappy results therein. Her advice to me on the knee issue goes against what most doctors would advise. After recapping the whole, sordid, three-year journey from specialist to specialist, she told me to quit seeing doctors about it. That each one would just order more tests. She said she agreed with me that the problem was likely a complex musculoskeletal problem affected by all the things I had described, with various areas all interconnected that are contributing to the problem, and that there is not one single, Holy Grail type answer. She encouraged me to seek out more alternative therapies, such as spending my money on more acupuncture instead of more doctor visits. She said if deep tissue brings positive results, try to get that more often as well. She discouraged injections, which not only temporarily mask a problem but can weaken tissue. She asked a lot of detailed questions about what my PT sessions have been like, saying that the goal is not to make the person dependent upon seeing the therapists, but to develop a program for you to work on at home, which is what the Metro PT people have been doing all along, but if I need more sessions, just send her an email and she will put in for more, so I don’t have to pay for another office visit.

I had my annual blood work done as well, and as soon as the results were in, she emailed me about them, saying the numbers are staying concurrent with past years and so no need for medications. She looks at the whole picture, including heredity, and recognizes that throwing a drug at everything is not always the answer.

These examples are what practicing good medicine looks like, at least to me. If you don’t have a doctor like this, keep looking until you find one.

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