It’s been a while since a doctor yelled at me. In fact, it’s been some time since anyone yelled at me. That’s why I was a bit taken aback, as I sat in the doctor’s office with a client, watching the veins bulge out of the cardiologist’s neck, thinking, ‘Wow, he’s a prime candidate for a heart attack himself.’
I don’t usually attend doctor’s visits with clients, but this time I felt like my older client was being thrown back and forth between specialists, prescribed tests without really anyone considering the repercussions or the burden of conducting all these tests on an older, frail, man who lives alone.
This is the point where I always feel health advocacy serves one of its most important functions. Doctors provide much information to their patients. Often, patients suffer from multiple health problems simultaneously and have other situations that can magnify their health issues, like age, family size, poverty, and other external stressors. Some doctors just see the patient’s individual problem in front of him, as if under a magnifying glass, with the other health problems and stressors blurred on the periphery. This can be the moment for an outside agent to help the client and/or his family to review the information and make an informed decision that is right for him.
I had a feeling that was what was happening in this client’s case, so I accompanied him to the specialist. The doctor spoke in a low voice, almost monotone, looking over the information on the computer to reacquaint himself with the patient’s case.
The doctor ushered us into the office, speaking in low tones, almost monotone, looking over the information on the computer to reacquaint himself with the patient’s case.
“I see most of the results, but where is the last test I prescribed?” he asked, and I thought, ‘uh-oh, we could be heading for dangerous waters here’. The client had chosen not to undergo that last test, as it was an uncomfortable test, requiring him to go to the hospital. Being as that he lived alone and had no family, this would require him to take an expensive taxi both ways to the hospital, ask someone a favor to go with him and be there for several hours, and then return home, exhausted, to an empty apartment. Only to have to pick up the results at the hospital later, and return to the specialist for another tiring visit, where the results would be interpreted and future testing suggested or ruled out.
I said to the doctor that the patient was hesitant about this test, and what exactly would the results give us?
“Well, if we see a problem, we’ll go and do the next test, which is more invasive but can solve the blockage, on site, if we do see a problem,” he responded.
Aha, now I was starting to understand. “Could we go on to the next phase from the get go, without the initially uncomfortable test, being that the patient was older,” I asked. “Age is not a factor,” the doctor replied.
Then I knew we were in a bit of a trouble. If the doctor saw only this patient’s specific health complaint, and not the fact that it belonged to an 87-year-old man with a history of heart attacks, then how could we get him to have a thought process at all about the necessity and role of further testing?
Gamely, I continued and jumped into an explanation about the difficulty of the patient traveling to and from the hospital, the unpleasantness of the test, etc…
The low monotone stopped. The doctor turned toward me, and with venom in his eyes, yelled a torrent of words at me, frankly, most of which I didn’t understand, but something about me speaking a bunch of irrelevant junk that was not in the least bit connected to the referral of this test.
Now, thank goodness, these situations do happen less and less in the Israeli healthcare system. I am frequently met with smiles and explanations from physicians, who want to help me, or the clients, make informed decisions. Clearly, I had entered the lion’s den of doctors who want the patient to be seen and not heard, meekly accept the forms given to him or her, perform all required tests and stay quiet.
So what were our options at this point?
- Yell back at the doctor.
- Shut up and ask no more questions.
- Storm out of the office.
- Argue with the doctor.
- Continue as if nothing had happened.
I usually choose the last option, as I did this time as well. I looked at the doctor, questioned his need to yell at me, and after a few second pause continued to ask my questions. I knew that we would not get him on board to help us make a decision that fit the client’s needs, but at least we could gather as much information as possible. Which is what I did for the next ten minutes. Slowly, waiting 30 seconds between each question to give him his computer time, gently judging how much to push and how much to hold back.
These kinds of doctor situations can be very intimidating. My advice is, don’t give up. It is still your appointment, no matter how uncooperative the doctor may be, and you have the right to ascertain as much information as you need.