“Doctor, Doctor, Give Me the News...”

Six anonymous doctors—all of whom have practiced or are still practicing in Colorado hospitals—disclose their secrets, explain the mysteries of medicine, and divulge exactly what they think about their patients and their colleagues.

January 2011

5280: If you had to describe doctors in general in just three words, what would those three words be?
Dr. Internal Medicine: Intelligent—you have to be to get your doctorate—but don’t confuse that with wise. I know many intelligent people who are idiots, and most of them are doctors. Motivated—they tend to stay the extra 30 minutes to find something out and don’t need someone to prompt them to do so. And jaded. Having to reason with the unreasonable and care for people who don’t care for themselves makes us begin to lose hope and question our influence in the grand scheme of things.
Dr. Anesthesia 1: Dorky. Intense. I would think most people would say arrogant, but that’s not what comes to my mind right away. My third adjective: apathetic.
Dr. Anesthesia 2: Motivated. Fatigued. Frustrated.
Dr. Psychiatry: Compulsive. Cordial. And I’d like to think empathetic.
Dr. Ob-gyn: Overworked, compulsive, and human.

Does the hospital where a doctor works influence what you think of that doctor?
Dr. Internal Medicine: Without a doubt. When is the last time you heard someone say, “I went to Mayo Clinic and it was nice but my doctor was an asshole”? Good example: People think all VA docs are horrible, but some of the nicest and most compassionate docs I have met work at the VA.
Dr. Anesthesia 2: I’ve worked at four hospitals, and there are good doctors and bad doctors at all of them.

What’s your take on having a resident (student doctor) work on you or on your child?
Dr. Internal Medicine: I would tolerate it on myself, but on my child? Never. The average adult takes about 72 hours to die, but a kid can die in 24 hours and that makes me nervous.
Dr. Anesthesia 1: I would, but it depends on exactly what it is. Do I think, in a hospital setting, that your care benefits from residents? Yes, because they are the ones that are there all the time. At a teaching hospital, if something were to happen, the wheels could start turning more quickly. If something happens in the middle of the night at a private hospital and the doctor is at home sleeping, the care might not be as good. On the flip side, if I need to have some sort of delicate surgery—neurosurgery—I might feel better with a seasoned surgeon as opposed to someone who is just learning how to do it.
Dr. Anesthesia 2: I’ve supervised residents and I’ve been in private practice without residents. I generally think the best person to take care of you is someone who has been in practice 10 years.
Dr. Ob-gyn: Because I’m a doctor and I know too much, I would not let a resident take care of my child or me. That being said, in general, residents provide excellent care.

How do you choose your own doctors?
Dr. Internal Medicine: I have a Magic 8 Ball. No, I usually go by word of mouth, and if I don’t have a reference I just take a chance. I have the luxury of being in medicine so I usually have a general idea when someone doesn’t know what he or she is doing.
Dr. Anesthesia 2: Word of mouth is 90 percent for me. And for specific specialties, I have certain requirements. For obstetricians, I feel strongly that I want to weigh their surgical skills over other aspects of their doctoring. My underlying suspicion is that even though we’re doctors, we’re not that much more informed about the docs we choose than the lay public.
Dr. Psychiatry: Personality is huge. Bedside manner. Rapport. A doctor that knows what they’re talking about only goes so far. There is an art to doctoring.

What does a patient have to do or say to get your undivided attention?
Dr. Internal Medicine: Most of the things that get my attention are nonverbal, or the patient is not aware of them. Loud people who get quiet, complainers who suddenly don’t want to talk, or normally sharp, little old ladies who can’t remember where they are all get my attention pretty quickly.
Dr. Anesthesia 1: On an individual patient basis, it’s the patient that is the most honest with me.
Dr. Anesthesia 2: For me, it’s basically if someone is in cardiopulmonary arrest, or if that person has disease processes that could lead to cardiopulmonary arrest. That’s extreme and specific to anesthesiology. Also, if someone is really nervous, I offer a little extra TLC. As an anesthesiologist, that’s my role.
Dr. Psychiatry: The best thing for a patient to do to get a doctor’s attention is to be organized. Tell me the top three things that you need to talk about today. Talk about your most important thing first.
Dr. Ob-gyn: If a patient is very honest with me about one specific problem, then I will do everything in my power to get that resolved. When a patient has a number of problems, it normally means that no one thing is really a problem.

Do you talk about your patients with your family and friends? Why?
Dr. Internal Medicine: I talk about my patients all the time. My spouse, father, and friends are all doctors, and no one understands like a doc.
Dr. Anesthesia 1: Absolutely. Of course, I believe in HIPAA laws and privacy. If I come home and tell my wife about a patient, she doesn’t know who it is, but yeah, I do say, “Geez, you won’t believe this patient I had today.”
Dr. Anesthesia 2: It’s a healthy form of venting for doctors. One night I had a patient that, for personal reasons, would not accept certain kinds of care. I had to watch this surgery unfold and could not help this patient. I thought the patient was going to die, and I was helpless.
Dr. Psychiatry: When you have profound experiences at work like doctors do, you have to get it out.
Dr. Ob-gyn: I do it all the time. I never use specifics, but I talk to my friends and family in medicine. Most of the time I’m trying to pick their brains about what else I can do to take care of that patient. We do a lot of learning by hearing about our colleagues’ patients.

Do you ever get embarrassed or grossed out by your patients?
Dr. Internal Medicine: I can’t remember ever being embarrassed by a patient. I have been embarrassed for a patient many times, usually when the family of a patient is telling me details about their son/father/granddad’s bowel habits while the patient sits there looking at me with an expression that says, “Every day I pray for death.”
Dr. Anesthesia 1: One word: maggots. What does that have to do with medicine? What it has to do with medicine is an old lady came in with a bandage on her foot. When we undid the bandage, maggots just fell out. Seeing those little guys wriggling around really grossed me out.
Dr. Anesthesia 2: I got grossed out on a regular basis in residency. Once I had a patient who was bleeding dark, black blood from her eyes. That was gross. These days, though, it’s when I go to intubate a person and you see a tooth you could just pick out because it’s so rotten.
Dr. Psychiatry: Excessive nicotine use. That grosses me out.
Dr. Ob-gyn: It is pretty hard to gross me out. I do think it’s nice when women shave their legs before an appointment, but they really don’t need to do it. And I don’t think patients understand, at the end of the day, I can’t remember what their private parts look like even under the threat of death.

Have you ever wanted to fire a patient?
Dr. Internal Medicine: Yes, I have fired many patients. I worked at a free clinic that had a three-month waiting list to be seen. We didn’t have time to waste on people who missed appointments or abused the system. In the hospital, however, I have never fired a patient because, unfortunately, you can’t.
Dr. Psychiatry: This is a good question for me. You can’t “abandon” a patient. But there are circumstances where it’s no longer therapeutic for you to work with a patient. You need to make sure that they have all aspects of their care covered. It kind of has to be a mutual firing. You can’t just say, “Hey, this isn’t working. See you later.”