How to get along with medical doctors?

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OliveOilMom sure had some great insights!! !! !! ! I wish she could come with me to the doctor!! ! I have seen A LOT of doctors over the last several years because I have a lot of health problems....problems that the doctors don't understand. I have met a few other people on the spectrum with similar health issues (usually things like weird allergies, chemical sensitivites, etc). At any rate, my pcp is fantastic!! ! And my Immunologist is also wonderful!! !! But the other specialists (especially the orthopedic surgeon I just saw...at a very highly respected facility) have been pretty awful. They don't listen (or don't understand what I try to tell them) and always assume that since most people are average then I must be too. I start every new appointment telling them that 1) I have Aspergers and 2) That my immunologist says that medically speaking I am a special kind of special....and STILL it takes them at least several appointments to start to believe me. It's really annoying because 3 appointments is usually about $300 (yes towards my deductible but still). I probably ought to ask my pcp or Immunologist to send them my records with a brief note saying that whatever is normal is NOT the case with me...

thanks ashariel

Thanks for sharing that - that is exactly my problem as well. I've been wondering if having bad reactions to meds is an autism thing, or just a ME thing... It definitely makes doctors frustrated, because my body doesn't react to substances the way an 'average' human being ought to! And once they get to the point where they're frustrated with me, I just give up, turn to natural healing methods and home remedies, and don't go back.

But I will persist next time. I might not be their favorite patient, but I am a human being, and in this country everyone is supposed to have a PCP - even those of us who have challenging physical and mental issues. So hopefully I can find a doctor who understands that, and doesn't deny me health care on the basis of poor health (I'm starting to realize how messed up that is!! !)

I've sought out replacement doctors/facilities a few times in my life when I've had one with condescending attitudes or felt they were just plane wrong about something. I remember one MD I saw only once at his private office when I tried to get a compleat physical after starting on a new health plan with my job. I did my interview with his nurse, everything went fine with that, she took my information and vitals, noted my heavy weight for my height, as well as my high blood pressure reading. She then went out of the room and the doc came in. He had me take my shirt off, listened to my chest and back, and then had me lay down on his exam table where he started "feeling around". His hands got to my abdomen area (which resembles that of a woman pregnant with tripletts), and began pushing his palm on top of my naval, after which he said, "YOU are very distended. Pressing here should never be this firm, YOU need milk of magnesia!" I tried to tell him I've always had a "hard gut" since I've been overweight, but he kept insisting it was "constipation!" I even tried to inform him I had sh!t my brains out the nite before, but he diden't want to believe me and told me he would not be able to continue my physical until I relieved myself of what was making my stomach feel hard to the touch. The doc continued with, "all you need to do is go to Walgreens or any grocery store and buy milk of magnesia. After taking the milk of magnesia, you will have a nice big movement and will feel a lot better, and then you can come back and we'll finish your physical." I actually began wondering if I was on Candid Camera or something, as I had never thought this sort of quackery still existed. I put my shirt on, checked out at the desk telling them I would settle the bill AFTER my physical was compleated. I never went back, obviously, and I ended up going to a family health clinic in a different area that had a number of doctors to choose from in case I ran into somthing like this again.
My next appointment is the first monday in November, and I'll be seeing a nurse practitioner as my previous doctor (that I liked) transferred to another medical group in a different part of the city too far away for me to want to hassle with. I'm going to have to re-introduce myself and hope my previous primary physician kept good notes in my charts so this new lady isn't totally blown away when she sees me.

I don't even go to a Doctor except to find out if I have swollen tonsils, ear infection, etc. In my experience, many of them are very arrogant, condescending, dismissive of my concerns and think they know everything, even when they are clearly proven wrong. That's not to mention how they ru$h you along with my average appointment being less than 2 minutes. After seeing my mothers experience of trying 25 different Doctors before she finally is on the road to correct diagnosis I really don't see the benefit of them outside of emergencies and what I mentioned above.

To be fair, I did see a specialist once and even though he was an oddball (talked to himself, never made eye contact, poor communication skills) I knew he was a very intelligent, very compassionate person. He made a very correct diagnosis in the end. I also met a really great Pharmacist who tried to go to bat for me but my Doctor was a complete a**hole to him. No surprise there.

Started seeing my current primary care physician about a year and a half ago. At my first appointment with him I told him (honestly and truthfully) that I hadn't been to a doctor in over seven years and that, if I didn't like him, it could easily be twice that before I try again, if I ever do. He remarked that I must have been lucky to have been able to avoid doctors for seven years; I answered "not really" and showed him some scars from wounds I've stitched myself, told him about a minor surgery I had performed on myself, and about scoring antibiotics at pet stores (in the aquarium section - you can't just buy dog meds in the store without an Rx, but you can for the fish stuff and it works fine - smells/tastes awful but it beats strep throat). He started taking me seriously, and has been pretty awesome ever since.

So to generalize, try to appeal to the doctor's desire to "First, do no harm" while reminding them that a sh***y bedside manner can be harmful all in itself.

Wow Rhody,
Have you thought about opening an underground practise?
I've only performed "bathroom surgery" on myself when I had a badly ingrown toenail and found out my medical plan wouldn't pay anything for me to see a chiropodist. So I carefully studied nail procedures online, and then got myself good and drunk after sterilising everything with Hexol (US version of Dettol) and finally going at it with my ever-shaky hands.
My toe looked horrible after my work, but did heal up without infection and the best part was the pain went away.

Thanks for sharing that, RhodyStruggle. I'm glad that you ended up with an awesome doctor. The moral of your story is good, too.

I have little to add but just want to reiterate my advice that it is really important to have a good relationship with one's PCP. The other docs, technicians, etc. are not as important, as long as the PCP relationship is sound. Good luck and good health, everyone!

Thanks everyone for sharing your stories... The medical profession is by no means perfect, and I think autistics are particularly at risk for receiving poor treatment, because doctors don't understand our symptoms and needs, and we have a tendency to offend them, without meaning to.

I'm calling to make an appointment today with a GP who seems to have good reviews online... We'll see how it goes!

This is my plan:

- Be super polite and patient with the office staff, because it seems they tend to be overworked to the point where they constantly screw everything up, and are rude to patients because they can't possibly keep up with the work that's placed on them, so they survive by not caring.

- Expect long waits, for appointments, call backs, waiting room (up to an hour past the appointment time), then sitting in the exam room for another half hour or so.

- Expect the doctor to be rushed, and only have 5 minutes to see me. Try to make the most of that 5 minutes. Get to the point, focus on the current physical symptoms I need help with, and don't worry so much about past medical history, or diagnoses. He's there to quickly assess urgent symptoms, recommend treatment, and move on to the next patient.

- Fill out the patient intake questionnaire truthfully and accurately, so that my medical history and allergies are on record, if he's interested (which he might not be).

- Be respectful to him, realize that he is doing his best to follow standard medical procedure. Symptom X requires Treatment Y. Don't argue or question his recommendation, unless there is a very good reason for it.

I'm going to treat it like going into an emergency triage situation, where there are too many patients, and not enough doctors. (Which is an accurate description of the health care system in general.) Doctors and staff are overworked, trying to help the most urgent cases, and really have zero time to be spending with someone who isn't actually sick (such as me).

So it will really just be a quick 'hello', introduce myself, get my blood pressure checked, agree to whatever lab tests he wants to do, assure him I'm doing fine, but just wanted my yearly routine exam. Nice and simple, in and out, and then voila, I have an official Primary Care Physician that I can go to when I actually need medical help.

(If anyone sees holes in my plan, please tell me now! Haha) Thanks everyone for the great advice

[UPDATE]: I made the call, and his policy for new patients is to have a consultation first, before the physical, so now I need to prepare for that, and figure out what to say! My plan is to be super positive and assure him I'm happy with my health, and my life, I don't feel I need medication for any of my physical symptoms, just wanted to get established with a GP. Hopefully that will work?!

I'm not averse to Agorist entrepreneurialism in theory, but that one seems way too risky. I'd have less of a chance of winding up in prison if I was cooking meth.

Your plan is really good, except for a few things I hope that you bear in mind.

1. The doctor may not be "personally interested" in you, BUT s/he would absolutely need to be aware of and take into consideration your medical history, any current or chronic medical issues and / or your allergies - especially allergies to medications or certain ingredients in medications. So the onus is on your to fill out your medical history form as accurately and as completely as possible. If this is difficult for you, and you are a new patient to the practice, then you can fill out a release of information at your previous provider's office, and they will - sometimes for a small fee - transfer all your documents over to the new practice. This will especially help (and is worth the fee) if your memory is poor or if you are unsure about what medications you have taken in the past etc.

2. INFORMED consent is the cornerstone of modern medicine. You have the right to need more information on any treatments being proposed, alternatives to these treatments, the good-the bad-and-the-ugly associated with these treatments and the RIGHT to refuse treatment. This is YOUR body, and you decide what you want done to / with it, and what you absolutely will not stand for. You can, and should, be assertive about your treatment options, and you have the right to give or refuse consent to any intervention the doctor suggestions, without that working against you.

3. You also have the right - if you are in the US and pursuant to HIPAA - to periodically examine your medical records and to correct information that you feel is in error or is inaccurate.

So, don't approach the medical office feeling like a lamb approaching the slaughter house. You have inviolable rights and you absolutely do not have to tolerate indiscipline, rudeness, inefficiency or patronizing by the office or medical staff. You are allowed to expect dignified and courteous service, professional treatment and the right to disagree with anything that makes you feel uncomfortable, including any treatments or medications being proposed or prescribed by the physician.

Finally, my brother, his wife, my cousin and his wife are all physicians. They have very different personalities and approach their practices very differently. Between the lot of them, I'd choose to go with my cousin's wife (if I was forced to seek medical treatment from any of them) as she is the one with the most comforting bed-side manner, and the most patient. My brother is probably the most intelligent of the bunch, although my cousin runs a close second as both a professor of Medicine, and the editor of a reputed medical journal. But their bed-side manners are horrible. They both tend to be abrupt, dismissive, and half-the-time do not use normal human speak to explain problems / procedures / options to their patients, instead seeming to assume that everyone understands the complex medical lingo they throw about so casually - UGH ! My brother also has a temper and can be extremely sharp at times, so nah... thanks, but no thanks.

What I am saying is that if this doctor and / or his / her personality and practice does not work for you, go find another one that will. Although all doctors practicing in the same specialty go through pretty much identical training, and schooling, and take the same or similar licensing exams to be able to do what they do, at the end of the day, they still all have unique personalities, with some of them just flat out being "nicer" than the others. Go find one of these "nice ones" and you won't have to worry about "getting along with doctors" anymore.

Good luck.

I have similar problems with some of my mother's oncologists. Some are good and doing all for the patient, whereas some seem to do almost the opposite. Doctors are probably annoyed with me, because I want answers and have read alot concerning mother's cancer and possible treatments.

Also it is frustrating that even in Finland treatment availability is very dependant on place and money. My mother is on last line treatment (in some other place it wouldn't be the last line), which costs 600 euros a month. My mother's pension is around 1000 euros. I am ready to help financially, but it makes you think, equality and things like that...

Last edited by VisInsita on 21 Oct 2015, 2:35 pm, edited 1 time in total.

Ashariel, your plan is good. Especially the part about just establishing the relationship so that when you get sick, you have somewhere to go. Also, it never hurts to try to be pleasant to other people!

Thanks for the advice & encouragement! I will definitely be truthful about my medical history, and it's good to know that it's all right to express concerns about side effects (since I tend to react badly to everything).

I'm learning to accept that I got labeled as a hypochondriac as a child, and that I really do have a lot of stress-related, psychosomatic symptoms (autism, duh) - and so I won't get upset when the doctor tells me there's nothing wrong with me, it's all in my head, I should just go home and not worry about it. (I realize now they may have meant that in a nice way, trying to reassure me, and I just have trouble interpreting people's intentions!)

Ashariel, I'm looking forward to an update after your APTT is finished. I have my own coming up in November where I'll be seeing someone for the first time and I'll try to follow up here afterward as well. One more idea for you which I've already been doing is to try and get your new MD to establish a personally tailored plan of care for you. In my care plan certain subjects such as dieting are never to be discussed due to the psychological stress it would cause me. In addition all my lab draws need to be done pediatric style due to my SPD. If there are treatment issues you simply can't deal with don't be afraid to tell your new doctor so they are not practised.

I'm curious, do most of you reveal that you have ASD or other co-morbid cognitive issues? If so, do you find that affects the way you are treated?

I've gotten a few doctors who started out with a somewhat condescending, baby talk voice when I disclosed, but I shut them down quick with my "Sherlock" voice: rapid patter using a lot of advanced vocabulary words and medical terms, helped along by a degree in biology, two years of chemistry, and courses in human anatomy, genetics, and cell biology. I must have a stupid-looking face, because it never fails to provoke a gaping mouth and stammered apology, like they just heard a monkey sing The Barber of Seville.