Tuesday, April 24, 2007
Out of Touch After Surgery
I'm back at work after an unexpected surgery. Waiting for my body to heal wasn't easy. But what made my surgery all the more difficult was the surprising lack of access I had to my doctor afterwards. Complications had me in the emergency room twice. I talked to ER doctors more than my own. I felt neglected.

Feeling neglected doesn't mean you're being neglected. But feelings are powerful nevertheless. When I got back to work I called Regina Sara Ryan. She's the author of "After Surgery, Illness, or Trauma." Ryan had some great advice on how to handle a doctor you think is out of touch. "It's a tricky path to walk," she says. "We are afraid of damaging this relationship." Still, she says the relationship we foster with our doctor is one of the most important bonds we have with someone. So... how to make things work:

1) Speak up. Don't let your physical weakness silence your concerns. Ryan says too many of us try to take on the burden of our recovery alone -- a saint-like approach that internalizes our worries and makes us passive healers. Sometimes our doctors intimidate us by their stature, their expertise. Try not to be overpowered by that fear, and if you still find yourself struggling ask a friend or relative to speak to your doctor on your behalf.

2) Keep a list. You're less likely to monopolize time and more likely to get the answers you need if you have a list of questions ready to ask your doctor. "A list gives the idea that you are not being casual," Ryan says. Remember, you're dealing with a physician you think is inattentive. A list of questions makes it harder to dismiss them.

3) Don't make your doctor the enemy. Your approach should be to salvage trust. Not an easy task when you're angry or in pain but try, regardless. Speak to your doctor about working together, even getting along. But be realistic. "Don't expect a best friend or the ultimate healer," Ryan says. What you want is a committed partnership.

4) Don't be blindly obedient to your doctor either. Express displeasure when your care seems below standard or your treatment disagrees with you. If your doctor isn't responding, Ryan says most hospitals have patient-advocacy programs that you can turn to for a new ally.

5) Last resort, make the switch. "A gruff manner is one thing," Ryan says. "But if your doctor isn't listening to you, if you have a real sense that something is wrong then it might be time to look for a new doctor." Red flags that should make you question: 1, a sense of incompetence, and 2, a lack of clear, available information.

Easing back into my routine feels so good, especially after the pain of surgery.

Have you ever felt neglected by a doctor? What did you do to get more attentive care?
Hi John, good to hear the part about how you're feeling better.

It's too bad that many people feel neglected by their doctor. It does indeed seem as if they run in, read your chart, ignore you, and then leave. I'd say that a lot of it is due to a lot of patients and not a lot of time, however, an incompetent doctor is a different story entirely.

I have never been ignored because the expression "vocal person who says what's on their mind" definitely applies to me. If I think I'm being ignored I've never been shy to say something- but I think that's what the point of your post is, that people generally aren't. We're paying for good care. If you are at the store and something isn't right, you'd complain, right? Why not here? We should never be intimidated in life by those we think are smarter or more learned. We're all people.
If Sanjay Gupta's producer can't get decent medical care after surgery, there is no hope for the rest of us. And doctors wonder why the malpractice rates are so high. Hey, at least the lawyers will return your call.
I've never been as close as I am now in planning to file complaints against my doctors. People around me have told me to switch but when you are someone with multiple medical complications, it's not that easy. Not all of us have the luxury to simply doctor shopping until we find someone that 'clicks'.

The thing is, I've been vocal. It really hasn't gotten me anywhere. But when you are talking to the 'gatekeepers' you can only get so far being outspoken. I'm in the medical field, so I don't feel intimidated by any other medical professionals. So it's not that the patients aren’t standing up for themselves... there are lots of barriers in between the patient and the doctor in healthcare.
Glad you are back among the living, John. My surgeon went out of town after doing my hip replacement and didn't inform me. His associate saw me but I didn't know him from a hatbox. I never saw him again until my six week visit.

During my hospitalization, the night an Rn who had to be brought in as a contract nurse, took my pain medication, oxycontin and didn't know (or was too stoned) to change my IV. How did I know this? I am an Rn with 45 years experience with a Masters and am certified in Substance abuse. I volunteer with nurses in the state of Texas who are in a two year program trying to save their nursing licenses because they have turned themselves in or been busted as being addicts.

I was unable to be an advocate for myself except to demand that they let me out of the hospital at 3 days rather than the usual four. I was most unhappy with my experience. If I am every hospitalized again, I will not send my family home at night when I can't advocate for myself. Dumb move on my part and I strongly recommend that all out there do the same. I wouldn't have been at risk that night but half the nurses called in sick and they hired a temp nurse.
Nice to hear things are better John.
As a doc, I can attest that the system won't save you. Take your healthcare by the horns and get the ammunition that will work for you. Get portable.. use free medical record systems like worldmedcard.com. If you have to switch, have all your ducks in a row. YOU are the client.. if you are not being served find someone who will work with you and your health.
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