Patients are people, too

Doctors who rush through office visits and fail to treat patients like people get a tongue-lashing at USF's Mini-Med School.

By SUSAN ASCHOFF, Times Staff Writer
© St. Petersburg Times
published February 20, 2003

TAMPA -- Opening night of the well-attended Mini-Med School, a series of classes for the public with University of South Florida professors who train future doctors, was to begin with advice on how to discuss embarrassing medical problems with one's physician.

But there was no talk of "Sex, Drugs and Other Unmentionables," as advertised in the brochure.

Instead, the more than 300 participants gathered in the Tampa Bay Performing Arts Center auditorium appeared to share a more basic complaint:

Why won't my doctor treat me like a person?

"I think they insult your intelligence," said one disgruntled man.

Whether the trouble is an assembly-line rush by the doctor or a patient's inability to get to the point during a seven-minute appointment, the relationship is suffering, said many at Monday's class.

"We want to be able to be cared for," said Dr. Francisco Fernandez, chairman of the USF Medical School psychiatry department. "It may seem like going to the doctor is a rather simple thing. It's very complex. The reason it's complex is the personal issues and whether you are treated as an individual."

Mini-Med School meets Monday nights through March 3. Topics range from subtle symptoms of stroke to hormonal treatment of menopause. Some people have attended every year since USF began the program seven years ago. Most are senior citizens who have no qualms about demanding what they need from their doctors.

"As you get older," said Helene Hott of Tampa, "you get more brazen."

Umayer Ali, a USF junior planning to go to med school, said there isn't anything to be embarrassed about at the doctor's office.

"I have to be honest with my doctor. If he doesn't know everything that's going on, how is he going to diagnose me?"

But many participants said doctors take little time to listen to their concerns and even less on the niceties of a relationship. Before Monday's session, they jotted down their best and worst experiences with doctors. The note cards, and comments, were shared with the audience.

When I go to the doctor the first time, I get a lot of attention. He sits down. He makes eye contact. He asks a lot of questions. When I come back, the visits are routine. And short, read one card.

There were more:

-- We go in with questions but the doctor maybe doesn't have time except for the first one.

-- The telephone operator is performing triage. I don't want to talk to the telephone operator. I want to talk to the doctor.

The point, said Fernandez, is that a patient wants his doctor to be interested in him, not just his body part.

"That's a critical element -- a personal contact."

Fernandez and Judith Karshmer, a nurse with a doctoral degree who specializes in psychiatric care, suggested that patients looking for a physician ask how the doctor and his staff handle appointments, prescriptions and callbacks. At some offices, an hour or so every day is set aside for returning calls. Patients who need more time for their questions were advised to request it when making their appointment.

For a first visit, bring your medical records and the names and dosages of all medications, said Fernandez. Take notes during the visit so you can refer to the doctor's explanation and instructions later.

More note cards:

-- When discussing my depression after the death of my husband, my doctor, with tears in his eyes, said he had experienced the same thing and that, with time and medication, I could be helped through this difficult time.

-- My doctor took time to explain things to me. She used words I could understand.

-- I told the doctors that my twin brother had had a stroke. His immediate reply was, when are you going to have yours?

Marie Kurz of Temple Terrace said preparation makes her doctor visits work for her. "You think things out ahead of time."

The first thing patients should look for in a physician is competence, said Fernandez. Then the challenge is how to be productively intimate.

"How do you talk to a stranger," Fernandez said, "about things that are personal?"

A doctor will keep your secrets, he said.

A doctor must also see a person as not just another patient, but an individual, and make that individual "feel heard and cared for in a compassionate way."

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