Chances are you’ve searched for a new primary care physician or sub-specialist at some point in the last couple of years. If not, just wait a few minutes…it’ll happen, I promise you. Doctors are leaving medicine – and primary care, specifically – at an alarming clip. I’ve complained before about all the reasons why this is happening, but what it really boils down to is moral injury. I could pen an entire post about this subject, but why bother when Dr. M at Reflections of a Millennial Doctor has devoted almost her entire blog to exploring the issue?
Rather, the point of today’s missive is to bring some much-needed honesty to the realm of online physician biographies.
Huh? I didn’t even realize that was a thing. Are you implying that doctors lie in their bios?
No, not really. At worst, your doc’s online bio is riddled with lies of omission. Unfortunately, the things we left unsaid are necessarily so – if we described our philosophy of patient care honestly, many of us would find ourselves summarily unemployed. So, what you wind up reading on the practice’s web page is a constellation of platitudes that sound great, but are exactly the same platitudes expressed by every other doctor you’re considering. It’s analogous to picking an episode from any season of The Bachelor(ette) at random and trying to figure out which contestant will be the best fit for the star of the show. Every contestant spews the same trite drivel as every other, to the point where the only opinion you can form as a viewer is which person you find most attractive and less crazy than their peers. If we extrapolate this experience to selecting a doctor, it means that you are currently choosing your doctor based primarily on her profile picture – does that sound like a smart thing to do?
What I would love to see – but will never happen – is for physicians to eschew the Universal Homogenizer Machine that scrubs and sanitizes profiles to the point of meaninglessness. Listen up, colleagues who are reading this: I know you think you’re doing the right thing by serving up palatable platitudes for prospective patients. But this ultimately contributes to the dissatisfaction many of our patients have with our medical system. Heck, have you read the comments section of almost any post on this blog? It’s filled with people who feel their doctors don’t listen, lack empathy, dismiss concerns, aren’t keeping current, and generally don’t know what they’re doing.
I believe that part of the reason patients feel so let down is because their physicians are not setting appropriate expectations – right up front. Instead, we reel people in with promises of “holistic care,” “shared decision-making,” a “strong belief in the mind-body connection,” “attention to the whole person,” and on and on and on. Is it any wonder that patients with a cornucopia of nonspecific symptoms that have gone undiagnosed and unresolved for years would invest an unrealistic quantity of hope in a physician who advertises herself in the above fashion?
Can you imagine how cathartic it would feel to lay out your actual practice philosophy in your online bio? Sure, you’d alienate a sizable portion of healthcare-seeking Americans; but you would attract a loyal following of patients who understand what can and cannot be accomplished in a 10-20 minute visit. These folks will trust your advice over the advice of Dr. Google, even when you tell them what they need to hear, as opposed to what they want to hear. Most importantly, when these folks acquire a tough-to-diagnose illness, they will not spin their wheels seeking quackery while simultaneously demanding that you order useless testing and non-indicated medications so that they can get their naturopath’s care plan covered by insurance.
Think about it, colleagues – this is a win-win situation. You win because people who choose your care will be infinitely easier to manage. You will satisfy your patients’ expectations, which will lead them to believe you are doing a good job. This will lead to more positive feedback from your patients, which in turn will enhance your job satisfaction. After all, we entered medicine to help people, so it feels pretty darn good when we actually fulfill that mission.
Patients who choose to see someone other than you also win. Instead of burning copious ATP patronizing a doctor who can’t possibly measure up to their expectations, these folks will seek out a care provider more likely to validate their beliefs, biases, and preconceived notions. Though it is possible they may not receive quality care, they are more likely to be satisfied with the care they receive. Of course, this isn’t optimal. But, if the choice is between perception of suboptimal care/hate clinician vs suboptimal care/like clinician, I wager many people will prefer the latter.
With that in mind, I’d like to present several examples of stereotypical bio phraseology, followed by their truth-ified versions (italicized). If you are a doctor and decide to implement this strategy on your practice web page, feel free to steal liberally from this post.*
Effective Listening
Dr. Harris believes that listening to patients and allowing them to feel heard is the most important part of being a primary care physician. It is only through understanding their hopes, dreams, family, stressors, and everything else that makes a person who they are, that a doctor can effectively partner with her patient to construct a comprehensive treatment plan.
Dr. Harris believes that listening to patients and allowing them to feel heard is a critical responsibility of a primary care physician. She also believes that effective listening is a two-way street. In order to cultivate an effective doctor-patient relationship, Dr. Harris expects her patients to trust that she will deliver on her promise to truly hear them and give their concerns sufficient weight before making any recommendations. In return, she expects patients to adopt an attitude of “how can I implement this change,” as opposed to “that won’t work because…”
Physician as Educator
Dr. Higgins loves taking care of patients who have questions and actively engage in their healthcare. He sees himself as an educator and is excellent at distilling complex concepts into language that anyone can understand. He is also skilled at helping patients separate the wheat from the chaff when it comes to navigating the often confusing labyrinth of internet medical information.
Dr. Higgins enjoys treating patients who actively engage in their healthcare. He especially appreciates when people bring him their internet research and ask his opinion about its veracity, before becoming overly invested in advice that is often of poor quality. While Dr. Higgins welcomes questions and wants his patients to feel comfortable with the care plan, he also insists they realize that internet demonization of commonly prescribed drugs does not trump his recommendation for said drugs. Dr. Higgins’ advice is based on years of education and experience; if he thought the drug would harm you, he wouldn’t ask you to take it. If, after he addresses the inaccuracies in these internet myths, you trust your “research” more than Dr. Higgins, he isn’t the right doctor for you.
Holistic Approach
Dr. Bristowe emphasizes a holistic approach to the care of her patients, focusing on nutrition, exercise, sleep, and stress management. She believes in searching for the root cause of disease, as opposed to simply treating the symptoms. Whenever possible, she employs natural therapies.
Dr. Bristowe emphasizes a holistic approach to the care of her patients, focusing on nutrition, exercise, sleep, and stress management. She strongly believes that deficiencies in these lifestyle issues are the root cause of most chronic symptomatology, such as fatigue and weight gain. If you’re looking for a doctor who embraces natural therapies, you will be happy to find that Dr. Bristowe is an enthusiastic proponent of the following all-natural interventions: cutting out sugars and processed foods; high-intensity interval training; sufficient quantity and quality of sleep; meditation; and yoga.
Every Patient is Unique
Dr. Pavelka believes that every person is unique; what works for one will not necessarily work for another. In addition, he understands that different patients with the same disease may present differently and require a care plan that is personalized for their situation.
Dr. Pavelka is an adept diagnostician, understanding that different patients with the same disease may present differently. While he acknowledges that people generally like to feel unique and special, there are certain principles of both physics and biochemistry that apply to everyone – even the most special of Americans. As such, Dr. Pavelka will create a care plan based on his experience of treating thousands of patients with various permutations of the same disease. If the treatment doesn’t work, he will again draw on his experience of treating thousands of patients for whom the initial treatment didn’t work, to create a new plan.
Patience
Dr. Brown thinks that patience is the most important quality a physician can possess. She understands that her patients entrust their lives to her, often in their most vulnerable moments. She believes that the best way to help people is to focus on them completely and allow them to tell their stories.
Dr. Brown believes that patience is a virtue every physician should possess and exercise as often as possible. However, she is also a pragmatist. Our current medical system requires doctors to see more patients in less time, which has turned patience into a luxury that doctors cannot always afford. Dr. Brown would truly love to spend an hour with every complex patient, but that is an impossibility. To maximize the time for each visit, she asks her patients to:
– arrive at least 10 minutes early to allow time for the rooming process; if the visit starts 10 minutes after the appointment time, that means the visit will be 10 minutes shorter.
– have reasonable expectations for how many issues can be addressed in one visit.
– not take offense if she interrupts to ask clarifying questions; this is necessary to efficiently extract the information Dr. Brown needs. Though people think they know what the doctor needs to know, they often present information that is irrelevant.
To my bolder physician colleagues who choose to implement some of this phraseology: let me know what kind of reception you get! To patients: I hope you choose to view this peek behind the curtain as instructive, as opposed to using it as more evidence to support your decision to condemn Mainstream Medicine and embrace Alternative Medicine. If you approach your MM physician with realistic expectations and an open mind, you are more likely to have a productive visit. Are there lousy MM doctors out there? Of course, but the vast majority of physicians I work with feel a deep sense of mission to help their patients be well – give them a chance to do that.
*I am not liable for any loss of reputation, income, respect, spouse, lease, life, or any other damages you may suffer by implementing my recommendations.
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Image Credit: Photo by Matt Collamer on Unsplash
I’ve never seen my doc’s on-line biography. When he became my doc 30 years ago, there was no on-line presence and he was one of 3 in a small practice. Later on he became one of one in a private practice. We agree that his job is to help me maintain my health and we have a 2-way conversation 2x a year.
But I know that he will retire before I die so I will need to replace him and I have a few candidates lined up — they have all avoided being sucked up by a corporate practice and I hope they can continue to stay that way. If not, I have a rating of the 3 (or is it 4 now) groups in my area.
Excellent post HD, thanks very much. I changed insurance providers on the first of this year and thus needed to select a new PCP. I carefully read the bios to make my selection. I chose a woman who was relatively new to the clinic and had some decades of experience. I’m blessed to have her as my PCP. She’s quick to refer me to colleagues as needed (for example, their director of trans health care, who is also wonderful). So, I really lucked out.
But as you said PCP (or any doc) selection shouldn’t be a shot in the dark and require luck. I felt I had to carefully read between the lines, parsing each word to glean whatever meanings I could discern. I would have much preferred to read bios such as your examples. I would have been much more comfortable making my selection and, in fact, looking forward to meeting my new PCP.
I believe a lot of patients do not know if what they see online is alternative or mainstream. Many of the posts I see where people complain about their PCP/Endocrinologists are situations where they asked for something alternative (but probably didn’t realize it). They were then disappointed in the response. Some of this may point out the need for their PCP/Endocrinologists to provide some context to why they don’t suggest certain tests that people have read online are so important. I’ve had Endocrinologists in the past just say those tests are not useful without really explaining it. Such as “why would we test FT3?” in a negative tone without explaining it. To a patient who has read online stuff, this makes that doctor seem not up on things. My PCP and Endocrinologist both explained that it’s tricky being a thyroid patient and that alternative providers can be scams. What I did appreciate from my current Endocrinologist is she explained that she was not into alternative treatments. And explained her approach to Hashimoto’s and Hypothyroidism. I appreciated that, as it let me decide whether I wanted to keep seeing her or not. However, it took me quite some time to figure out what concepts are alternative and what are mainstream. This helps me when interacting with my doctors as I know what not to ask them. Quite frankly the best thing I got from this site is knowing what my doctor’s position likely is on concepts. Although, I do ask some questions based on studies I find which may contradict traditional approaches. I usually get something thoughtful back from my current providers. All that being said, I do believe autoimmune thyroid is a complex issue that is not well managed for many people. Which is why so many people are suffering and why so many people are turning to alternative providers.
Great perspective, Mike, thank you. I agree that people often don’t know that what they’re asking for is kind of quacky, which certainly causes problems with the PCP/Endo – Patient relationship.
Finally something I do agree with you 100% . “Are there lousy MM doctors out there? Of course”
You must work with a higher number of good physicians. Or I have had bad luck choosing Dr & hospital ER’s since the ones I have seen in the last few years do not share your deep sense of mission to help their patients be well.
Why doesn’t my endo give a book or something to read so that I can educate myself?