Changes in doctoring and engineering over the last decade have followed a similiar path…
Like Engineers, doctors have come to rely more and more on diagnostic tools and machines… to tell them how you are, what is really going on with you. All those tests and tools are expensive… and they may reveal things that the doctor would have missed otherwise…. Or they may not.
In the Old Days, doctors used their hands and their touch/feel for what was going on with you to try to determine what was wrong. They practiced an art….
Very similar to how engineering has changed over the last several decades… engineers used to be “hands on”, used to touch the things they were working on, and used their natural talents to determine whether a thing would work or not. Those days are gone. These days, finding an engineer who engineers things by the seat of his/her pants is quite rare… one who does it well is even rarer…. The same was probably true in the old days but it was also probably more obvious to the casual observer… There are just some people who have a talent. {This particular Gabby was an aerospace engineer for 2O years and has seen this shift in engineering “practice”}
Which brings us back to our doctors.
How do you find the one with talent? The one who will order just the right number of tests but not too many – because s/he is pretty certain what they will find?
How do you know whether you can trust them in the exam room when maybe something in their “record” indicates that maybe they aren’t perfect. {like maybe they made a young doctor stupid mistake but they are actually quite brilliant?}
Here are a few things I’ve come to value….
1 – They innovate in their area of expertise… they tinker with things, they are always looking at newer technologies, know how they work, and have opinions on when the best time to use them is
2 – They are willing to say they don’t know… when they are stumped, they say so… and then they get on with figuring out what to do.
3 – They are probably challenging to their scheduling staff… because they spend as long with the patient as they think the patient needs. This means they probably don’t make as much money… but they have better outcomes
4 – They probably hate the healthcare “system”…. Because the system pays them the same as some schmuck doctor who doesn’t know beans about how to really practice medicine… the Top–of-my-class doctors make the same money as the barely-passed-my-classes doctors… the insurance companies don’t discriminate based on who is actually a GOOD doctor, just on whether they ordered the right set of tests
5 – I know they care about me because their actions say so. They work crazy hours. Maybe they’ve had 3 wives… and maybe not the best home life…. But they are there for me when I need them.
6 – They are recognized as being really good at what they do by their peers…. Other doctors come to learn from them… they have “awards” {maybe not plaques, maybe just letters…, they’ve been published, etc.}
7 – They educate their patients or try to get their patients to educate themselves. I once had a doctor sit me down in his office for an hour to have me read the medical book on the surgery he was going to perform… then came back in to answer any questions I had.
8 – They love a good challenge and get a certain twinkle in their eye when you present them with something different and new
9 – Their staff is a reflection of who they are…. Stable, helpful, caring, capable {If there staff aren’t these things…well, just know that they reflect the person who hired them… make sure it was the doctor before you judge… but then, if it was the doctor, pay attention to how the staff makes you feel… every “organization” has the personality of its founder}
1O – They have the latest technology in their offices or available, and they use it… but then, if what a machine says doesn’t line up with what they think they’ve found, they still weight their decisions more on their judgment than the machines… they may keep asking questions but they don’t assume the machine is automatically right
11 – They make me feel better and I can tell when they are genuinely frustrated if their solution didn’t work
12 – They don’t automatically look for a pill to hand me. Some of their solutions include a round of golf, a prescription to go be intimate with my husband ;-D, or talk something out with my mother. {without being condescending or implying that I needed therapy long ago, even though I probably did!}
13 – Their performance speaks louder than their “records”, which is to say… if a doctor has a blemish on their license that is over 1O years old AND they have an outstanding set of referrals from a variety of people since then… then think about your credit report. Has it always been perfect? Maybe you made a mistake or two in the past but you learned better and now you do better… You will have to use your own best judgement – not just rely on the “tools” and “diagnostics” that checklists for finding doctors points you to…. and remember, doctors are still human. They do make mistakes, but they aren’t always defined by them.
All of which is to say… the very best doctors I’ve ever been treated by… treat me like a partner, they value my perspective and seek it often… they expect me to be part of the plan AND part of the solution. They practice medicine with me, not on me. In short, they want me to be a Gabby Crusader…. Want me to speak up for myself AND fight for what is right for me (or a member of my family….
Those are the doctor’s I’m looking for….sometimes I find them by asking other patients who judge these things the way I do… but there aren’t enough of us yet.
Many times I find them through other doctors or care providers. My magic-hands Physical Therapist knows the best surgeons… my midwife – the very definition of a hands-on practitioner- recommended my OB/Gyn… If you find one you really like, ask who they see or who s/he sends his/her family to…
Ask what the doctor would tell you if insurance weren’t a factor…. If money weren’t a factor…. If time weren’t a factor…. If location weren’t a factor. Sometimes we have to help our doctors “think outside the system” because so few patients expect it, even some of the best physicians fall into the trap of what the system requires them to say.
Happy hunting. If you happen to find one of these rare and special individuals, please come back and tell us about them. Nominate a Care Provider for Crusader recognition.
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