While I agree with this— providers should know more about their patients, especially as it relates to social drivers of health, in order to provide the best care, but how would you go about having these conversations if your doctor isn’t asking you questions, is short on time, and doesn’t seem interested in getting to know you as an individual?
This type of dialogue is just not realistic for most patients within the healthcare system that exists today.
I go to an ObGyn office where all the doctors know my mother (a former RN), and I know this fact alone has afforded me better care than other patients, but even still, I have had my concerns dismissed, I have had to advocate for myself and my health, and I have felt overlooked.
I think we have a long way to go, but my hope is that we will continue to change the structure that prevents providers from spending quality time with patients and build more reliable systems and processes that support personalized, holistic care.
I hear you loud and clear, however I *do* think this kind of dialogue - of course in smaller chunks and over an extended period of time - is possible but *if and only if* you find a primary care provider who is interested in the relationship part, too.
I truly believe that physicians in the field of primary care (that is: general internal medicine, OBGYN, family medicine, general pediatrics) went into this particular area for the distinct reason that we care about the whole person. Otherwise we would have chosen radiology or surgery or anesthesiology!
But the system is broken. Patients and doctors alike feel robbed of the time we actually need to foster a strong patient-doctor relationship to support trust and patient-centered longitudinal medical decision-making.
So if you are sensing your doctor isn't interested in you as a person, I'd wonder two things: 1) if he/she is simply burned out and feeling morally injured by a system that places more value on prescriptions and testing than time with patients, or 2) that person maybe didn't pick the right profession .. such that you might try someone else.
Two other points: One of the reasons I wrote this post is the very issue you brought up - even the most well intentioned doctors don't have time. So instead of waiting for them to ask you about your social determinants of health, I'm suggesting you bring them with you - in writing or in short form when you next talk.
Secondly, the mere act of contemplating some of these prompts on your own can help generate insight and self awareness which can then lead to a more robust conversation with your doctor next time ... even if you don't get asked that particular question in the doctor's office.
Thanks for your great thoughts and for engaging with this post!
Thanks for the thoughtful reply. I agree that most doctors want to develop that relationship and are truly interested, but are unable to focus their attention on it due to time.
Unfortunately, many patients don't understand this and aren't equipped with the information or knowledge or even confidence to come forward and advocate for a better relationship. This is why it's helpful to have SDOH screenings or other forms which ignite the dialogue, as opposed to putting the responsibility on the patient.
That being said, I have definitely brought issues to my doctor and pushed for better dialogue, so I know it's possible. I just hope that eventually the system will be set up in a better way so patients don't have to do it as they do now.
Thank you for the thoughtful discussion and addressing this!
Three months ago I left Raleigh North Carolina, moving to Richmond Virginia to be closer to my daughter. During the last visit with my primary we talked of the progress over the thirteen years I had seen him.
He took the time to ask the important questions and advocated for my rights as a patient, never once showing anything but respect for decisions we made together. Always answering MyChart questions, there was never a topic left unresolved.
He spoke often with my cardiologist who worked at a different hospital, their care for me as a person not a patient was apparent from their hand shakes at every appointment to the smiles as I left.
At my last appointment he said he would see me in 24 years to celebrate my 100th birthday. I told him that I'd cook the meal and he would have to bring a 36 year old Macallan. We hugged before saying good bye.
What many of us realize is compassion, sympathy and empathy are the hallmarks of great doctors. Few of us express thanks to those who listen and truly care for us. You care for those who come to you, no one could ask for more.
The article I published yesterday talks about how the financial drivers of healthcare delivery are undermining physical and mental health: of physicians as well as the public.
Data has shown that doctors stop listening at 11 seconds to redirect patients and cover what they need to cover in order to be paid by insurance companies. Direct Primary Care is an outstanding alternative and much more affordable than most people think.
I’d be happy to collaborate with you on these topics.
Exactly a year ago I became a new patient with a woman who is my primary care provider (my former doc who I had a long relationship with retired). We had a "get to know each other appointment" and I have to say, she was very thorough. I liken her and any other primary care provider as the "quarterback" of the health care team. All the other players and coaches, of which there are many (specialists, surgeons, lab techs, etc.) also include my cohort of friends and acquaintances. To me, this latter group of laypeople, are extremely important in terms of comparing notes, getting feedback, good (and bad ) reviews on certain doctors, procedures, tests, surgeries, etc. and making good, informed decisions about one's health care. There is an overabundance of information and disinformation on the internet promoting this pill or that supplement for all the various ills and illnesses, aches and pains and God knows what else. All I can say is "Caveat Emptor". So much of this is snake oil stuff. A waste of money. I really think that it boils down to the trust you have in your primary care provider and her immediate team (nurse, PA, nurse practitioner). As a patient, be pro active in your health care. Be your own best advocate.
Aiming high toward your suggestions and goals might just allow us to get a little closer to this medical/health Nirvana and that would be a substantial improvement. Poco a poco se va lejos, little by little one goes far. Frankly, the utopian situation that you speak of maya be available with some consierge physicians but,unfortunately, there is no time or money sufficient to make it happen across our system. I am currently in treatment for metastatic breast cancer to the ribs and have a whole cadre of very good and talented caring physicians working with me. Only one comes close to your almost unattainable target and I have known him for 20 years. It takes lots of time, caring,determination,trust an a mutually appreciative and respectful attitude as well as luck to get to that almost perfect place in holistic health care. Bless you for knowing it, wanting it for everyone and sharing. You're always an inspiration, Dr. McBride.
Great! It would be impossible to cram this all in in a single visit.. sometimes it takes a lifetime to tell our story and to be heard :) .. but one step at a time
I feel so lucky to have found a family practitioner that listens to me and acknowledges my concerns, especially as I was dealing with Long Covid this past year. The fact that I’m registered nurse helps too because I understand the limitations of the system and I know the challenges that healthcare providers have these days. I remember when my old family doctor used to call us at the end of the day to follow up on labs and such, since my parents, children and us all went to him. It was so helpful to have conversations about all of us, but those days are gone now with MyChart use and the even more challenging time constraints of being a healthcare provider.
Three months ago I left Raleigh North Carolina, moving to Richmond Virginia to be closer to my daughter. During the last visit with my primary we talked of the progress over the thirteen years I had seen him.
He took the time to ask the important questions and advocated for my rights as a patient, never once showing anything but respect for decisions we made together. Always answering MyChart questions, there was never a topic left unresolved.
He spoke often with my cardiologist who worked at a different hospital, their care for me as a person not a patient was apparent from their hand shakes at every appointment to the smiles as I left.
At my last appointment he said he would see me in 24 years to celebrate my 100th birthday. I told him that I'd cook the meal and he would have to bring a 36 year old Macallan. We hugged before saying good bye.
The article I published yesterday talks about how the financial drivers of healthcare delivery are undermining physical and mental health: of physicians as well as the public.
Data has shown that doctors stop listening at 11 seconds to redirect patients and cover what they need to cover in order to be paid by insurance companies. Direct Primary Care is an outstanding alternative and much more affordable than most people think.
I’d be happy to collaborate with you on these topics.
While I agree with this— providers should know more about their patients, especially as it relates to social drivers of health, in order to provide the best care, but how would you go about having these conversations if your doctor isn’t asking you questions, is short on time, and doesn’t seem interested in getting to know you as an individual?
This type of dialogue is just not realistic for most patients within the healthcare system that exists today.
I go to an ObGyn office where all the doctors know my mother (a former RN), and I know this fact alone has afforded me better care than other patients, but even still, I have had my concerns dismissed, I have had to advocate for myself and my health, and I have felt overlooked.
I think we have a long way to go, but my hope is that we will continue to change the structure that prevents providers from spending quality time with patients and build more reliable systems and processes that support personalized, holistic care.
I hear you loud and clear, however I *do* think this kind of dialogue - of course in smaller chunks and over an extended period of time - is possible but *if and only if* you find a primary care provider who is interested in the relationship part, too.
I truly believe that physicians in the field of primary care (that is: general internal medicine, OBGYN, family medicine, general pediatrics) went into this particular area for the distinct reason that we care about the whole person. Otherwise we would have chosen radiology or surgery or anesthesiology!
But the system is broken. Patients and doctors alike feel robbed of the time we actually need to foster a strong patient-doctor relationship to support trust and patient-centered longitudinal medical decision-making.
So if you are sensing your doctor isn't interested in you as a person, I'd wonder two things: 1) if he/she is simply burned out and feeling morally injured by a system that places more value on prescriptions and testing than time with patients, or 2) that person maybe didn't pick the right profession .. such that you might try someone else.
Food for thought!
Two other points: One of the reasons I wrote this post is the very issue you brought up - even the most well intentioned doctors don't have time. So instead of waiting for them to ask you about your social determinants of health, I'm suggesting you bring them with you - in writing or in short form when you next talk.
Secondly, the mere act of contemplating some of these prompts on your own can help generate insight and self awareness which can then lead to a more robust conversation with your doctor next time ... even if you don't get asked that particular question in the doctor's office.
Thanks for your great thoughts and for engaging with this post!
Thanks for the thoughtful reply. I agree that most doctors want to develop that relationship and are truly interested, but are unable to focus their attention on it due to time.
Unfortunately, many patients don't understand this and aren't equipped with the information or knowledge or even confidence to come forward and advocate for a better relationship. This is why it's helpful to have SDOH screenings or other forms which ignite the dialogue, as opposed to putting the responsibility on the patient.
That being said, I have definitely brought issues to my doctor and pushed for better dialogue, so I know it's possible. I just hope that eventually the system will be set up in a better way so patients don't have to do it as they do now.
Thank you for the thoughtful discussion and addressing this!
Appreciate your comment, to learn how to earn weekly Write to @Lennystradingplatform
On 𝘁𝗲𝗹𝗲𝗴𝗿𝗮𝗺 tell her I sent 📤 you
Three months ago I left Raleigh North Carolina, moving to Richmond Virginia to be closer to my daughter. During the last visit with my primary we talked of the progress over the thirteen years I had seen him.
He took the time to ask the important questions and advocated for my rights as a patient, never once showing anything but respect for decisions we made together. Always answering MyChart questions, there was never a topic left unresolved.
He spoke often with my cardiologist who worked at a different hospital, their care for me as a person not a patient was apparent from their hand shakes at every appointment to the smiles as I left.
At my last appointment he said he would see me in 24 years to celebrate my 100th birthday. I told him that I'd cook the meal and he would have to bring a 36 year old Macallan. We hugged before saying good bye.
Your writing is heartfelt and you are a gift.
I love this.
Thank you.
What many of us realize is compassion, sympathy and empathy are the hallmarks of great doctors. Few of us express thanks to those who listen and truly care for us. You care for those who come to you, no one could ask for more.
❤️
The article I published yesterday talks about how the financial drivers of healthcare delivery are undermining physical and mental health: of physicians as well as the public.
Data has shown that doctors stop listening at 11 seconds to redirect patients and cover what they need to cover in order to be paid by insurance companies. Direct Primary Care is an outstanding alternative and much more affordable than most people think.
I’d be happy to collaborate with you on these topics.
Appreciate your comment, to learn how to earn weekly Write to @Lennystradingplatform
On 𝘁𝗲𝗹𝗲𝗴𝗿𝗮𝗺 tell her I sent 📤 you
Exactly a year ago I became a new patient with a woman who is my primary care provider (my former doc who I had a long relationship with retired). We had a "get to know each other appointment" and I have to say, she was very thorough. I liken her and any other primary care provider as the "quarterback" of the health care team. All the other players and coaches, of which there are many (specialists, surgeons, lab techs, etc.) also include my cohort of friends and acquaintances. To me, this latter group of laypeople, are extremely important in terms of comparing notes, getting feedback, good (and bad ) reviews on certain doctors, procedures, tests, surgeries, etc. and making good, informed decisions about one's health care. There is an overabundance of information and disinformation on the internet promoting this pill or that supplement for all the various ills and illnesses, aches and pains and God knows what else. All I can say is "Caveat Emptor". So much of this is snake oil stuff. A waste of money. I really think that it boils down to the trust you have in your primary care provider and her immediate team (nurse, PA, nurse practitioner). As a patient, be pro active in your health care. Be your own best advocate.
I completely agree, Ken. Being your own advocate is so important; we also need trust in those who care for us :)
Appreciate your comment, to learn how to earn weekly Write to @Lennystradingplatform
On 𝘁𝗲𝗹𝗲𝗴𝗿𝗮𝗺 tell her I sent 📤 you
Aiming high toward your suggestions and goals might just allow us to get a little closer to this medical/health Nirvana and that would be a substantial improvement. Poco a poco se va lejos, little by little one goes far. Frankly, the utopian situation that you speak of maya be available with some consierge physicians but,unfortunately, there is no time or money sufficient to make it happen across our system. I am currently in treatment for metastatic breast cancer to the ribs and have a whole cadre of very good and talented caring physicians working with me. Only one comes close to your almost unattainable target and I have known him for 20 years. It takes lots of time, caring,determination,trust an a mutually appreciative and respectful attitude as well as luck to get to that almost perfect place in holistic health care. Bless you for knowing it, wanting it for everyone and sharing. You're always an inspiration, Dr. McBride.
Appreciate your comment, to learn how to earn weekly Write to @Lennystradingplatform
On 𝘁𝗲𝗹𝗲𝗴𝗿𝗮𝗺 tell her I sent 📤 you
I hope all of this is in your upcoming book. Brilliant! ❤️
Thank you for this, Dr. McBride! I’ll be making a list for my next visit to my PCP’s nurse practitioner.
Great! It would be impossible to cram this all in in a single visit.. sometimes it takes a lifetime to tell our story and to be heard :) .. but one step at a time
Appreciate your comment, to learn how to earn weekly Write to @Lennystradingplatform
On 𝘁𝗲𝗹𝗲𝗴𝗿𝗮𝗺 tell her I sent 📤 you
I feel so lucky to have found a family practitioner that listens to me and acknowledges my concerns, especially as I was dealing with Long Covid this past year. The fact that I’m registered nurse helps too because I understand the limitations of the system and I know the challenges that healthcare providers have these days. I remember when my old family doctor used to call us at the end of the day to follow up on labs and such, since my parents, children and us all went to him. It was so helpful to have conversations about all of us, but those days are gone now with MyChart use and the even more challenging time constraints of being a healthcare provider.
Three months ago I left Raleigh North Carolina, moving to Richmond Virginia to be closer to my daughter. During the last visit with my primary we talked of the progress over the thirteen years I had seen him.
He took the time to ask the important questions and advocated for my rights as a patient, never once showing anything but respect for decisions we made together. Always answering MyChart questions, there was never a topic left unresolved.
He spoke often with my cardiologist who worked at a different hospital, their care for me as a person not a patient was apparent from their hand shakes at every appointment to the smiles as I left.
At my last appointment he said he would see me in 24 years to celebrate my 100th birthday. I told him that I'd cook the meal and he would have to bring a 36 year old Macallan. We hugged before saying good bye.
Your writing is heartfelt and you are a gift.
The article I published yesterday talks about how the financial drivers of healthcare delivery are undermining physical and mental health: of physicians as well as the public.
Data has shown that doctors stop listening at 11 seconds to redirect patients and cover what they need to cover in order to be paid by insurance companies. Direct Primary Care is an outstanding alternative and much more affordable than most people think.
I’d be happy to collaborate with you on these topics.