Diagnosing Doctors

Beth and I have met our share of doctors over the year+ that MG's health has been a question. I have decided that there are four "types" of doctors:
1) doctors with great technical skills and great bedside manner
2) doctors with great technical skills and lousy bedside manner
3) doctors with lousy technical skills and great bedside manner
4) doctors with lousy technical skills and lousy bedside manner

Obviously, 1 is the best; get one of those, you're golden. Counterintuitively, 3 is better to have than 2, which I will explain in a second. 4 is a bad, bad situation.

I put a great value on doctors who have a bedside manner, or what might also be labeled "basic communication skills." Does a doctor speak with you, or at you? Do they listen to your thoughts and intuitions and value them; or do they only ask condescendingly, knowing that they have been advised to ask the patient such questions, even as they impatiently wait for you to stop your yammering so that they can tell you what they've already decided to do? I don't exaggerate here. About 1 of every 2 doctors actually cares about the patient/parent's perspective.

Bedside manner, to me, is more important than technical skill in doctoring. Why? Because 70% of medical care is diagnosing the problem correctly--and we've learned from Margaret that many health problems are so subtle in their symptoms and due to interrelated bodily systems, that if you're not engaged in dialogue with the patient, you're not going to get the diagnosis right. A doctor who does not listen is no better that a refrigerator repairman--a "fixer" (see below).

The next 25% of good medical care is getting the patient to buy into your diagnosis and work with you toward a cure. Can we--do we--trust our doctor? Do we believe that they've sized up the situation well? Have they consulted every necessary colleague? If I buy the diagnosis, it's because I trust the method by which it was made. My trust depends on a doctor's demonstrated intelligence, imagination, and care and concern. If I trust the doctor, I will participate in the treatment plan.

The last 5% of doctoring well (IMHO) is "fixing" the problem (ie, surgery, medicine, etc.). Unfortunately, many of the docs we've met along the way are fascinated by the 5% and not so keen on the other 95%. They want to come in to the bedside, get a <5min diagnosis that leads to an actionable step for them. A lot of docs are "fixers." They like to fix things--do the procedure, prescribe the medicine. But I believe you can't fix a person's health unless you engage the whole person. And most of a person is between the ears.

Find a doctor who listens, and that person is more than a doctor--they're a healer.

Of course, doctors can't bill the insurer for time spent listening.

Any (medical) doctors reading this? Let me know. Lest this sound too negative, we've had the privilege of meeting many, marvelous doctors who have cared for MG along our journey. For them (and, OK, for the crappy ones who tried their best, too), we are very grateful.