This unhealthy dependency relationship some pts have w/ the Doctors needs to stop!

onetiredmomma · Apr 27, 2010

With the older population (70+) they are of the mindset that the Dr knows what to do and you don't question him/her. When I did home care many pts had no idea what meds they took or why. "Doc said I need it so I guess I do". Not sure why the younger set is not taking responsibility for themselves. Good job of trying to educate them.

**canoehead, BSN, RN** · Apr 27, 2010

For my grandmother her doctor's appointment was a social occasion she looked forward to/obsessed over all week. She went for the sake of going, and the health issues were really secondary.

brownbook · Apr 27, 2010

It is very frustrating. I doubt if it would do much good but maybe have signs posted in the lobby and pt. rooms, simple (6th grade level), how to be a better patient, know why you are seeing the doctor, ask what any medicine is for, ask why the doctor wants to see you again, etc.

TDCHIM · Apr 27, 2010

There are also those doctors who take it as a mortal insult if you question them about anything. I don't have any now but I had one of them as a GP for a while about ten years ago. I switched away quickly.

Some people, even those in their 20s and 30s, still see a physician as an authority figure not to be questioned (I know a few). Not a lot, I'll grant; it's far more common among those in their 60s and 70s. There are also those who are dependent on the doctor for controlled medications to handle chronic pain or ADHD who will do whatever s/he says, whether they understand it or not, to keep from jeopardizing that supply. A recheck appointment under those circumstances doesn't necessarily have a real, explained purpose (other than maybe refills, if needed) to the patient; it's just part of the required deal.

But it's still silly not to have a clue as to why you're there (again, unless there are memory impairment issues involved).

maxthecat · Apr 27, 2010

Many doctors see patients for recheck appointments and won't reorder prescriptions unless they see the patient every 3 to 6 months. They may just say "Everything looks OK, I'll see you again in 6 months." Patients may not know what to say other than "the doctor just said he wanted to see me" when questioned at the recheck. However, when the return appointment is made, the reason for the appointment is supposed to be listed. Can't you just refer to that and then inform the patient, "the record says you're supposed to be here for a med check?" I mean, you could question the patient and emphasize their need to be informed, but many of them are going to take that as being "scolded" by the nurse and probably won't change their behaviors anyway. As nurses we're used to questioning physicians when they are not clear, but many of the general public are not, and some physicians make it clear they don't want to be questioned, as we know all too well!

bookwormom · Apr 27, 2010

It is also possible that the patient really only wants to share their information with the physician.

dudette10, MSN, RN · Apr 27, 2010

I do all the healthcare arrangements for a family member of mine, and I do ask. I haven't yet received a response other than something to the effect of "to check up on the health status," which is translated into, "He said she needs to come in," when interrogated by anyone in the doctor's office.

Maybe docs have an unhealthy dependency on insurance payments charged for 5-minute visits that only end up with a refill of prescriptions she already has.

Then, you always have the visits by normally healthy people like me or my children where you give the reason when you make the appointment, at the reception desk when you arrive, to the med tech or nurse who takes your vitals, and then again to the doctor when he or she comes in. It could become a fun little game, if you think about it. Just give a fake, different reason to each person except the doc and see what happens! :yawn:

mamamerlee, LPN · Apr 27, 2010

I think you are making too much of this. 'Because the doc wanted to see me again' is easily interpreted as a follow-up visit, routine for a med change or to check pt's progress. What's the big deal here?

These people are being responsible - they were told another visit was necessary, the appt was made, and they arrived fot the appt. What more do you really want?!!! Just because they do not say 'well, one of my prescriptions was changed and the doc wanted to see if it made a difference' does not make them difficult or ignorant.

You are being a bit too sensitive - these are ordinary people who are doing the right thing. And maybe you are a bit biased because you are in the healthcare field. Just write down "routine follow-up" instead of giving everyone the 3rd degree!

brillohead, ADN, RN · Apr 27, 2010

I had a gastroenterologist once who, after having done a gazillion different tests over the course of several months, told me that there was nothing wrong with me, I needed to be on tranquilizers, and I needed to see a psychiatrist. He followed that up with, "Did you want to come in and see me in three months for a follow-up?"

Why the heck would I want to do that? It was pretty obvious that he only saw me as a way to bill $90 for a two-minute appt.

(Incidentally, when I got my actual diagnosis two years later from a different specialist, he fell all over himself trying to backtrack on his original "diagnosis".)

I honestly think a lot of doctors just want to guarantee their revenue stream. They get to charge just as much for a "wellness check" as they do for a sick call, and wellness checks are a heck of a lot easier/faster/cleaner. Yeah, the same thing could get accomplished by having the nurse call the patient and ask about their symptoms over the phone, but then the doctor wouldn't get to bill for his/her services. :rolleyes:

dudette10, MSN, RN · Apr 27, 2010

For my grandmother her doctor's appointment was a social occasion she looked forward to/obsessed over all week. She went for the sake of going, and the health issues were really secondary.

Oh, this is so true. When I was sitting in the doctor's office, waiting for the pre-scheduled appointment my aforementioned relative had, I saw this in action.

An older woman with two of her grown children made an unscheduled visit for a problem that I can't remember. Anyway, the nurse told her that she would have to wait about three hours because they had a full schedule. As her children tried to talk her out if it (of course!), she insisted that she wanted to see him anyway and would wait. You bet your butt that her children had their cell phones out within seconds, calling other siblings (I think there were eight kids in all!) to take turns with Mamma! :lol2:

roser13, ASN, RN · Apr 27, 2010

"I think you are making too much of this."

I absolutely disagree with this statement. OP is dead on.

I spend the majority of my work week questioning adults on their medical history. I often wonder how some so-called adults have managed to survive thus far, as cavalier as they are about their knowledge (or lack thereof) of their own bodies and medical history. If they're as clueless in other aspects of their lives, god help them.

There is usually an "enabler" (almost always a wife or daughter) who keeps track of the clueless one's medical history, but not always.

It is possible that those Americans who are lucky enough to be covered by health insurance/Medicare/Medicaid have simply become used to the 10% copay. Or the 0% co-pay, in some cases. When it costs you very little to see the doctor, why not just go with the flow? We have come a long way from the days where a family member rode on horseback in the night to fetch the county doctor, and paid him in chickens.