When Trust Is Lost – Part II in a series on Healing

Welcome back!  Last week we started a month long discussion on the Doctor/Patient relationship, facilitated by Dr. Deb Roman.
This week’s response to her blog comes from Jan Guttormsen.  Jan makes many good points in her blog, and I would bet most of  you can, and will, relate.  Feel free to leave your OWN comments below in answer to Dr. Roman’s question at the end.
We have a blog sponsor for the next six weeks, Drs. Joan and John Takacs!  For more information on their practice and techniques, click on the ad and it will take you directly to their web page.  If you’ve been in a motor vehicle accident, experienced an on the job injury, or just don’t “feel right”, give them a call!  You will find the ad in between Jan’s blog and the Doctor’s response.  

And now, please welcome Jan Guttormsen, this week’s community blogger:

Once upon a time, we used to have one doctor, a general practitioner.  The doctor knew everything about our health issues, and often had been the trusted “family doctor” for years.  Women often had two doctors, a GP (General Practitioner), and an OB/GYN (Obstetrician and Gynecologist). These doctors, for the most part, treated all our health issues, with rare exceptions.  They ordered the tests, reviewed the results, consulted with other doctors if need be, and created a treatment plan.  Folks pretty much paid as they were treated.  There were not many who had “comprehensive health insurance”, although many carried “hospital coverage”.   

Zoom ahead and we find the medical industry starting to explode.  Doctors were finding there was so very much to know about how our bodies work, and incredible research was uncovering an incomprehensible amount of knowledge and information.  So much so, that it became impossible for one doctor, to know everything.  Enter, the “ists” (cardiologist, gastroenterologist, oncologist, etc.) and the hundreds of other classes of specialists. 

Slowly, the family doctor was relegated to a clearing house employee.  They write prescriptions and order tests.  If something shows up on a test, they refer the patient to a specialist.  The consultations between specialists and/or the PCP (primary care physician) do not seem to happen often.  The left hand doesn’t know what the right hand is doing the majority of the time. 

Now, the family doctor, who could be an MD or a physician’s assistant (PA), receives “points” for recommending that we have a flu, shingles, or whooping cough shot, or a PAP, or mammogram.  The points increase the doctor’s or PA’s salary.  I find this particularly offensive.  My PA wanted to know why I refused all the inoculations.  After I explained my reasons, I asked her, “Why do you think I should have them.”   Her response was to explain the “point” system.  Her recommendations were not based on my health needs, but rather on the points.  Result…I don’t trust her now.

My mom was in the hospital following a serious heart attack, followed by surgery to put in stents.  Her medications had been changed and some new drugs introduced.  Suddenly Mom was in a semi-comatose state.  We were all very alarmed by this sudden change.  Dad would leave during the day for several hours, to go home, and research the drug interactions.  He finally approached the doctor and requested she be taken off one drug.  The doctor refused at first, stating she needed to be on it, and that wasn’t the cause of her state.  We were told by the doctor in charge of the wing, that Mom had a “failure to thrive” diagnosis.  We KNEW that could not possibly be true. Dad was relentless about taking her off the drug, and the doctor finally gave in to his demands.  The next day, Mom was sitting up in bed, talking, eating…she was back!  Result…I don’t trust doctors.

A close friend of mine was having issues with high blood pressure, and was seeing her long time doctor.  After eventually finding a drug that took care of the problem, she went for more than a year without seeing him.  She began having symptoms, and I asked her if her doctor was checking her potassium levels periodically.  He had not told her it needed to be done, had not scheduled bloodwork, or done any follow up.  At my suggestion, she called to question this, and was basically told he had dropped the ball on that and she needed to get in right away.  Result…she doesn’t trust him now.

Another piece of this puzzle lies with the health insurance companies.  We have allowed them and pharmaceutical companies far too much power over our health care.  Our doctor, alone, does not decide what treatments or tests are needed.  Health insurance companies now have the ability to allow, or deny treatment.  If the doctor feels an MRI is in order, the insurance company can overrule the physician and refuse to pay for it.  There are so many good doctors that are leaving their profession by retiring early, or just leaving their practice.  They are no longer allowed to treat their patients so they are walking away.  DO’s are being hired by companies like Providence to work in their clinics, yet they are not allowed to treat their patients with the skills and knowledge they have spent years obtaining.  They are restricted with regard to what they can and cannot do. 

The NW Osteopathic Medical Foundation is clearly aware of the problems inherent in providing medical care.  They are working to sponsor and assist young doctors in opening private practices, where they can treat their patients using all their skills.  It gives me hope that somewhere down the road, we might have access to quality medical care, without the influence of the insurance companies.  I applaud their efforts!

Times have changed, and we must change too.  We no longer have the doctor/patient relationships we had in the past.  This is not to say we cannot like our medical providers, many are very personable.  But, we must be aware of our bodies and our own health.  We must advocate for ourselves and others close to us with regard to care and treatment.  If it doesn’t “feel” right, or sound right, listen.  We must be proactive, we must gather information from the doctor, we must question, question, question and we must do our own research into health issues that are specific to us, and our loved ones. 

We must look beyond western medicine and into natural remedies and treatments.  When the doctors throw up their hands and say, “There is nothing more that can be done”, all that means is that the medical community has no answers.  But that does not mean there is not an answer somewhere else.  The computer age has linked us together in ways we never imagined.  We have access to information, online groups, and websites that contain a wealth of information. There are so many people at our fingertips who can share experiences, situations, and information.

Knowledge is power. We must be in charge of our doctor/patient relationship.…or we shall be at their mercy. 

  Here is the response to Jan’s blog from our guest DO, Dr. Deb Roman:

Hello Jan,

Thank you for sharing your experiences and insights. You address so many important points. 

I agree that communication and collaboration are integral to high quality, compassionate healthcare.

When I worked as a primary care family physician, I frequently spoke directly with specialists in an effort to provide integrated care to patients.  Often, while still in the treatment or hospital room with a patient, I would pick up the phone and call a specialist to share details about the patient’s situation and ask for input. By doing so, I could share the discussion with the patient at the time of the visit – and the patient, specialist and I could work together to identify ways to enhance health.

While it is more difficult to do so now, many of my colleagues and I still try to connect directly when possible.  In addition, many medical schools and healthcare organizations are highlighting the importance of communication and collaboration. I am hopeful that with attention, this will become common practice again.

From your perspective, in light of the many challenges in healthcare, how do we strengthen the relationship between physicians and patients and re-establish trust?

About Deb Roman:
Deb Sheinbach Roman, D.O. www.finding-health.com Dr. Deb Roman has worked as a family physician in clinical medicine for over 30 years – with a focus on enhancing the body’s inherent ability to heal and express health. As a Board Certified Family Physician, she offers integrative medicine consultations and hands-on osteopathic medicine to individuals of all ages. She integrates advanced training in nutrition, mindful practice, biodynamic osteopathy and integrative medicine into her work. She is an Adjunct Clinical Assistant Professor in the Department of Clinical Medicine at the Pacific Northwest University of Health Sciences, teaches classes on osteopathic principles and practice, and mentors medical school students and residents. Dr. Roman also serves as the Director of Physician Wellness and Chair of Continuing Medical Education for the Idaho Osteopathic Physicians Association. She is the Founder of Rediscovering Meaning In Our Work – a consulting and educational program with a focus on the well being of physicians and medical school students. She teaches workshops, organizes retreat-like conferences, offers presentations, provides consultations to individuals and organizations, and facilitates a monthly physician discussion group. The next Rediscovering Meaning In Our Work conference for physicians is scheduled for September 28-29, 2018 in Boise: finding-health.com/2018conference. Dr. Roman offers Meaningful Work physician to physician consultations. She contributes as a speaker to medical conferences nationwide, exploring ways to enhance physician health and well being and facilitating interactive discussions on the science of mindful practice and the cultivation of compassion in healthcare.