Wednesday, February 11, 2009

Caregiving when doctors dislike you (Duke Medical)

I have never done the formal research. But, based on my extensive experience as a patient and patient's advocate, "I know what I know."

Like all human beings, physicians and surgeons have personal feelings and impressions of other people. When those "other people" are the physicians' patients, then the resultant medical care could be either tremendous or horrible.

I firmly believe that a physician or surgeon's personal feelings about a patient will dictate the availability of the doctor and the quality of medical care.

The reasons why a physician may like or dislike a patient are as diverse as in "real life."

(1) The patient may have an unpleasant personality;
(2) The patient may ask too many questions;
(3) The patient may be unattractive.

I have experienced "angry doctors" when I advocate for my dad. I accept when my advocacy for dad results in physicians and surgeons effectively dumping me as a patient. For example:

(1) Duke Medical orthopedics (Dr. Alison Toth) and even a terrific surgeon that I like and who treats my dad (Dr. Mark Easley) will not treat me. Regardless of the fact that I have expressed my physical limitations and extreme pain, Duke Medical orthopedics has no intention of helping me;

(2) My dermatologist and primary care physician (at Northwestern University) have recommended that I be seen by a vascular doctor because of the damage in my leg. I have asked Duke Medical whether I could be seen by a vascular doctor and my request has literally been ignored. Duke Medical has no intention of allowing me to be evaluated by a vascular doctor.

Since my dad is a priority, I am frustrated but not traumatized by Duke Medical's abandonment of me as a patient.

I do get upset when my strong advocacy on behalf of dad causes Duke Medical physicians to abandon him. For example:

(1) Dad falls in a Duke hospital room. He is found by Duke hospital staff. Dad was admitted with a subdural hematoma.

After the fall, I asked that dad be evaluated by a neurologist. The Duke nurses told me that there is only one neurologist at Duke Medical and that doctor is occupied with "important cases." Within hours, dad was discharged and no physician would provide us with discharge paperwork.

(2) I was giving dad antibiotics through his chest port. The nurse at Duke Medical Infectious Disease placed a needle in the port with tubing that was so long that it tucked into his pants. One day, when dad tucked his shirt into his pants, the needle came out.

I spoke with the Infectious Disease Fellow and she said that I should take dad to the Duke ED. I followed the instructions and took dad to the Duke ED on the next day (a Monday). I waited for a long time with dad and no one was attending to dad. All dad needed was a needle placed into his port. Dad is very sick and frail. An ED was not a great place for him. The Infectious Disease Fellow did not contact the ED. So the ED did not know what to do.

After a period of time, I decided to take dad to the Infectious Disease Clinic where (on Mondays) patients do not need an appointment to have needles inserted. Initially the Infectious Disease Clinic said they would help dad. Then, after an extended period of time, the Infectious Disease Clinic Medical Director (Dr. Eric Stout) told me that we had to go back to the ED "because dad did not have an appointment."

(Dr. Eric Stout was dishonest thereafter and insisted that dad could not be helped because the port site was red and there was no one available at the clinic to assess the area.) Umm,

#1 - Dr. Eric Stout never said that to us. And in fact, I took dad to the chemo treatment area and despite the fact that dad had not been there for many months, the nurses pushed in the needle with absolutely no mention of the area being red.

#2 - After dad and I were kicked out of the Clinic by Dr. Eric Stout, dad's actual Infectious Disease doctor entered the room. That doctor could have assessed the site if indeed that was a concern.

The bottom line is that since dad was kicked out of the Infectious Disease Clinic, no one has examined dad's wound site or drawn blood to determine whether the infectious still exists. It has been months. I have told both the Duke Infectious Disease and orthopedic doctors that the wound area appears to be infected to me. I get no response.

It is one thing for Duke physicians and surgeons (Infectious Disease and orthopedic) to refuse to treat me because they dislike me. But I think it is unconscionable for Duke Medical to provide poor medical treatment and ignore my dad because the doctors dislike me.

My dad is absolutely nothing but pleasant, respectful and gracious to all medical personnel.

Shame on Duke Medical.

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