When Patients Act Inappropriately

January 24, 2011

Last week, I talked about patients who do not tell the truth, the whole truth, and nothing but the truth, and how that impacts their care. Today, I’d like to talk about other behavior that can be deemed unacceptable, annoying or just plain freaky.

Last week, I talked about patients who do not tell the truth, the whole truth, and nothing but the truth, and how that impacts their care. Today, I’d like to talk about other behavior that can be deemed unacceptable, annoying or just plain freaky.

The other day, my associate saw a patient for the first time, who at the end of the visit asked if from now on he could see Dr. Young (me). Now, as with all other patients who ask if they can switch between us, he had already been told that it is the practice’s policy that, except under emergency situations, patients “belong” to one doctor or the other, and there is no switching back and forth. She asked him if he had a problem or was dissatisfied with his care or his visit. He said no, but he wants to see Dr. Young. Oh, and isn’t Dr. Young a man?

Well, he was remained of the practice’s policy and informed that, no, I am not a man. He said he would rather see the male doctor in the practice. Well, hello? There is no man in our office, and even if there were, it wasn’t going to happen. Of course, we were both offended. He insisted that his primary-care physician referred him to me and therefore he had to see me, and aren’t I a man? I’m not sure what part of “there are only two physicians here and both are female” he didn’t understand. At the end of it all, my associate, just finally said, “I don’t want to see you anymore either.”

Yesterday, I had a patient who made some comments that made me very uncomfortable. I was giving him some advice, and he said, “yes, my wife told me that, too, but it’s kind of annoying coming from her.” I responded by saying, “well, it’s always different when advice comes from a spouse or a family member, as opposed to a physician.” Then he said, “well, when you or my primary tell me, both of you being beautiful Asian women (note that his wife is Asian, too), I don’t mind so much.” I ignored his statement and continued to give him advice. Later, as I brushed a lock of hair off my face, he said, “Could you just put you hair back where it was?” It took every ounce of energy I had to keep from saying “you freaking weirdo” after saying, “No, I cannot.”

I’ve had patients in the past make racist comments about staff and other people in general. I’ve had people try to start political debate. I’ve had people make what I feel are inappropriate comments about certain religions. Do they have the right to do so? Absolutely. Is my office the appropriate place? I’d say no. Most of the time, I ignore it. Unless what they say has impact on their endocrine disorder, I let them wallow in their ignorance.

We are not supposed to let personal feeling interfere with our clinical judgment. We are to be objective. We are to do what we feel is in our patient’s best interest. And we strive to do that everyday. But sometimes, it takes a lot more extra effort.