So-Called “Patient-Centered” M.D. & the Worst Medical Appointment of My Life
Having such severe and varied symptoms as I have had for so many years means I’ve seen A LOT of doctors. Most have been compassionate, knowledgeable and kind, with a few appalling exceptions. Yesterday’s was far worse one ever. Ironic, given that this is the first M.D. I’ve seen who specializes in functional medicine, a patient-centered approach that considers the whole person by spending time with and listening to the patient, according to the Institute of Functional Medicine.
Sounds great, right? Except that she seemed to have missed the memo. She explained that has an M.D. and practiced as a gastroenterologist for 30 years, but got into to functional medicine to consider the physical, psychological and spiritual aspects of patients, including their “roots and soil.” She then interrupted me non-stop and got aggressive and angry. A handful of examples:
- She’d ask questions then cut into my response almost immediately to explain why what I was telling her (about my own life and experience) was wrong or inaccurate.
- When I misunderstood a question, she let me answer for a minute, then barked, “That’s not what I asked.”
- I tried to clarify a statement. She cut me off and said my response “didn’t matter.”
- She told me she would not call what I have migraine, that I have headaches. (I’m not too picky about whether the attacks are called migraines or headaches, since that’s the terminology that specialists and researchers use, but I’ve never had someone refuse to acknowledge migraine at all.)
- The dietary discussions were all either her saying, “Really????” when I mentioned a trigger or telling me I had to stop eating something and that I should try the alternatives. I’d list all the alternatives that have been triggers and she’d say, “Really????” There was no input, no guidance, no connections, just disbelief.
- She was 70 minutes late to start the appointment. At the end, she handed me off to the person who could give me prices for tests and told her, “These are the tests I want ordered. There’s no dietary plan or supplements because she’s too sensitive.” Then she left. No “It was nice to meet you” or “We’ll try to figure this out” or even “Thank you.”
As galling as all those examples are, it gets way worse.
The main assessment: I have migraine because of a psychological block from my childhood and I need to do some deep emotional work. When I mentioned the great work I’ve done with my therapist in the last year, she said that if my therapist were going deep enough, my migraine frequency would have declined. (That’s the only time she said migraine instead of headache.) The solution? To journal at home. With my non-dominant hand.
She pleasantly explained that she’d read all the ingredients in a supplement aloud and I should tell her if I’d reacted to anything that was in it. She got through one list and, when I said quercetin had triggered migraine attacks in the past, she said, “If you can’t take this [supplement], then I have no idea what I can do for you.” Later, she sighed and said, reluctantly, “We’ll see what we can do for you.”
Then she told me about the tests that she’d need to do to figure out what was wrong with me. Although the office doesn’t take insurance, she asked what my health insurance company is. “That’s terrible,” she said. “If you’d had X or X, they’d reimburse for these tests, but your company doesn’t.” Then she said that the most helpful test she wanted to do was $2,000, but she wouldn’t order it because of the cost. The other tests she wanted me to do totaled $2,228.63. I’ve looked into the recommended tests. They all claim to gather tons and tons of seemingly useful data (a seductive prospect for someone who is trying to make connections to improve their health) that has absolutely no solid utility.
Hart’s take: She’s a fraud who preys on sick and desperate people. When I arrived with 10 years of records from impressive medical centers and a detailed dietary analysis and used medical terminology with ease, she knew she couldn’t pull the wool over my eyes. She was aggressive and accusatory to show me that she couldn’t help me through no fault of her own, but because I was in the wrong.
I agree with his perspective. I was already suspicious of the office’s financial set up. According to their website, they don’t accept insurance because “we prefer to have a direct relationship with our patients and to give them the opportunity to make the final decision as to which treatments are most beneficial for them.” Some perfectly reputable health care providers don’t take insurance, so that alone isn’t a red flag. Right before the appointment, I learned they charge for medication refills through a pharmacy. Afterward, I discovered that every test they do has an added service charge of $40-60 and another $40 if shipping is involved.
I know enough about migraine, medicine and my own body to know this doctor was mistreating me to save face. I was able to get angry and not be heartbroken by having an “expert” tell me there was little hope for me. If this had happened 10 years ago, I would have been devastated. I would have believed that I would never be able to find relief from migraine, not that the doctor was blaming me for her shortcomings.
That’s what I’m angriest about. I saw through her bullying, but what about the people who do arrive in her office doe-eyed and terrified? Either she takes them in for thousands of dollars of tests, supplements and follow-up appointments or they leave believing they’re a hopeless cause. How is that patient-centered? How is it in the best interest of anyone or anything other than the doctor’s bank account?