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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?

32 Responses to So-Called “Patient-Centered” M.D. & the Worst Medical Appointment of My Life

  1. Sarah says:

    You nailed it. She’s a quack. People like that prey on the vulnerable, and I’m grateful you see what’s happening so clearly. It *is* heartbreaking to think of those who will be violated this way.

  2. Kelly says:

    I’m so sorry this happened and I do feel your pain. I once had a doctor who listened to me explain how I’d like to get to the root cause of my migraines not just cover them up with botox therapy and he just said “Well honey, I’m sorry to tell you that you may never solve the root cause.” While I agree that I’ll most likely have to fight this battle my whole life, I’m not ready to give up on solving the underlying cause(s).

  3. Rose says:

    I’m outraged on your behalf! This is terrible. I loathe these types of behaviors from medical professionals, it’s all too common. You are your own best advocate, everyone else is there to assist YOU. Everyone has to be their own cheerleader, to have high standards of care. I’m sorry there are bullies out there like this woman.

  4. Amanda says:

    Wow. That’s horrible.

    Journal writing… with your non-dominant hand? Good grief. That sounds so 1800s. And if only it was so easy.

    I don’t understand why doctors would ever feel the need to line their pockets in this way. So strange and unconscionable.

  5. Virginia says:

    Shades of Dr. F reincarnated! So sorry you had such a bad experience and wasted your time and energy on this crackpot. You might want to file a complaint with the state medical board to keep other people from falling prey to this dingbat.
    Love and kisses, Mom

  6. Holly says:

    I think I know this woman. I saw her in DC 15 years ago when she was still a gastroenterologist. While under her care I had a gastric bleed (too many NSAIDS, migraineurs can relate!). Very blaming. Two years later I had a 2nd bleed in another city and the attending gastroenterologist
    thought to test me for Heliobacter Pylori. I was positive, treated, and no problems since. I’m more careful now, but whenever I think of her – and her oversight re: H Pylori – my stomach churns all over again. So sorry for you.

  7. Mary says:

    Seriously consider posting about this and the ‘doc’ on WebMD and some of the other ‘doc rating’ type sites. I am a strong believer in using social media to highlight both positive and negative experiences. While all patients and needs vary, it is obvious that you were treated by a snake oil saleswoman, not a doctor, and that needs to be put out there for other sufferers to see. I had a similar experience about 15 years ago with a ‘nutritionist’ who took hair samples and proceeded to sell me about a dozen supplements to take to alleviate the migraines. It only lightened my wallet but DID enlighten me that even in our pain we have to be VERY conscious of the quacks that abound. Like you, I go into each appointment prepared with eyes open.

    • Ellen G says:

      Hair samples! Hmmmm… me too! same type of nutritionist quack. Although he didn’t charge me for the “lab testing” of my hair or the analysis write-up, he sure did want me to take lots of expensive supplements! Its funny how everyone I encounter in treatment always wants to ADD medicine or supplements, but never take any away. Hubster says all the sups I’m on might be part of the problem but i’m loath to let some of the tried and true ones go such as magnesium oxide and vitamin B2. Next, acupuncture…

      • Ellen, I’m sorry you’ve had experience with a quack, too. I know what you mean about it being difficult to give up supplements that may be working; it’s so hard to know. My fingers are crossed for you for acupuncture.

        Take care,
        Kerrie

  8. Sarcozona says:

    I am so sorry that happened to you. I had a bad experience recently at a program for people with chronic pain. It can really feel like a betrayal when you go to someone who’s supposed to help you and they hurt you instead.

  9. Lisa says:

    Something tells me you do enough writing for several people’s therapy 😉

    Humor aside, I’m sorry you had to experience this and I too cringe thinking about how it must affect less seasoned patients. Thank you for sharing.

    Lisa

  10. Peggy says:

    This has happened to me numerous times over the past 20 or so years of having undiagnosed migraines. Then a few years after they were diagnosed I was treated exactly this way by the only “migraine specialist” in my area. It was devastating to me since I had never seen one before. It took me 3 years to finally get away from her because no other neuro would take me after seeing “the best” in town. Finally my PCP referred me to my current neuro who just told me straight out in a kind way there was nothing he could do for me and I really appreciated it. He also explained that many doctors won’t take complicated cases. He also warned me that doctors get paid to prescribe certain meds and that they put people through all kinds of unnecessary tests and procedures that are a waste of money and my time. I wish doctors would just admit tcan’t help us instead of blaming us for our problem that many of us are working very hard at managing.

  11. Angie says:

    I am so sorry you had to endure such an uneducated and unprofessional “doctor”.

    Like many other long term migraineurs, I to have been sold on various supplements, treatments, etc in the past that promised relief. I have also had the heart breaking experience of being told there is nothing that can be done for me. Unfortunately, the longer one lives with migraine the more capable you become at seeing through the promises, scams and charlatans so when faced with such you are able to do just as you did, get angry and not allow them to take you for a costly yet unfruitful ride which only ends in them saying the unsuccessful treatment was your fault in some way in order to justify their despicable actions.

    I commend you on writing this post and warning others about what to look out for. Sharing our experiences is the best way we can arm those who are just beginning their migraine treatment journey.

  12. Thank you all for your kind, supportive comments. I’m sorry so many of you have also had bad experiences. The appointment was infuriating, but hasn’t left lingering wounds.

    Take care,
    Kerrie

  13. Marie says:

    Hi,
    This is the first time I’ve come to your website and am really benefiting from reading about your experience. I just wanted to chime in to say how much I appreciate you sharing your terrible experience with this so called expert, and helping us reflect on what makes a good doctor. I had a similar experience a few years ago and can empathize (I will spare you details, but it was pretty similar!). I am still angry when I think about it, so reading about your reaction is very helpful. My best experience was working with a neurology fellow who was warm, caring, and really listened. She prescribed the same thing as everyone else, but made me feel like there was nothing wrong with me for suffering and asking for help. Looking forward to reading more of your previous posts!

    • Thanks, Marie! I’m sorry you know first-hand what a doctor like this is like, but am glad you found someone you like. Good bedside manner can be powerful medicine.

      Take care,
      Kerrie

  14. Becky says:

    What is her website URL? I cannot find it in the blog post.

    • I didn’t include it. I’m uncomfortable calling her out publicly, but if you’re in the area and want to be sure you don’t schedule with her, let me know and I’ll email you.

      Take care,
      Kerrie

  15. Traci says:

    I’ve ran into too many bad doctors this last year, including one like yours that said it will take years and years of psychotherapy for me to get better. They can definitely do more harm than good. It makes me feel almost paralyzed for awhile when it comes to pursuing help. Eventually I gear up and go for it again. Right now I am without a general practitioner because one was rude and condescending. I went to another that was recommended to me by a migraine/ fibro friend. This guy acted suspicious of me from the very beginning. Like the words “severe pain” led him to think I am a drug seeker even though I had not asked for drugs. After two visits with him I will not be going back. Now I haven’t been able to find a new GP to take me on because they are seeing something in the medical system that is flagging me. I was told I have seen too many doctors but I think that one of those doctors must have said something else about me…..something that cannot be accurate as I am a rule follower. Very frustrating but I am at the point now where I am not letting them crush my spirit. I know I will get the help and answers I need somehow, someday. Keeping the faith alive.

    • Traci, I’m so sorry you’ve encountered so many bad doctors this year. You can request your medical records to find out if they contain any negative comments, though the office may require you to pay for them.

      Take care,
      Kerrie

  16. Peggy says:

    I had a neurologist that just never would provide me with my requested medical records even though I signed the required release form. I think she did write some bad things about me in her notes even though she only prescribed migraine preventives and triptans for pain relief. I’ve heard (but don’t know if its true) that doctors can take out sections that could be hurtful to the patient when they do provide the records. All I know is that it’s made finding another doctor very difficult.

    • Peggy, how frustrating! Have you had the new doctor’s office request the records? Sometimes doctors send records more readily to other doctors than to patients.

      Take care,
      Kerrie

  17. Stacy says:

    I have been seeing my neuro 7 years. Great in the beginning. Comes out of the back room with brown bags stuffed with samples of different triptans. After years of “regular” doctors telling me they did not believe me, or asking me, “Why do YOU think you are getting so many headaches?” He was a lifesaver, I felt safe. Then he “moved” his practice and after waiting the entire year to see him, TWO of my appointments were canceled consecutively. He would be “busy in office meetings”. The first time, I fought with the receptionist to be seen, After an hour of being told rudely I would be seen by a PA, I had to threaten to quit the practice to get in with the doctor. I saw the doctor and he prescribed my drugs. Then the dreaded pharmacy horror: no refills. I call the office; leave a message. (They NEVER pick up). Assistant ended up making me call every month for a year begging for drugs because she would only refill one month at a time. So demeaning. Never got a phone call from her, a whole year of leaving mess. “Please refill for the year so I won’t have to keep calling, etc.) After new office grand opening bruhaha, He ends up selling his practice to a huge company. I have waited in his office for sometimes 1-2 hours since people would show up late. When I arrived last time, I was 15 minutes late. First time I had ever been late. The receptionist says, “If you are going to be 15 minutes late, we are now asking that you cancel your appointment.” I said to her, “I would like to follow you around and see if you are ever 15 minutes late.” She shouts across the lobby to the Dr. assistant to please “Make HER understand!” while pointing at me. I was so pissed. I go in and Dr. starts telling me I am using too many triptans. This is after 7 years of no questions asked. I had asked him about a systemic yeast infection I had and could he prescribe long- term antifungals. I thought the yeast was causing the migraines. (I had thrush). He refused to do that, and so I was still having daily migraines. Yet now he was telling me I was taking too many triptans. Since he sold his practice, his face was stuck in his computer screen entering everything I said. He shoved the “migraine calendar” with the new logo at me. I had filled those out for years with no benefit and had quit doing it. I was tired of wasting my time. He then told me I might have “rebound headaches.” He told me he wanted me on Topamax or Botox injections. He had never pressured me before when I told him I was not going to do either. I said to him. “This is all because of _______ isn’t it?” (the new company name) “Oh, no, no.” he says. He was like a different person. He had confided in me that his wife’s family had survived the concentration camps and she did not trust anyone and would not take Topamax herself. I had told him I had fears about it. He was fine with it. We had a good relationship. He ended up refilling my triptans but told me to start taking Soma daily. He went into a long spiel about when to take the Soma, etc. It was all new after years of having pleasant chats with him. I felt he was preparing me for the next time when he would refuse the triptans. When I left, I thought I could still make it work. I really liked him and did not want to end our relationship. I told the receptionist, “There have been a lot of changes around here and I am sure it has been very difficult for everyone.” She quickly interrupts me, “Thank you for apologizing.” As my next appointment came up, I started having anxiety. It fell on Halloween, and I thought, I just do not want my day ruined. I called to reschedule. The b—- receptionist said, “I cannot reschedule you until February.” I told her I was slotted to come in every 3 mos. due to the Soma. She was unrelenting. I asked if I could still get my drugs. She said she “Didn’t know.” That I “had a better chance of getting them if I was on the books, but she didn’t know what the doctor would do.” After her being evasive and manipulative like this for 10 minutes, I finally agreed to be transferred to the nurse. She never picked up, and her message actually says, “Do not call multiple times as that only slows down the process.” I left a message saying I was going to cancel my appointment in a week, and could I still get my meds? She never called back. I called 4 days later and told a different receptionist I was quitting and was not going to deal with the unprofessionalism anymore. He could not care less. His callous demeanor upset me all over again.He actually said, “Well, if you need help getting your drugs, call me back & I’ll see what I can do for you.” They take advantage of weak, sick people who cannot fight them and threaten to take their drugs away! They are sadistic. Having all the power and they know it. It is SICK. I did end up getting my prescription for anti-fungals, (after begging another doc) and 2 days after taking 200 mgs fluconazole, my migraines stopped. I have gone from 30 migraines per month to 5. I could not tolerate the anti-fungal for the full 6 weeks, so I have had to use herbal meds and colloidal silver. The worst part was after everything, I looked at the print out the neuro, my once friend, had given me. It said, “Non-migranous headache, no aura. Rebound headache. Fibromyalgia syndrome.” I have an aura, sensitivity to bright light, one sided weakness, throbbing in left temple, nausea and vomiting. For 7 years he diagnosed migraine based on these symptoms. Nothing about Fibromyalgia or rebound headaches. He always told me I had migraines. Well, I am done being abused. I was able to call a top rated neuro, and as a new patient, got in in a month! Tomorrow would have been my appointment at the old neuro and I will be sleeping soundly tonight. What a relief!

  18. Peggy says:

    Hi Kerrie,
    Yes, the new neuro requested the records and I’m going to have to work up the courage to ask for them.

    Stacy- that whole scenario sounds horrible and brings back memories of some similar situations I’ve been in. I still get panic attacks before seeing any new neurologist.

    Peggy

  19. Stacy says:

    Thanks Kerrie! In the past, I have tried to “make it work” even if things get difficult. Now if it seems like I am “pulling teeth” to get in or the receptionist is rude on the phone etc. I am not going to bother! I will look for early “signs” and heed them!

  20. Stacy says:

    Peggy, it does help to hear that others have had to go through this and I am not alone!

  21. Carolyn says:

    Hi Kerrie,
    What a terrible experience! I suffered from migraines for 30+ years and visited so many doctors of different specialties. Unfortunately, not one ever really tried to discover the source of the problem, but instead tried to find a drug treatment for me – none of them worked. Instead, over time I slowly got worse. Somehow I knew food was part of the issue, but the Heal Your Headache diet did not work for me either. However, what worked for me was the Paleo AutoImmune Protocol Diet. I started on the Paleo Diet and noticed immediate improvement, but was still having migraines from time to time. When I removed nightshade vegetables and spices, I discovered what it was like to live drug free and feeling good. Evidently migraine sufferers may actually have some autoimmune reactions to food. The Paleo Mom website is a great resource as is her book, The Paleo Approach. I just wanted to share this for anyone that might want to look into it. This diet changed my life!

  22. Cesta says:

    I’ve suffered migraines since childhood and like many of you have become an expert on my disease. I know what does and doesn’t work for me and have gotten to the ‘end of the meds’ according to my headache specialist. I pushed through several rounds of Botox, which didn’t work, while they withheld any other preventatives because they would have screwed up the experiment. When I ‘failed’ the Botox, my specialist (highly regarded in my area) informed me that I needed to get a nerve stimulation implant, that it was my last hope. I’d recently had several blackouts that were attributed to migraine aura, and she interrupted me every time I tried to explain my new symptoms. Finally, I started crying from sheer frustration. She looked at me and said “Crying causes migraine. You need to get control of yourself.” I haven’t been back. This experience was a good reminder of why I should always take someone with me to appointments as an advocate. The sad truth is, if my husband had been with me she would never have spoken to me the way she did.

    • Cesta, I’m sorry that you’ve had difficult experiences with providers. It is true that having someone along with you can really improve the interaction. I wish you all the best in your search for relief.

      Take care,
      Kerrie

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