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Arrogant Doctors

I’ve been curious for some time about the arrogance and rudeness in my profession. When a new patient starts to relate her health history and interrupts herself with a comment like, “The so-and-so doctor was awful” (or really unpleasant or disrespectful), I inquire “Oh? What happened?” And she’s truly glad to tell someone, especially a seemingly sympathetic member of the offending profession.

After years of listening to patient complaints about doctors, there are few surprises. Most commonly it’s a variation of “didn’t listen to me,” “didn’t take my opinions seriously,” “kept interrupting and talked down to me,” “got impatient answering my questions,” “got defensive when I challenged his/her conclusions,” or generally was visibly preoccupied with something more important than the patient in front of him.

When I typed “physician arrogance” into my Google bar, I found a couple of chat rooms where doctors were defending their behavior with “We’re too rushed,” “Don’t have time to review a bunch of stuff you happened to find online,” and the supremely super-arrogant “Like it or not, we do know what’s best for you.” I pictured these angry patients and defensive doctors like two semi-crazed terriers on opposite sides of a cyclone fence yapping furiously at each other into eternity.

To me, there are two forms of physician arrogance:

The first is the physician with one of your basic personality disorders who really shouldn’t have gone into medicine in the first place. The idea of weeding out these docs beforehand–medical damage control, so to speak–was addressed in an editorial in the British Medical Journal several years ago. It suggested that along with good grades, recommendations from professors, and the clichéd desire to help others as criteria for acceptance into medical school, every potential candidate should undergo extensive psychological testing.

Previous studies in the UK have shown that “successful” GPs (competent, respected, well-liked by patients) were as a whole rather extroverted individuals who sincerely enjoyed people and weren’t schlepping a knapsack of unresolved psychological baggage. I’ve come across no shortage of the unresolved issues crowd, highly introverted or narcissistic individuals who need Valium to make eye contact with their patients and who generally regard all patients as an interference to their self-absorption.

For a while I wondered how these physicians could ever build a practice and financially survive until I realized almost all of them became salaried specialists employed by huge medical groups. As long as these doctors remained reasonably competent in their field, their behavioral problems were either not noticed or deliberately overlooked by their colleagues.

These guys virtually never got fired.

The second form of physician arrogance seems an institutional phenomenon, in which a whole culture of arrogance permeates everything associated with the medical center, from its hospital on down through its residency training program and medical school, even including its undergraduate school if one exists. In other words, a historical arrogance passed from generation to generation, a whole self-enclosed medical/academic culture whose members are thoroughly convinced their collective digestive tracts produce odor-free feces.

Without naming names (you institutions do know who you are), anyone living in Chicago after a few years can differentiate the basic jerk institutions from the generally nice ones. Not surprisingly, these same places are often brutal to their employees and create utterly dysfunctional workplace environments. But these institutions who know who they are really don’t care, do they? Of course, they wouldn’t care, they’re…Is this what tautology means?

If you’re uncertain who’s who in this regard, my suggestion for honing your arrogance-detection radar (Arro-dar for short) is to keep track of the time you spend waiting to see your doctor or waiting in an emergency room.

To me, repeatedly keeping someone waiting is the height of rudeness. Acknowledging that I personally have the patience of a hungry rat, I dislike waiting for anything. Keep me waiting a couple of times–maybe some sort of an emergency occurred–and I can forgive. Recurring, unconscionably long waits and I’m out of there and you should be too, because encounters like these will likely predict every subsequent visit within this institution.

If you find yourself in an emergency room and realize that you’ve knocked off a dozen chapters of War and Peace and no one has seen you, trust me, it won’t get a whole lot better once you’re admitted. On the other hand, if you’re in a doctor’s office or ER and see a sign that reads, “Please let us know if you have been waiting longer than 15 minutes,” the whole center is being run by someone who keeps track of patient satisfaction.

As a primary care physician, my own arrogance radar is much different, based largely on how well an institution’s specialists communicate with me. You’d think that in a huge multispecialty medical center, relying very much on referred patients from us primaries, communication would be a non-issue, but this is too often not the case. From some centers after I refer a patient I hear nothing, utter silence, the patient apparently having fallen off the planet. My inquiry calls are not returned. Occasionally, adding insult to injury, I later discover the specialist referred my patient to the institution’s own primary care department for follow-up care.

But at opposite end, at really good medical centers the specialist will call or fax over the consultation notes–often within an hour of your visit–and follow up with copies of test results, x-rays, and a summary letter (often closing with a “thanks for having confidence in our institution”). All this provides me with a lot of information on how you, my patient, fared, and after all that’s what I’m here for.

Let me end this by adding: Do not tolerate physician arrogance, period. If you’re sitting in the waiting room and your longevity and good will are being chipped away reading endless back issues of People Magazine, just exit and find someone else. If you leave any encounter with a doctor feeling tense and angry from your experience, then every single time you have an appointment you’ll have a vaguely sick feeling about the potential stress ahead. Your concerns will never be adequately addressed, your questions will remain unanswered, and you’ll feel bad to boot.

This is really not healthy.

Because of the recession and the health insurance crises, American Medical News reported this week that people are going to their doctors less often than ever. Office visits are down. Referrals to specialists are down. Elective surgery is way down. In other words, health care is becoming a buyer’s market.

You really never again have to pay to suffer through some doctor’s arrogance.

Be well,

David Edelberg, MD

PS:  At WholeHealth Chicago, we’re somewhat obsessive about being on time. Practitioners who run late get their knuckles soundly rapped at staff meetings. I hate to throw the blame back onto patients, but if you find yourself waiting in our center, the single most common reason is that a patient scheduled earlier in the day arrived late and threw the whole day’s schedule out of whack.

 

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20 Comments


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  1. melissa mcclayton says:
    November 22, 2011 at 6:11 am

    Once again, a superb, informative and helpful article. How lucky for me to have signed up for this wonderful letter!

    Melissa McClayton

  2. Dan Marselle says:
    November 22, 2011 at 7:35 am

    Dr E, I read your newsletter as often as i can. This issue was exceptionally good. I won’t tolerate arrogance or rudeness from anyone, not just MDs. I am in need of a freelancer to help me write and post a quarterly newsletter. I have budget to pay for this. Do you use a writer to assist you, and if so, would he/she be interested in extra work? If you do this all on your own, then my hat’s off to you!

  3. Marie Raziuddin says:
    November 22, 2011 at 7:46 am

    Amen! Amen!! I’m surprised that a doctor notices this problem and admits it. I don’t go to doctors because of this and when I do go it is under dire circumstances. I go to Whole Health because Dr. E. doesn’t have that “my shit doesn’t stink” attitude (just sayin’). I do feel that some of the support staff at Whole Health should be given an attitude adjustment pill.

  4. Brad in Ohio says:
    November 22, 2011 at 7:54 am

    Dr. E

    I couldn’t agree more. It’s almost like you were a fly on the wall at my last doctor’s visit. He was more interested in bemoaning the economy and the current Democratic leadership than listening to me and my concerns. I’m an R, but really, I can get my political commentary on TV. And when I challenged the diagnosis of the specialist he sent me to, and his desire to send me back again for a repeat set of the same tests, he got defensive. “Well, everybody’s different” is not a good justification. And you’re right about the unhealthiness of the feeling of stress ahead should I go back, so it’s time to make a change. BTW, I’m not referring to a Chicago experience.

  5. TSA says:
    November 22, 2011 at 8:14 am

    Thank you — feel much better for “firing” our “replacement” family physician for his arrogance.

  6. c.laporta says:
    November 22, 2011 at 8:20 am

    3 years ago, I had hysterectomy by well known Chicagoland surgeon, leaving me in agony. Many treatments, meds and tests were given as problem was “mine” and there were NO results, or diagnosis for my agony, even after admission to hospital. Arrogance of 38 year old surgeon was evident, because error could not be his fault, there must be something wrong with ME, the patient.. Finally, 4 months later, the arrogant doctor (who thought I was a wimp) did 2nd surgery to extend the sling that was placed too tightly during first surgery, but sling was slit apart instead. Bladder AGAIN fell out. I was told to live with it. Also told I have Vulvodynia, I do not, that I have CPP, Chronic Pelvic Pain, I do not, and Interstitial Cystitis, I do not. I suffered greatly and my own primary was dismayed at ME. One doc defending another doc. I had no where to turn. Finally, after many uti’s, and much discomfort with end stage prolapse, on my own, I went to different surgeon at different hospital, recommended by nurse friend, and last month, had a colpocleissis surgery, and am a new woman. She was a caring and compassionate doctor who put her arms around me and said I had suffered too long. The first surgeon, upon realization that his error caused my agony, stated: This is only the 3rd or 4th time in my career that this has happened”….concern was for himself, NOT for the suffering patient. I still feel such anger at first doctor, because I suffered needlessly due to his arrogance and his not even considering he could have made an error. The blame was put on the patient instead. Thanks for hearing me out. I did tell this to my primary, when I told her I was leaving her practice as she too did not “get it” when I turned to her in agony …. and she asked me to stay with her (which I did) and said: Thank you for telling me, you are making me a better doctor. So, egos affect treatment, let me assure you of that.

  7. Mery Krause says:
    November 22, 2011 at 8:28 am

    Love the way you speak the truth with no hesitation or beating around the bush. So much like the man I live with. Didn’t know there was another like him. Happy Thanksgiving to you and yours.

  8. Elizabeth says:
    November 22, 2011 at 8:48 am

    Thank you Dr. E. My son has seen 35 doctors (many specialists) and recently, we went to one where I specifically announced that my son is the “most medically complex kid in Chicago. I don’t expect you to have the answers today.” Within 30 seconds, he had an answer for me and then wrote a note with treatment recommendations that could kill my son. He did not listen to half of his story and now the office staff is calling to ask why I never followed through with his testing or a follow up appointment.

    I did promptly tell the doctor’s colleague who referred me about the visit, the complete unprofessionalism, and the unjustified arrogance. She was embarrassed that she referred me to him, of course. Perhaps, unsatisfied patients need to speak up about their experiences more – to other doctors and to staff in charge in institutions.

  9. Teresa says:
    November 22, 2011 at 9:00 am

    Thank you so much for this issue! I have suffered from a chronic illness since I was a teen and have dealt with innumerable doctors over the years. I learned at an early age the importance of finding a physician who treats you with respect and kindness and have no qualms switching doctors if I detect arrogance, rudeness or impatience. And kudos to your team! I’ve often told Mari I feel like I’ve been to a spa when I leave my appointments, and not a doctor’s office. Thank you for treating the whole person and not simply treating the illness.

  10. Addie says:
    November 22, 2011 at 9:30 am

    Physicians’ arrogance has been an acknowledged and sadly accepted reality for as long as I can remember (a long, long time). Most people I know who complain and complain about it end up putting up with it. That’s because patients themselves contributed greatly to the problem. We looked up to physicians like gods. We expected them to be psychic Einsteins. We gave them total control of our physical well being, accepting their diganoses without question, popping pills like candy, and running to them for every little blister and wart. We, the patients, have been whiny babies, and what we got in return was, not surprisingly, autocratic parent-doctors. In one sense rising medical costs were a blessing in turning patients toward alternative solutions –in reaction to which, many physicians appear to have retrenched and become charitcatures of themselves. But much of our upset with physicians is because they’re fallible human beings just like us. When we take more responsibility for our own well being, we’ll be happy iconoclasts, and physicians will develop better manners –or have to become dentists..

  11. Sonia Choquette says:
    November 22, 2011 at 9:42 am

    I am so happy to read this.. It is so affirming and respectful of the patient. Well done David.

  12. Ann E. Nonimus says:
    November 22, 2011 at 10:38 am

    Bravo to the person who told you your staff needs chill pills. I once called to ask when the next breast scans were being done and the person who answered said she didn’t know and made no offer to find out. Also I changed my appt. once and it didn’t get recorded somehow and I had money deducted from my checking account with a rude note that said I was being billed for a missed appt.Fortunately the change had been made online and I had a record of it. Also not the warmest bunch to deal with while waiting to see you. Lot of gossiping among themselves
    as if no one else were in the room.

  13. Dr. R says:
    November 22, 2011 at 10:51 am

    Your feedback is helpful; thank you! Changes have been made and we continue to work on improving all aspects of our patient’s experience at WholeHealth Chicago.

  14. Lenore Urbanski says:
    November 22, 2011 at 2:19 pm

    Dr. E. How brave it is for you to address this topic. Believe me, after working in the medical field and being a patient myself, I am so well aware of being put in a situation of being made to feel stupid and ridiculous after trying to explain an ailment or feeling that I have had. Most doctors think that they are Gods and have the answer to everything. If they are not familiar with it, have had no experience with it they will make the patient terrible. Instead of just saying, I don’t know or I didn’t study that, they will walk out of the office and announce to the staff, that this patient is loco. I would rather give up every bad thing that there is for me than sit in front of doctors or be in the hospital. Dr. E, that’s why I love you so much.

  15. Bonnie Lennon says:
    November 22, 2011 at 4:01 pm

    Got my attention with this topic….I was just sent 2 termination letters(one certified) from my eye dr. for questioning him. I questioned his choice of meds after I had some muscle weakness, very dry mouth, and wanted to scratch my eyes out…I am now having a difficult time trusting!

  16. Colleen Jersild says:
    November 22, 2011 at 4:13 pm

    I was once kept waiting an hour and a half in the examining room at a major medical center in Chicago. When the doctor finally appeared, he graced me with his presence for approximately 5 minutes.

    In contrast, at Whole Health, I have never have had time to select a magazine!

  17. Judy Kayser says:
    November 22, 2011 at 4:53 pm

    Thank you Dr. E. Once again you have nailed it. These arrogant, know-it-all doctors actually harm patients in many different ways. Having an rare neurolo-muscular disease which doctors know very little about, I encounter this constantly. When I go to you and you advise me to do something that will adversely affect me, all I have to say is the name of the disease and you say “say no more”. I don’t get that from ANY other doctor and I thank you for it, it’s a “big deal” to me.

  18. Kathleen Harris says:
    November 22, 2011 at 5:16 pm

    I love the way you write these, but this one in particular makes me miss my insurance since having to go on Social Security.

    The clinic I had to choose is hard to get to, and fear of being faced with the arrogance you write about here, is what has kept me away from an overdue checkup and mammogram. I hope I can muster the courage to give them a try after the holidays are over. But more than anything, I hope to change my fortunes and become able to choose again. I’d run back with wings on. Thank goodness I have your newsletter to help until then.

  19. Debra young, Dom says:
    November 24, 2011 at 11:43 am

    I agree and try to schedule and minimize wait times. I love spending enough time to get all the facts and questions. I’ve learned that it sometimes takes a couple more minutes for people to relax and reveal all the details related to their foot problem. it’s better for them and for me in planning treatments.

  20. Pat Conley says:
    December 5, 2011 at 9:04 am

    Thank you!!!