6 Things Doctors Do to Frustrate Patients

How does your doctor annoy you? Let us count the ways.

ByABC News
June 24, 2009, 11:00 AM

June 24, 2009— -- Earlier this week, ABCnews.com looked at the top frustrations doctors experience with their patients such as bringing meddlesome family members into the examining room or stopping important medication without telling the doctor.

But there's another side to this coin.

In comment boards for the story, our audience shot back with their gripes about doctors bad habits that were not only irritating, but often led to misdiagnosis, wasted time and wasted money.

Indeed, such concerns have been raised by the medical community as well. Organizations such as the American Academy of Family Physicians do research about where doctors go wrong and how to better improve their care. Over the past 10 years, the term "patient-centered care" not doctor-centered or disease-centered care has gained traction in medical schools and conferences as a way to help doctors be better healers.

"I think students, residents, and physicians are being taught this care more than they ever have before," said Dr. Scott Fields, vice chair of the Department of Family Medicine at Oregon Health and Science University in Portland.

"But the health care system is not really rewarding them for doing it," said Fields. "If we actually listened to people, we would probably do less."

In a health care system that pays for all the tests run and prescriptions written within a 15-minute window allotted for an office visit, Fields said doctors rarely see an economic reward for taking the time to listen to a patient.

But that's just the tip of the iceberg. Read on for some of the most common patient complaints about their doctors.



In response to the wait complaint, many doctors say they feel exactly the same way.

"I really don't think that physicians think their time is more valuable than their patients'," said Dr. Jim King, on the board of the American Academy of Family Physicians. "But they're exactly right that doctors are rushed."

King said under the current payment system in the country's health care, most family medicine practices must function at maximum capacity to make a profit.

"The profits are so slim you have to see a quota, but none of us like functioning under a quota," King said.

But while that might explain the rushed office visits, the quota system doesn't explain why people are sometimes left waiting hours for their 15-minute appointment. King said the problem with most family medical practices -- unlike with some specialists -- is that office visits can also be unpredictable.

"In a family medical practice we never know what is on the other side of the door," he said. "You may think an appointment takes 10 minutes, but it actually takes 30 minutes."



King admits some doctors tend to cut a patient off once they've heard a certain bit of information.

"I think that the thing with that particular area is that most physicians are very objective in their thinking so even though something may seem important to the patient, it may not be medically important," said King. "[Cutting people off] is not the best thing to do; it's not the right thing to do."

As for Fields, he believes that listening is the most critical point of the new movement for "patient-centered care" and in treating many chronic conditions can actually lead to better care.

"The primary thing that frustrates patients is not being listened to and not being heard," said Fields.

For example, no matter how many times a doctor repeats "check your blood sugar" to a diabetic patient, Fields said the patient won't be helped managing their diabetes until the doctor figures out why the patient isn't checking their blood sugar.

"It may not be because they're lazy, it may not be that they don't understand what they're supposed to do," said Fields. "It may be that they have a really busy job and they don't have the time to check their blood sugar as they should or it may be that they consider diabetes a sign of weakness and they don't want to show their coworkers they have it."



"So I researched my symptoms online and it told me to get a blood test for hypothyroidism and menopause, mind you I was 37 at the time. I went to my doctor yet again and upon seeing me he rolled his eyes and stomped his feet. I told him I was not leaving till he ran a TSH and a FSH blood test. Well 3 days after my visit I got a call from my doc telling me I was menopausal and I had hypothyroidism... imagine that... My doc apologized over and over. Needless to say I have a new doctor now who takes good care of me."

While it is difficult to know how many troublesome patients are subtly labeled as mental cases, King said doctors are taught that very few people truly have psycho-somatic illnesses.

"There's only a very small percent of patients that are truly 'it's in your head' type of case," said King.

King said cases like these often arise when the doctor can't diagnose what's wrong with the patient.

"I think more often than not the patient perceives that the doctor thinks it's in their head, but just because we can't find the cause doesn't mean the doctor thinks it's in your head," said King "It's frustrating for the physicians too."



King said many doctors are well aware of the problem, and some might just be negligent. However, most doctors' offices are struggling to communicate with restrictive privacy rules and out-of-date record-keeping technology.

"Telephone tag is a significant problem in the way of getting a hold of our patients with lab results," said King. "Under the privacy guidelines, we have to talk to the patient, we can't leave a message on the house answering machine and we can't talk to a spouse."

Traditionally, doctors have resorted to mailing lab results unless the tests come back with a concern. But King hopes there will soon be better software for physicians to take advantage of the Internet.

"Hopefully we can start e-mailing lab results to people," he said.



While some doctors may be lax, King explained that the miscommunication between doctors sometimes comes from logistical problems with record keeping.

"All doctors want as much accurate information they can about their patient," said King. "It's not that we never consult, it's just difficult because one physician is extremely busy the other doctor is extremely busy."

While most offices are functioning on FTP, shared files and e-mail, King said most medical records are stuck in the mail-and-fax age. As a result, information has to pass through a lot of hands before it gets back to the right person.

"The nurse lets the billing people know, the billing people makes a copy, then billing people do a fax to the other doctor's billing people, who have to let the nurse know," he said.

Such problems are why King and many other are calling for electronic medical records that are safe and secure.

"Right now the things that are limiting that are security issues and getting the vendors and the people to build it," he said.



But while King said he certainly doesn't condone a physician showing disdain for alternative medicine, he understands why doctors haven't immediately clung to the idea of using what may be unproven treatments.

"Realize that most physicians are considered scientists, and we want evidence showing what works and what doesn't to help their patient," he said. "I think the most important thing is that patients do need to let their doctors know -- whether they make a face or not -- everything they're taking."

King said some herbs and supplements can interact with other medicines and cause serious complications. But unfortunately, many patients still don't fess up about their home remedies.

"[It's] because they fear the doctor will belittle them for 'believing in a folk remedy' or will beleaguer them into not taking it," one commenter wrote.

Whether or not doctors believe an herb will work, Fields said it is the job of the physician to be tolerant of any patient's beliefs.

"Having an openness to their belief system is critical to patient-centered care," said Fields.

Despite the frustration expressed by many ABCNEWs.com readers, at least some people commenting showed a great sympathy for the family doctor's position.

"I can't believe nobody brought up the insurance companies. They are the reasons [doctors] are so rushed these days," one commenter wrote. "They pay next to nothing for a visit and the [doctors] have to book so many patients just to pay the overhead. I feel badly for [doctors] today -- all that schooling/debt and they are not making as much as the public thinks unless they are a specialist. We need insurance reform badly."

ABCNews' Dan Childs contributed to this article.