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This one was written after a very long and frustrating day……

To my patients –

I try very hard to be on time and keep on schedule. I know what it is like to wait hours and hours for a doctor appointment, so I try to be prompt. I know your time is as valuable as mine. So, please be yourself on time. If you are very late, please remember the policy is to reschedule you; we are not a ‘drop in clinic’. If you are slightly late you expect to be seen as you are here – and you want your full time. Naturally if you need more time in your appointment I won’t cut you off. However, this makes the next patient have to wait for their appointment. So the day gets thrown off. And if delays due to other people’s emergencies don’t evoke empathy, merely ire, please schedule your appointments first thing in the morning before the day’s matters occur.

I have lots of people on file. I don’t remember all your names/faces and all your information off the top of my head. (Trade secret; if your doctor can instantly remember you and your case that is usually a bad sign). Please don’t be insulted that I have to check your chart for details or ask you on matters you think I ‘should know’.

Alas, the clinic doesn’t leave me space in the day to take phone calls. I think I do a very good job at returning phone calls. But I often have to return the morning calls at lunch time and the afternoon calls in the early evening. Please take this into account when you are pissed that I did not call you back within the hour of your phone call on what primary care doctor can I recommend. Urgent matters I call back right away by the way.

You are responsible for the recommended changes in your treatment. When you come in and report you are still doing crack or drinking on your meds or not taking your meds or still doing the behaviors that makes so much grief, please don’t be too surprised that your ‘meds are not working’.

When you come in to talk about ‘life issues’ I listen and make a few suggestions but these are matters that are best processed in regular appointments with a therapist. Often you want to deal with ‘life matters’ by opting to take a pill. For life issues, this usually doesn’t work well. Prozac won’t solve your parent/child conflict; Wellbutrin won’t cure your unhappy marriage. You tell me you can’t find make the time to talk to someone/can’t afford therapy but when I add up the co-pays on your meds and many office visits for ‘med checks’ this looks equivalent to talking to someone on a regular basis.
P.S. I’ve done some arithmetic. If you lay off the 100 dollar/week drug habit you can afford a therapist.

I am out of touch with several other branches of Medicine, so don’t be shocked and alarmed I don’t know the difference between your two options for knee surgery, or which medicine for high blood pressure you are considering has the least amount of side effects. I can’t explain what another doctor meant or is doing. Ask that doctor for clarification.

Finally I am not God, your Parent, or a Magician, although a part of you wants me to be these things (I have to be watchful that the reciprocal part in me that wants to take on those roles does not overcome). I am a human being who makes mistakes. I can be tired, sick, and even at times not very bright. Please give me some slack if your appointment was canceled due to me having the flu or a death in the family.

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December 2006

Spo-Reflections 2006-2018