Why relationships fail

[Guest guest]

Since I pride myself on providing relationship-driven health care,

I was curious why some of my patient relationships fail.

A chart review of inactive files reveals the

following stats:

138 inactive files

MOVED 30 (20%)

INSURANCE CHANGE 25 (18%)

SELECTED ANOTHER DR. 28 (20%)

TRANSFER to give spot to someone on wait list 2

TRANSFER inconvenient location 2

TRANSFER to better clinic for indigent 1

DOESN'T WANT MD/allopath 1

FIRED " noncommunication " 23 (17%)

FIRED no shows 1

FIRED poor fit (mutual) 3

RIRED noncompliant (my discomfort) 8 (6%)

FIRED drug seeker 2

FIRED can't locate 8 (6%)

FIRED dishonesty 1

FIRED ME - mad 2

DIED 1

Relationship failure is hard like a divorce.

The guilt, anger, feelings of inadequacy. . .

I want to improve my care, my communication,

the way I relate to patients--difficult patients.

Two patients fired me because they were angry. One was upset

that I told her she was obese. Maybe I should not have told her

during her first 60 minute visit. Maybe a skinny doctor telling

an obese patient her body mass index and labeling her as obese

could be handled in more compassionate way.

One man fired me because United did not pay out of

network docs and I did not know that and he thought I

should have known. Live and learn. I know now!

I think about the anxious woman I couldn't handle

because she would never submit to an exam--ever.

I think about the out-of-control diabetic who wouldn't

comply with lab testing. I wonder if I could have been

a better doctor for them or if they found a better doctor who

could meet them with more courage, more understanding,

more compassion.

I wonder why 23 patients failed to communicate with me.

Never returned my phone calls. . .

I understand death, I understand when a patient moves

to Japan or Portland or North Carolina. I understand

why I fired a patient for filling in his own lab test slip

with tests I never heard of. I understand patients MIA

in a chaotic world.

It's that gray area between death and the patient moved

out of town that I'd like to understand better.

The gray area leads me back to my own gray matter and

endless neurotic contemplation on what could have, should

have, would have been. . . had I only. . .

Ideas?

Any other neurotic Jewish doctors with unresolved guilt out there?

Hope goes well at summer camp. Look forward to jumping

in next year on the left coast (as Marty says).

Be well,

Pamela

Pamela Wible, MD

Family & Community Medicine

3575 St. #220 

Eugene, OR 97405

(541)345-2437

roxywible@...

www.idealmedicalpractice.org