What should we expect from our doctors?

What are our expectations when we visit our doctor? Do expectations differ with age? I pondered this question recently after an unsatisfactory visit to see a medical professional.

Two years ago, I had a problem that landed me in the emergency room. A specialist physician was called in to perform an emergency procedure. I spent five days in the hospital and recovered well, but in the process learned I had a treatable autoimmune disease.

After my hospitalization, I continued to see this physician for outpatient checkups. In the past two years, I have had three office visits and an additional procedure.

As part of my treatment, I was prescribed a daily medication. Recently, as I was trying to order a refill, the physician’s office informed me I would need to make an appointment so the doctor could check me before he renewed my prescription.

This made sense to me, as it has been over a year since my last visit.

What resulted from that appointment was a feeling of disappointment and dismay, not by my prognosis, but because it felt like Groundhog Day.it was as if I had never seen this doctor before.

My appointment didn’t require a physical exam, only a conversation. I waited while the doctor logged in to his computer and took a few minutes making sure he had the right chart. Once he began, every question he asked implied he was unfamiliar with my case, my history, my manifestation of the disease or his own treatment of me.

There were red flags when he suggested a diagnostic test that would not be feasible because of a previous surgery and another red flag when he went on to suggest a surgery that was a moot point due to my history.

I had a real feeling of unease as I left his office.

On my drive home, I began to think about why he appeared to have no recollection of my case, even with his charts in front of him. At best, I concluded, he was busy, overworked and attempting to treat me without fully reading my chart. At worst, I considered that he may have been trying to drum up business by suggesting procedures and surgery.

I did some research and found studies that demonstrate that patient expectations are associated with the way information about disease and treatment is conveyed by the physician.

When it comes to medical visits, patients, especially those of baby boomer age, have specific expectations of a clear diagnosis of their disease, explanations of the cause of their problem and possible forms of therapy.

One study showed that patients ages 50 to 64 had the highest expectations of a physician’s explanation of their disease and treatment compared to young and middle-aged participants. Additionally, patients 50 to 64 had higher rapport expectations than other age groups.

At 62, I guess I am right in that sweet spot.

I know physicians are stretched thin. I know specialists focus primarily on their area of expertise and may not get into details about the whole patient.

But I also know how a good doctor treats their patient.

Earlier this year, I moved away from my long-standing general physician because she went to a concierge service. I had multiple recommendations for one specific physician and made an appointment with her.

Before my visit, I signed a release with my outgoing physician to have my records sent in advance.

As I sat on the exam table, it was clear to me that this new doctor had read my records. She asked me pertinent questions and made appropriate recommendations.

I left feeling confident that I had made the right decision in choosing a new primary care provider.

Meeting pre-visit expectations is key to how patients evaluate their experiences after a visit.

In case you are wondering, I will be finding a new specialist in the coming year.

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Andrea GallagherAndrea Gallagher

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