There is a longstanding belief in the optometric and medical world that the longer you are a doctor, the “harder” you become.
Some might call it being “crusty” or “rough around the edges.”
Feelings of sympathy and compassion for patients become replaced by frustration and cynicism.
Thoughts begin to cross your mind like, “He is just a hypochondriac.” or “Can this patient really be that dumb?” or “It’s all in her head and I’m stuck looking for an answer that doesn’t exist.”
I have to admit that after being in practice for twelve years now, I was allowing cynicism to creep into my practice life. After all, dealing with the public is NOT easy!
And then it happened.
I became a patient in a medical system wrought with frustration.
I began experiencing symptoms that I knew were abnormal and should not be ignored. And while my discomfort was not ocular, I began a journey within a system of medical professionals who wanted to help and yet met me with the same cynicism I had developed.
I was told I was just tired.
I was assured it was just stress.
I was told that the bloodwork did not match the symptoms so finding an explanation was not likely.
They would “watch it” and see if it improved on its own. It wasn’t life threatening, so why should I worry, they said. I was told it was fibromyalgia and I promptly interpreted the diagnosis to mean that I was depressed and crazy, even though I knew I was neither.
I was shuffled around from one provider to another, from primary care to rheumatology to otolaryngology to gastroenterology to dermatology in order for each specialist to work on their isolated symptoms while ignoring the others.
The big picture became microscopic.
At every visit with each specialist, I tried to remind them that this seemed to be a systemic condition and that the strange constellation of symptoms seemed to be connected. Yet, my thoughts were politely acknowledged and then ignored as each specialist focused in on his or her area of expertise.
Each specialist would find something questionable or abnormal and then refer me to another to dig deeper. Every referral seemed to be a lost leader and I was caught in the middle of a sick joke. I felt trapped in a maze of referrals with no exit and yet no one was looking at the maze from a distance to put the findings together.
I began to feel guilt when I decided to switch doctors because no one was really listening.
How ironic, I thought to myself, that in looking out for my own health I am the one feeling guilty for “doctor shopping.”
I just wanted answers.
I was exhausted and ready to give up, beginning to believe the doctors who hinted it was all in my head. But I knew something was not right and persevered until I found the one rheumatologist (in combination with my very caring primary care physician) who really listened, who gave me a thorough systemic exam, who took her time to put the constellation of symptoms and signs together.
It was not easy for her either.
She ordered a lot of tests and I felt the guilt of over-utilizing my insurance plan.
But the one thing that impressed me most about what she did compared to many others was that she was not going to rest until she found the answer. She assured me that there was something real happening to my body and it was not psychological. She trusted me and my gut. And she was right.
Now, four years after beginning the most frustrating period of my life, I have the diagnoses and aggressive treatment plan I needed all along. And I am feeling so much better. Maybe just having the answers is a treatment in itself.
The experience made me a better doctor.
I am conscientious about acknowledging frustration in patients. When I feel cynicism creeping in, I remember my own desire to feel validation, to be believed and respected and, most importantly, I don’t give up the search for answers, for reassurance, for second opinions.
Actually, I empathize with them because I WAS them.
It is easy to feel connected to patients when you first graduate from optometry school, motivated and eager, but most of us reach a point in our careers where we begin to burn out.
Unintentionally, we care less.
It begins to matter less whether the patients are satisfied with their care. If you have not reached this point in your career, you probably will- it is a natural evolution. That is not to say we don’t care, but we lose trust in our patients.
We may allow bad experiences with a few distort our perception of ALL patients. My physicians had likely reached the points in their careers where cynicism tainted their perceptions of patients. Or they lacked the expertise or desire to dig deeply into problems that are not straightforward, so they make referrals.
I get it, I totally do. But I also now understand that patients need us to follow them through to the answers, to stay positive, to trust, to advise, to console and never, ever give up.
We, as doctors of optometry, need to maintain the same compassion and motivation to help that we had as we first entered practice, not to be taken advantage of by patients surely, but to remain truly caring.
When the doctor becomes the patient, the patient changes the doctor.