Monday, September 19, 2011

i might think that, but i would never say it out loud

a new patient with a complicated history came to my office last week.  when i asked her why she was changing physicians, she said that when she met her last physician, he looked at her list of medications and said, 'boy, you're going to be a tough one to take care of.'  the relationship just foundered after that tactful opener.

you don't, and without a doubt can't, always know when something you say will offend someone.  i once had a patient yell at me that her toenail fungus may not be important to me but it was a big deal to her.  this was after i spent half an hour working through her acute issues of angina, major depression and anxiety. when she brought up the toenail fungus, i asked her if we could address it at her next visit because i felt the other issues were more pressing and we were out of time.

i am sure there are countless other instances when i've offended patients and not known it, but i do try to conduct myself professionally at all times.  sometimes that just means keeping your mouth shut and your expression neutral and not saying the thing that is blaring in your brain.  you have to have a strong edit button or you will get yourself in trouble.

so here are somethings i've thought but haven't said out loud:

1)  dude, you are wearing way too much cologne.  my nurse is in the break room using her inhaler for the asthma attack you've triggered, and after you leave we will all be smelling you for the next four days.

2)  neon orange is not your color.

3)  no, i will not prescribe a stimulant for you just because you thought it was a good idea to commute 2 hours to your 30 hour per week job while going to school full time.  oh wait, i did say this one out loud.

4)  what the hell were you thinking?  fill in the blank with any number of tempting but unsuccessful self remedies - i stuck a pin in it, i put bleach on it, i tied a string around it, 1 didn't work so i've been taking 4 at a time...

5)  leave him.

and let's not forget that i can be inadvertently offended too, as i mentioned here.


  1. "Look wise,say nothing and grunt. Speach was given to conceal thought."

  2. I keep telling my daughter, and I truly believe this; If you choose to be offended by something you certainly will be. My reconstructive surgeon once told me that I was a bitch to treat, and I had to agree with him. I come attached to multiple medical zebras and a five page list of medications I shouldn't take. It doesn't endear me. At my last cardiology appointment my cardiologist looked at the results of my sleep study and asked me why I'm not dead...I suck at dying? Both doctors are still getting paid by my insurance company. I have only ever left the care of a competent doctor because she offended me when I gave her an honest answer and she mocked it. At that point, I was just like well, oh screw you. I have left many practices, but really that was the only time I left because I was offended.