Conditions

What Your Doctor’s Really Thinking (But Won’t Say to Your Face)

Here’s what your doctors would tell you if they weren’t worried about time, lawsuits, or hurting your feelings.

By Nancy Kalish

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Put away your phone!iStock/Thinkstock

“I hate when patients text during a visit. It tells me that they do not value my time. I feel disrespected. I have left patients talking on their phone in the examining room and moved on to see another patient.” —David Broyles, DO, a doctor of family medicine who practices in the Philadelphia suburbs. These are 11 other things patients always do.

Oncologists hate pinkiStock/Thinkstock

“Of course raising money is great. But during breast cancer–awareness month, in October, everyone comes in thinking she has advanced breast cancer. Our patients hate it because they can’t go anywhere without being reminded of their disease.” —James C. Salwitz, MD, a medical oncologist specializing in breast cancer in East Brunswick, New Jersey

Don’t ask me to lieiStock/Thinkstock

“I’ll get a call from a daughter who says, ‘Don’t tell my dad I called you, but you need to know he’s having chest pains again.’ Now I’m not supposed to know, but I do know, which is bad for everyone. I want to sit down and say, ‘John, your daughter says you’re having symptoms that you’re not telling me about.’ I don’t like those kinds of secrets.” —Vincent Bufalino, MD, senior vice president of cardiovascular services for Advocate Health Care in Chicago

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Your missed appointments really worry me…iStock/Thinkstock

“I want to give my patients the best care, so I get frustrated when they turn it around and accuse me of trying to ‘pay for my new boat’ instead of taking responsibility for their disease. When patients delay treatment, something as simple as a filling can become involved and costly.” —Colleen DeLacy, DDS, a dentist in Sandusky, Michigan

…But late is better than neveriStock/Thinkstock

“When a patient finally comes in, years late, I walk in with a smile and an outstretched hand. ‘Where have you been, stranger? So glad you are here! Tell me, what has happened since I last saw you? I know patients are busy. I know it is not in our nature to think about our health, even though we should. With good health, you can always make more money. With more money, you can’t always buy good health. So the fact you are here is a good thing.'” —Davis Liu, MD, a board-certified family doctor in Sacramento, California

I’m not scared of your Google searchDan Saelinger for Reader's Digest

“When patients come in with three inches of printouts, I know I’m going to have a good conversation. But they’ve also almost always terrified themselves beyond need. I wish they would e-mail or call me so I could put things in perspective. But in general, patients who have researched their condition tend to educate faster and take better control of their care.” —James C. Salwitz, MD. Doctors reveal the 11 ways patients screw up in the ER.

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I could use sympathy tooiStock/Thinkstock

“Many doctors have depression, so don’t take it personally if they seem distant. Our greatest desire is to help patients. That’s why we delayed starting our lives until our 30s. Many doctors give up their own family life to overextend themselves to you. And they’re kind of a mess after years of doing that. I’d like to see more patients have more empathy for doctors. It would be so great if a patient said, ‘You look kind of frazzled today. Can I give you a hug?'” —Pamela Wible, MD, a board-certified family physician in Eugene, Oregon

Tell me your story, not your symptomsHemera/Thinkstock

“I like it when my patients in the ER tell me things like ‘I was running my usual five miles when at mile one, I started to have chest pains that stopped when I sat.’ That’s much more helpful than just saying ‘I had chest pains.'” —Leana S. Wen, MD, director of Patient-Centered Care Research at George Washington University

I contradict you very carefullyiStock/Thinkstock

“Even if a patient is wrong about her problem, it’s not helpful to tell her so. Finding the right answer is the best way to dispel the wrong answer. I never try to shake someone’s belief until we have enough facts to do it.” —Mark Liponis, MD, corporate medical director of Canyon Ranch in Lenox, Massachusetts

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I trust your gutiStock/Thinkstock

“Parents are so smart and so intuitive and know what’s normal for their child and what’s not. So I always work to take them seriously.” —Wendy Sue Swanson, MD, a pediatrician in Mill Creek, Washington

Sometimes I don’t know what’s wrongiStock/Thinkstock

“Doctors are supposed to know everything, but we don’t. When I’m worried about whether a treatment will work, getting sued is always in the back of my mind. It’s scary.” —Lisa Smirnow, DO, a family practitioner and the medical director of Sagebrush Treatment Center in McLean, Virginia

I welcome your e-mails—within reasoniStock/Thinkstock

“I tell all my patients that we need to be on the same page for surgery. If that means you need to e-mail me 30 questions, then it’s totally fine. But don’t expect that I’ll e-mail you back. I’ll call instead.” —Anthony Youn, MD, a plastic surgeon in Troy, Michigan

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I may cave to your pressureFuse/Thinkstock

“If you really want a test that’s not covered by insurance and not really necessary, I’ll give in as long as it’s not ridiculously expensive or invasive. In primary care, our relationship is important. If you feel like I resisted your seemingly innocuous request, you’re not going to trust me. This way, I keep you as a patient so I can steer you toward appropriate tests.” —Kenneth Lin, MD, MPH, an associate professor of family medicine at Georgetown University School of Medicine

I run late for good reasons…Dan Saelinger for Reader's Digest

“It’s hard to be a patient, but it’s also really hard to be a doctor and walk into a new room every 15 minutes with a new family and new challenges. One person shows up late, and it creates a domino effect. But when a teen comes in and admits feeling suicidal, I’m not going to kick her out. Sometimes I want to go into the next exam room and say to the irritated person who’s been waiting, ‘You are so lucky your child is healthy. If you’ve never had to double your doctor’s time, you’re just really lucky.’ ” —Wendy Sue Swanson, MD

…But you’d better have a good excuse if you’re tardyiStock/Thinkstock

“When patients are very late, the good doctor in me feels that there must be a valid reason, and I want to accommodate them. The bad doctor wonders how they could be so inconsiderate. Why should my other patients have to wait because someone else could not be punctual? Typically, I will see a late patient as long as it does not inconvenience other patients.” —David Broyles, DO

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Second opinions help me tooDigital Vision/Thinkstock

“They could confirm my diagnosis, which means the patient will have confidence in it, and that could reduce my liability. And if the other doctors don’t agree, I might learn something.” —Mark Liponis, MD

I read your body languageiStock/Thinkstock

“A patient’s gaze tells more than any exam. A patient who is modifying his history — because of anxiety or concern about what I might say — makes poor eye contact, squints, and looks slightly distracted. If he is trying to control me, he may stare without blinking, ignoring things I say, and tend to give short answers. You can spot pain from the distant, glazed nonfocus of a patient’s gaze.” —James C. Salwitz, MD

I relish your tough caseiStock/Thinkstock

“Here’s how I react whenever a new patient tells me, ‘Every other doctor said that this was all in my head.’ On a bad day, I might think, This patient has a million complaints, and I am never going to figure out what’s really wrong. On a good one, I will see it as a therapeutic challenge. Most days are good days.” —Kenneth Lin, MD, MPH

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I never get over losing patientsDan Witners for Reader's Digest

“An old doctor friend used to say that a piece of you dies with each of these cases. When you’re taking care of people for 15 years, you really get to know them and their families. I know all the children and the best vacations and who fishes. I go to most of the funerals. After someone has passed away, you wake up at 3 a.m. thinking about him or her.” —Vincent Bufalino, MD

I hate seeing you sufferiStock/Thinkstock

“I know the old joke that dentists like to inflict pain, but I hate it. I spend a lot of time telling patients to let me know when they feel they need a break or additional anesthetic. I think about those patients quite a while after the procedure.” —Colleen DeLacy, DDS

Your vaccination joke isn’t funnyiStock/Thinkstock

“I deal all the time with parents who don’t want to vaccinate their kids. Some people get so scared by myth that they can’t pay attention to science. My job is to listen to their true concern and dispel their worry with the best science. But I can get really upset when they joke that their choice not to vaccinate is going to make my job harder. Yes, it does make it harder, and that isn’t funny at all.” —Wendy Sue Swanson, MD

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Why don’t you follow directions?iStock/Thinkstock

“When I was new and patients didn’t take my advice, I would be like, ‘Why are you even seeing me?’ I’m still a little irritated, but I’ll try to probe what’s really going on. Maybe there’s a financial reason, or they didn’t understand directions. Sometimes patients won’t want to be helped until after a heart attack or a stroke. In a few cases, it may never happen. It’s been part of my maturation as a physician to feel comfortable with that.” —Kenneth Lin, MD, MPH

This is a judgment-free zoneiStock/Thinkstock

“When I diagnose a 14-year-old with an unplanned pregnancy, of course I feel a sense of dread. Who wouldn’t? But we have many years of training, so we’re prepared for these fastballs. There’s a pit in my stomach, but I feel empowered to help patients make the best decisions. That’s why I practice.” —Wendy Sue Swanson, MD

Herbal remedies can give me pauseiStock/Thinkstock

“When a patient asks about an unstudied supplement, I think, You’ll pay $100 for this unproven ‘natural supplement’ but not $4 for the scientifically proven drug I recommended? From what medical school did the health food store clerk get his degree?” —David Broyles, DO

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I cringe when you save the best part for lastiStock/Thinkstock

“It’s frustrating when people don’t know what [symptoms] are important or not, so they go on and on. My 15 minutes is taken up by stuff that doesn’t matter. Or they’re worried about a scary symptom but delay bringing it up. Then, as I’m leaving, they say, ‘By the way, I have chest pains.’ What?!” —Lisa Smirnow, DO

The Worst Thing a Patient Did During Treatment…iStock/Thinkstock

• “I’ve had patients hit on me, threaten to hit me with their car, ask me to party in the college dorms with them, and accuse me of having an affair with their wife (who was 30 years older than me).” —Anthony Youn, MD
• “Ignored sound medical advice for an alternative that hurt him, like the 20-year-old college student who, with the support of his family, refused curative therapy for lymphoma and chose exercise, diet, vitamins, enzymes — and a quick death.” —James C. Salwitz, MD
• “Told me she mailed in her stool-testing packet (screening for colon cancer), when she didn’t. Later, when I was seeing the patient’s daughter, I mentioned how bad I felt that we’d lost the packet. She rolled her eyes and said, ‘Right — like she would ever do the specimen collection!’ I was shocked that a patient would flat-out lie to her doctor.” —Mitch Kaminski, MD, a board-certified family medicine physician in Hammonton, New Jersey
• “Lied about pain to trick me into prescribing drugs.”—Kenneth Lin, MD, MPH

The Patient I’ll Never Forget Is…Fuse/Thinkstock

• “The first one whose life I saved. I was a new medical student, and all I did was spend time listening to him and showing him I cared. I convinced him to undergo lifesaving surgery, while all the doctors had written him off.” —Anthony Youn, MD
• “The one whose intuition told her she’d live longer than the six months her doctors predicted. Her spirit and drive to try alternatives gave her six more quality years.” —Mark Liponis, MD
• “One woman, well into her 80s, who golfs with people in their 60s and 70s because those her age can’t keep up with her. She exercises every day to stay healthy and started doing so only when she retired.”—Davis Liu, MD
• “The ones who have true dental anxiety and start shaking and sweating as they walk into the reception room. The fact that they show up and ‘get it done’ impresses me.” —Colleen DeLacy, DDS
• “Harry. He used to hitchhike six hours round-trip to see me. I excised a lesion from his back that turned out to be metastatic lung cancer.” —Pamela Wible, MD
• “My mother, who played golf with two cancers and chose a final view of the water instead of sterile sheets, white tile, and barren halls.” —James C. Salwitz, MD

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