TIPS: Reasons to visit your doctor, How much to say, Ordering your thoughts, Lists to bring, Questions to ask...

The first patient I ever saw as a medical student was a man who was dying of AIDS. All one hundred or so of my classmates were sitting in an auditorium, feeling a little awkward in our creased white coats with that just-out-of-the-box look. The AIDS patient had a friend videotape the encounter. He told us that he had always been gay, that his family had hated him for it, how he had taken out his frustrations at bath houses in New Orleans. He ran across the stage - IV line in arm - pulling out photos and holding them up after he got right in front of the videocamera. He told us that he was still married after 10 years to a woman with whom he had never had sex. "How many women do you know who would stay in a marriage like that?" he asked with tears in his eyes. Then he cried. I think it was because he knew that he was going to die. And he did just that, I heard, some three months later.

This patient encounter was unusual. The patient gave some history - that is, he told us about himself and his medical issues - but there was no physical exam. There were no diagnoses rendered or treatments given. But the typical patient encounter does have all these things. The doctor's appointment starts with a history, followed by a physical exam, followed by an assessment (diagnoses), followed by a plan (treatment).

The second patient I ever saw was a woman in the hospital with metastatic (spread) breast cancer. Not knowing this, I asked the first question that many healthcare providers ask upon first seeing a patient: "So, what brings you in today?"

"Well," she answered, "I need to get some medicine for my breast cancer that has come back again, but I don't think I'll be around much longer." Needless to say, I felt like an idiot. She had essentially told me that her cancer was going to kill her, and I felt stupid for reminding her of that. But the first thing that your doctor wants to know is why you are sitting in front of her. In some cases, such as check-ups, the answer is already clear. In most others, a Chief Complaint (CC) must be identified. This is usually a sentence or less, usually less: chest pain, earache, breast lump, depression, etc. Next comes the History of Present Illness (HPI), which comprises the events leading up to the chief complaint. "Two weeks ago, I noticed some vaginal discharge that was thin and yellow. For the past several days I have had an awful itchy feeling down there. Now, it just plain hurts." So the doctor asks questions - verbally prodding and poking - to precisely define the HPI.

What follows is the Past Medical History (PMH). Your doctor will ask you, assuming he doesn't know already, what has ailed you in the past. This includes diseases, injuries, surgery, or other abnormal happenings that afflict us all. "I had sex a lot when I was a teenager, and one time did it with this guy who was a sailor, so now I have genital herpes. One doctor once told me I was depressed and I took some pills for a while, but they didn't help much. I haven't ever been to the hospital, but I have had two teeth removed."

Enough said? Nope. The PMH is followed by the Family History (FH), which with older patients generally consists of what all their kin died of. For the rest of us, it's really just a bunch of our relatives' chief complaints: "Dad is an alcoholic, Mom has severe depression and fibroids. Grandma has arthritis, diabetes, and a bad heart. My brother is good except that he is a crack addict - but he's in detox now."

Then there are other things that your doctor wants to know from you: medicine allergies, drugs you take, your alcohol and tobacco use, dietary and social histories. He'll usually even do what's called a Review of Systems (ROS). The ROS is a bunch of questions designed to discover any problems that you forgot to mention or didn't even know about in the first place. For the ROS, doctors usually ask questions by system - cardiovascular system (heart and vessels), respiratory system (lungs), digestive system (stomach, bowels), nervous system (brain, nerves), musculoskeletal system (muscles, joints, bones), etc. An example would be: "Have you had any heart palpitations, trouble eating, diarrhea or constipation, numbness or dizziness, weakness or joint pain?"

All in all, the doctor should ask open-ended inquiries like "describe the pain" rather than "it doesn't hurt there, does it?" Tough to do, though, since all we have together is ten minutes or so.

DOCTORS' WRITING

Click on the above image of a notebook for an example of a written history. This patient was admitted to the intensive care unit following a knee operation because of trouble breathing. The patient's name has been changed.

IMMUNIZE ME!

Immunizations have become big news recently, with the near worldwide eradication of polio, the new vaccination for chicken pox, and the debate over immunizations and autoimmune disease. They are a good example of an item that should be included in the history for all new patients.

1. Come up with a clear reason why you are going to the doctor before you get there. This will save you both time and will allow for more effective treatment.

2. Don't worry about being too brief. The doctor is trained to ask relevant questions if something is unclear. The key is that you should mention all the points you think are relevant. Write them down ahead of time if you have to so that you won't forget.

3. Present the HPI in logical chronological order, starting with the first thing that happened. Again, write it down if you want to. The same thing might be said about your PMH.

4. If you can, bring in a list of your family illnesses and a list of the drugs that you take. Don't forget to mention allergies, even though the doctor should ask.

5. Many doctors will ask you if you have any questions. If you have any, think about these before the visit.

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I have had several really unpleasant experiences with allopathic, (normal) doctors. One in particular was when I had my wisdom teeth taken out. I made it extremely clear that under no circumstances did I wish to have general anesthesia. I wanted local and to remain conscious. I said they did NOT have permission to put me under. I was about 14 years old at the time. Needless to say, they never told me they were thwarting my wishes about my own body. They just gave me whatever and it knocked me out. I awoke several hours later on a recovery bed and as soon as I recovered from the tooth extractions, I developed TMJ, chronic jaw pain. Now honestly, I was out for a longer time than the surgery and at one point I awoke slightly and realized that my jaw was being held open, WIDE open and no one was even owrking with my mouth. I believe that those awful, disrespectful orthodontic surgeons GAVE me TMJ. I have to live with my jaw the rest of my life. Is there some way that doctors can develop more RESPECT for their patients bodies and their patients wishes? Is there a class on this in medical school? Thanks for starting this web-site. It looks very informative and interesting.

-- claire, July 26, 2000

This site is fantastic.... I would like to discuss with the appropriate person my own personal interest in this research. Please advise where and when I can contact someone. On another note, where would one find more information about medical school teachings??? I have been looking for information related to a syndrome called the Nightingale Syndrome. Any information regarding this would be great.

-- Anonymous, September 15, 2000

For over 40 years I have suffered with itching all over my body. My doctor diagnosed Urticuria. Fine you say, we have a symptom, lets treat it. So he did, with antihistamines. These piled on the weight over the years and made me drowsy. During these years I underwent a hysterectomy because of endimetriosis, gall bladder removal because of gall stones, I have contracted a hiatus hernia, osteo arthritis,Irritable bowel syndrome, Migraine, Palpitations, Fibromyalgia and other joint and muscle cramps and pains. Feeling rather low about myself one day I decided to contact someone who deals with allergies and intolerences that a friend of mine referred to. After testing me with over 100 samples he found me to be intolerant to all animal milk products and proteins, something which had been conisitent in my life since about the age of two. One simple allergy test that cost me under £40 has cleared me of the Urticuria, Migraines, Fibromyalgia,Palpitations & IBS. Unfortunately with regards to the Osteo arthritis the damage is already done, but further damage can be controlled by not including Lactose, a protein in animal milk, in my diet and supplementing the calcium that my body did not absorb with the product Osteocare, this gives me the the magnesium, calcium and zinc I need that I have not been taking in from the animal milk products. I am so annoyed about this, to think that I could have been more or less symptom free for over 40 years had my doctor had the forsight to have me tested initially for food intolences. Hope this has been some help so many people.

-- Shirley, September 26, 2000

I am eighteen years old and am getting ready for my twentieth surgery. I'm an ENT's nightmare. My ears were mal-formed when I was born and have had several tubes put in, a clostiatoma(serious infection) drilled out, among several other above the neck surgeries. It's hard being young and always being sick because dr's don't always want to listen to you. A year ago I was diagnosed with H.pylori bacteria that lives in stomach acid. I lost 30lbs and got down to 83lbs. Every dr I saw thought I had an eating disorder except for one. She found out what was the real cause of my weight loss and she found it just in time. i was so skinny I could have had a heart attack. Don't give up if you really think something is wrong. Fight until you find that one dr who will listen to you!

-- Jessica, January 7, 2001

Dear Anonymous, September 15, 2000

Sub: Nightingale Syndrome. If it's not too late, you may wish to check out these links. (Copy and paste each address to a search engine, and press ENTER.) Good luck. Best wishes.

1) http://www.cfids-me.org/

2) http://www.cfids- me.org/index.html#Diagnosis

3) http://google.yahoo.com/ bin /query? p=nightingale + syndrome & hc=0 & hs=0

Ps: The last one gives 1,340 web page matches!

-- Basky, August 8, 2001

Iam a research scholar working on doctor patient relationship. i would be greatful if you could give me some inputs on this aspect. your site is a good one. PBS

-- P.B.S., September 4, 2001

Dear :

i came to ur web by chance and i like it , am a 3rd year medical student and i have history of patient in Surgery , before yesterday i had a pateint with diabetes mellotes , he had an operation and they cut his three toes' from his left feet so just can u help me to write this patient history :)

with alot of thanx

sincerely yours

Armstrong

-- david armstrong, April 3, 2002

I had my gallbladder removed nine months ago and have subsequently gained over ten pounds. My metabolism was already on the sluggish side, but now it seems to have completely stopped. Is there any food supplement or vitamin I might be able to take that will get things moving again?

-- Anonymous, May 15, 2002

Hi, i was on the site hoping to find someone that has had some of the same problems. I was diagnosed with clostiatoma of the right ear when i was 3, ive had 11 surgeries and my specialist has told me at least 3 more to go. Ive had 6 sets of tubes and my ear drum is permanently deflated for the simple fact that it kept bursting. I was also told I was the 5th kid in the US diagnosed with this particular disease under the age of 10, so I haven't really found anyone I can talk to about it. So if there is anyone out there that can relate, please email me!

Thanks,

Chelsea

p.s. Those out there fighting, don't give up! I promise if you find the right specialist and never give up hope, you'll find some sort of relief!

-- Chelsea, 14, August 8, 2002

what do you think of osteo check test?

-- Anonymous, August 20, 2002

During a recent visit to an opthalmologist, one of many in the past year ( I have an eye hemorrhage),

I was given a form. Besides the usual questions this form also asked for educational level. Miffed by this question, I declined to answer. my sister-in-law, a nurse, thought there could be a bonafide medical reason for asking this question. I looked on it more like asking what was my hole card in a game of five card stud. Who is right? Would my lack of formal education be seen as a license to condescend? If I had said I had been to graduate school, would I be treated with the greater respect due a potential intellectual peer?

-- ishmael, March 14, 2003

hi by chance i vist this site but this site give me the clear picture of life and the way we face the problem .more this type of experinces should me shared with the people around the world.

-- sweet namisha, April 13, 2003

I agree with everyone, don't stop until you get a doctor to listen. I have hydradenitis-suprativa since puberty and everyone just thought it was real bad pimples on my butt, thighs, underarms. I have endured two surgeries to remove sweat glands so that I would start clearing up and not getting worse. When I was finished with surgery, it just got worse again and the suture lines that the doctors made started to get pimples. There is no hope. This disease is a major cause of sucide in the United States. When your sweat glands don't work, you get very bad scary skin. I was lucky and never got it on my face, but I went through agony until adulthood to even know what the name of my condition is. This needs to be fought from the inside out, but instead they keep wanting to operate. I still continue to have this problem and my only hopes of getting rid of this is menapause. Then basically your hormones are diminished. and i should not have to wait for this to happen. I am in school to go into the allied health field and then at least I know that I have a brain will listen to the patients. In the meanwhile always remember, patient care always begins with the patient.

-- Robin, April 14, 2003

I was at the Drs. about 17 years ago and questioned him about a rash on my face and nose. Could I have lupus? he told me that it was just dry skin. A few months later I went with what I thought was a inner ear infection,he told me it was a abcessed tooth, I have had dentures for over 20 years and no way possible could I have had a abcessed tooth. Needless to say I immediatily changed Drs. In 1992 I was tested for lupus and diagnosed with it, after it had caused lupus nephritis. I feel that possibly if he had listened and tested me I might not have had kidney problems. Drs don't listen to what you are saying, they think we don't know our own bodies and can detect something is wrong. I worked in the medical field for 34 years and I am not dumb, I do not trust Drs and feel they don't tell you the truth. In this day when hospitals are in such bad shape they tend to do test that are not necessary,just to make money, especially if you have good insurance.In the meantime with all these test they do, you about out of your mind with worry.I feel that is patient abuse mentally and physically. I could tell you stories that would raise the dead and these are just ones I know to be fact, because I was the patient in all of them.If you would like to e-mail me My address is ladyliz345@yahoo.com

-- Betty, July 7, 2003

i went to a doctor and had hurt my ankle and he x rayed it said i had adouble sprang said in six week it would be better but ,it got worse so i went dack and he orderd a mri and i went back after the mri he still said i had adouble sprank ankle but no. i ask about the sectuary about the mri she said we do not have a mri on you after in the same hospital that he work he orderd the mri , so i go down stairs and get the copy of the mri and in my leg after i read the mri it showed i have a torn leagament . i mean it torn in to , not to gether at all , so well the doctor still said i have only a double sprang ankle . now i have another doctor tell me due to this i hurt the other leg and realy spranged it , and now later in a fw month i may not be able to walk , is what the new doctor told me so is this right , ivy a

-- Anonymous, November 11, 2003

This isn't a comment, nor a tip, nor an experience. Its a question, and I feel foolish for asking it. But oh well. Can I get sweat glands from my forehead and armpits removed? And if so, will I get sick from a diease?

-- Amber, January 13, 2004

I am hypersensitive to needles, especially IV needles. Upon induction I go into traumatic shock from the pain (hyperalgesia?) which the anesthesiologist controls with meds. A few weeks after the surgery most of my hair is gone. I tell every surgeon about this and they refuse to use anything else. They say, "That's all we have." After much research I found that this is not true.

Do I have to pre-sedate myself with 30 mgs. of Valium and 30 mgs. of hydrocodone before procedures? Well it sure looks like it. I should have never had to learn about drugs - you should be able to trust your doctor.

This is abuse of the worst kind - fraud, intentional infliction of physical and emotional harm and humiliation.

Comments please. Thank you in advance.

-- susan, February 9, 2004

just by chance i found this website and luckily for i found someone who had emailed in with the same condition as i have. its called Hydradenitis Suprativa and causes boil-like infections in all sweat gland areas. it is very uncomfortable and have been told that it is uncurable. i have been placed on antibiotics (yet again!!) for another year. The person that wrote in had said that she went for operations on removing them but was left worse than before. thank you for that information as that was going to be my next step. it has taken 5 doctors, 2 surgeons (1 in UK, 1 in Australia), 14 blood / urine tests, many many antibiotics over a total of 5 years and finally (this week) i have a name for my condition.

-- Claire, August 11, 2004

I'm so happy to have found this website and to notice in the comments that I am not alone in my experiences with doctors (although that's not something to be happy about, that's just really sad...). I've been having problems with my tongue/throat ever since a cycling accident, and it just keeps getting worse and worse, but the doctors are so completely uninterested in helping me that I am truly in despair. I've gone from intense muscle strain and grinding/popping when I swallow to now the feeling that I have loose bones or cartilage in my throat and a sharp bone feeling under my tongue. The first ENT, after a cursory exam, said it was psychological and that I needed to see a psychotherapist. A few days after that, when my tongue and jaw started to go numb, I went to the emergency room and after another cursory exam, was told that the ENT was correct and that it was all in my head - another psychologist reco. The second ENT said it was GERD - I had a barium swallow xray (FINALLY! A TEST!) that showed it wasn't GERD, but it didn't show why my cartilage was popping around when I swallowed. Now with the loose stuff floating around in my throat, I am on my 3rd ENT, this one recommended by a friend. I agree with the other folks, don't ever give up until you find the answer, although to be honest I'm finding it hard to not just give up.

-- Kay, January 18, 2005

I have had have had shoulder pain for four years.It has become steadliy worse. I take several medictions during the day and to sleep. I awake in terrible pain and have a alot of limitations in what I can do. I have ben to several dr.s who just blow me off. I have had 2 MRIs. the second found difinate problems. I was sent to a orthopedic surgeon and he said that it was not bad enough to operate. Mind you I have kept my range of motion through daily walkng ang gentle yoga streches. I cold not believe what Iwas hearing. He was in the room with me for no more then 10 min. Didnt even let me ask and questions or finish my questioneer and he was out the door. Even though he said that eventually I would have to have surgery right now was not the time.. Why do they have to wait till it is so much worse? I cant imagine it getting any worse. What do you do to cope with the pain and sleepless nights. It is very fructrating when you are in pain all the time and all they want to do is give you drugs.... Any comments or suggetions? PS this is a work related injury.

-- Char, March 28, 2005

I have had headaches, burning sensations in my eye, weird pains all in my left side for over 2 years and have been told that it was migranes and tension headaches yet nothing was done about it. I have been told that I am anxious and nervous too. These pains are scaring me and no doctor is giving me the correct answer.

I ahve also had other pains and have been told that it's just anxiety. I feel them and know that it is not true.

I am sick of these doctors.

-- Anonymous, April 5, 2005

I went to see a respected doctor on a Monday in our town after becoming ill on a weekend trip. Prior to that visit, I had visited this doctor only for medical check-ups, blood tests, and pap smears, so she had seen me before, although I had not been sick. The nausea, vomiting, sweating, and weakness had gone away by the Monday, however I wanted to know why I was so ill on Saturday. She found my sugar high, but said that that was probably unrelated to the illness. She offered no definite for cause for my being sick. She suggested that it may be something I ate. I had eaten two raw carrots during the trip, a ham sandwich after I got to our destination, a glass of sweet tea, and then became nauseated, and had to be driven back home, sleeping most of the way. The vomiting, sweating, and weakness lasted until Sunday morning. She prescribed a glucose meter, test strips, and asked me to test my blood sugar each morning. If it tested higher than 110, that I have diabetes. To leave off foods containing refined sugar, and to limit calorie intake.

I have high blood pressure, and when I went to see the doctor that is treating me for the blood pressure, I mentioned that my local doctor had found my blood sugar to be high. This doctor was inclined to believe that I was not diabetic, that my blood sugar would return to normal levels if I could lose just 10 pounds, get more exercise and he recommended Atkins. He did blood tests, an abdominal scan, an ultrasound of my gallbladder, and after a follow up visit, said that I was still producing insulin.

I later visited my local doctor for the yearly pap smear, and recounted what my other doctor had told me about the diabetes, and she said there is one test that will let us know for sure, and she sent me to the hospital for a glucose tolerance test. This test was indeed positive for diabetes. She gave me the results in another (paid) office visit. They ask for your copay to be paid as you enter the waiting room, before you see the doctor. She gave me samples of an oral medicine for lowering blood sugar, and gave me a new prescription for my blood pressure medicine at my request. We have new insurance at work, and my other doctor was not on the provider list, so to keep everything at one doctor's office, I asked for a new prescription. She said that my sugar may be going high at times, and if it goes high it can cause damage. I didn't notice that she only gave me a 30 day supply prescription for the blood pressure medicine, with 3 refills, until I had the prescription filled.

I only took some of the blood sugar lowering medicine, because I didn't feel well when I was taking it. I called the office back when I realized I only had a 30 day supply of the blood pressure medicine, and was told that I had 3 refills. I wanted a 90 day supply with 3 refills, because it is less expensive to buy it in larger quantities, and you don't have to keep going back to the doctor as often, paying the office visit copay each time.

I still had 90 day refills left from my other doctor, so I just got that refilled, and continued to try to manage my sugar levels with my diet.

My local doctor's office called me at my home to remind me of my next appointment. My husband told me when I got home from work that I had an appointment at the doctor at 8:00 the next morning. I had not made an appointment. I was a bit put out because I was concerned that they may charge me for an office visit if I didn't show up, and I could not go because I had not arranged at work to take time off to go to the doctor. I didn't want to go anyway. I called their office the next morning to discuss this appointment after I got to work at 8:00 AM. I first asked why they keep calling my home to remind me of appointments after I had asked them to contact me at work. They said that the work number had been noted in my file as the home number, they would correct it. I told them that I had not made an appointment, and they said the doctor had made it for me. When I asked what it was for, they said it was a follow up appointment after the tolerance test. I told them that I had already had a follow up appointment, the medicine samples had not agreed with me, and that I may need to just find another network doctor. That I didn't like paying the copay before I saw the doctor, and I wanted a 90 day prescription for blood pressure medicine, which she was not willing to provide. I canceled the appointment she made for me, and did not go. It was beginning to look to me as if this doctor was going to make as many appointments as possible to get as many office visit payments as possible.

This was several months ago, I never did get the primary care physician changed at the insurance company. Now I began to have periods of numbness in my back, near the center between my waistline and the bottom of my neck, to the right of my spine, and my right hand gets numbness at night, and has been for a long time, and I was wondering if these two things could be related, and if I needed treatment. I also developed arthritis in my left foot. I called this same doctor for an appointment. I paid my copay in the waiting room before going in to see the doctor. I was called to go into the lab, I was weighed, my blood pressure was checked, and I asked the technician to check my sugar. My sugar reading was 105. The lab technician asked me what problems I was having, and I told her about the numbness in my back, and right hand, and mentioned that my left foot has pain from arthritis, and that there is a spot on my right foot that itches. I was shown to an examining room, and only waited a few minutes for the doctor to arrive. I was sitting in the chair, and she went to the other side of the examination table. She asked how I was doing, and I stated that I was still in denial about the diabetes, and she announced that she would no longer treat me as a patient, that I had shown disrespect to her on the telephone, would not follow the treatment she recommended, and I could just treat myself, or go to my other doctor. I told her that my other doctor was not an approved provider, and she said I could get another doctor. I asked for a referral to an endocrinologist that I named, and she said that it takes too long to see a specialist, and refused to give me a referral to the specialist that I named, that is on the provider list. She repeated that she no longer would be seeing me as a patient. I sat there stunned that she would not treat me, nor would she give me a referral. It crossed my mind to ask for my money back, however as I sat there stunned, she came around the table, and bent down to look at my left foot, she said that for arthritis, it is helpful to wear supportive shoes. I asked her if she would reconsider her decision, and she said no. I left her office, and after getting used to my hurt feelings from being rejected at the doctor's office, I called their office the next day to ask for my copay check back, and was told that since she looked at my foot, she was entitled to the copay, and to file my insurance. The total was over $100.00. She was being vindictive because I was critical of her fee maximizing practices. Now I have to call my insurance company and specify another primary physician, wait 30 days, and see another doctor for what she should have treated, since she kept the money. She would not give me my medical records, she will only release them to another doctor.

I am considering reporting her to the state medical licensing board, and I hesitate because although my feelings are hurt, I know I will need medical care, if I complain will my complaint keep me from receiving treatment from other doctors in my town or state. If my records are transferred to another physician, will she prejudice their accepting me for treatment?

If any of you took the time to read all this, please post what you think. Should I report her, or not? Since I stated that I was going to find another doctor months ago, and did not do so, does that excuse her from the responsibility to let me know of her intent not to treat me in the future?

-- Anonymous, April 10, 2005

I was diagnosed with diverticulitis a few years ago. I had a bad bout of diarrhea, and after that a nagging pain on on the left side of my abdomen, and across the middle. This was accompanied by difficulty in bowel movement, and stools that were pencil thin. The doctot said that this was classic diverticulitis, and prescribed an anitboitic to clear up the infection in the pouches in my colon. These pouches are caused from straining to have a bowel movement from years of constipation. I had two colonoscopies, the first one with removal of polyps. The second one was a few years after the first one. The diverticulitis would get better, and worse, I thought I was dealing with a chronic illness that would never get better without removal of part of my colon.

I later discovered on my own that drinking large quantities of red grape juice was the food intolerance that was keeping the inflammation active. As long as I leave that off, and eat 5 prunes about three times a week, I don't get the inflammation or the stomach ache, and the prunes prevent the constipation. In my younger days, when I asked the doctors about constipation, and if having only one or two bowel movements a week was normal, the only remedy offered was liquid Milk of magnesia. No mention was made that you will have diverticulitis if you don't find a way to have regular bowel movements.

-- Anonymous, April 10, 2005

I went to Department of Vocational Rehabilitation for help with depression. Since then I have been reassigned to 3 different counselors. The first 2 retired. The current one seems to be narcisstic. She demands I do something then changes the requirements. If I ask for assistance and don't agree with her decision I am a "uncooperative". She has forced me to get E & A after being determined by her superior to be eligible for services. Now I am being forced to go on social security disabilty because I wanted to open my own business. By disagreeing with the diagnosis reached in the E & A, I will be deemed with a disorder that will Haunt me for the rest of my life, even though no physical exam nor eye exam were performed to rule out a physical or visusal problem.

If you go to Voc Rehab or anywhere to a gov agency. DEMAND copies of ALL papers in your file; keep a PRE NUMBERED journal that you record everything in from Phone calls, appointments whether missed or not, reason for appointment, reason for missing it whether you rescheduled or your counselor did and why. Be prepared to be treated as less than you are.

-- Anonymous, April 16, 2005

Okay, here is the story, and a solution that some of you may be able to try in order to get out of appointments. I made an appointment with my doctor for a very sharp pain in my head that I had for a couple of days. the day of the appointment It was suddenly gone. (maybe stressed induced). So anyways, I call up my medical office HMO and tell them I would like to cancel the appointment, they tell me there is a fee that is about 5 bucks more than my copay. I ask them if I can just reschedule a few days later because I'm not sure if it will come back or not, but that the problem went away. They said that they had me scheduled for this slot and that the slot was useless to them if I cancel.(this was within 2 hours of the appointment). Okay, I thought, recalling all the times I waited almost an hour to see my doctor for 5 minutes, I tell them "I'll come in". Anyways, my office has the policy of getting the co pay prior to seeing the doctor.. I told them to print up a bill for me and I'll sign it and pick it up after the doctor sees me. (this is legally my right to ask to be billed rather than pay cash up front) I've also heard of people writing a check (but nowadays they might be able to process that right away). Anyways, I also asked them what slotting schedule they used, i.e. when was the next appointment for my doctor, they told me they schedule in 15 minute blocks. Okay....now the stage is set. ....I'm waiting and waiting and waiting...15 minutes go buy....no movement, still waiting in the waiting room. 16 minutes after my "scheduled" appointment was to begin, I told the front desk I was leaving and did not expect to recieve a bill. They told me that I still had to pay the copay, which I told them "I don't think so" I recieved no service and the copay is not an "administration fee" it is a "portion" of the billable doctor fee. At this point the woman said that she will cancel the appointment in the system and that corporate would send me a cancellation fee. I told her "okay....then I took out my digital camera which was in my bag and took a photo of the sign in sheet, the clock on the wall, and the newspaper on the table" She asked me what I was doing and I told her "well...when I recieve the fee from corporate, I will send them a letter explaining that I arrived at my allotted appointment time (picture of the sign in sheet), on the assigned day (newspaper on table), and was not seen within 16 minutes of my scheduled appointment (the clock on the wall), and that since I WAS there and I did NOT cancel the appointment, that I would refuse to pay the fee and that any further harrasment from that medical group would be met with a letter to the medical review board and better business bureau for misleading business practices." At this point, she became quite rude and said that I couldn't take the picture of the sign in sheet because it had patients names on it. I in turn told her that in that case I would report the office to HIPPA for displaying private medical information (offices are supposed to cover up the names of people once they sign in). She then said that she's ruining any chances of using her office. I told her that we can easily switch medical groups and that others were closer to our new home anyways. She then went on to say "why do people feel that they can just make an appointment and cancel it without causing problems", I countered with, "why do doctors offices feel that they can make their patients wait for hours and overschedule patients all the time just to get the co-pays and bill the HMO's ~$100 for 5 minutes of doctor time." She then said that the doctor has to handle patients who make last minute appointments. I countered, "then you should have let me cancel my appointment and then you could have used my time slot to catch up on all the other patients, and that if anything, you should promote late cancellations especially when the doctor is behind schedule." At that point, she knew I wasn't going to take the bill, and that it's out of her hands. I told her I held nothing against her or the doctor, but I disagreed with corporate policy on this issue. She said "bye". I recieved the bill the next day in the mail, and wrote "return to sender" on it. I recieved another one a few days later and wrote "return to sender...again" on it.

I recieved a call from the office asking me what my address was, I told them the one of file, and went through the story with them at which point they said they would send me the bill again. This went on for about 2 months of them sending me bills, in new envelopes with new stamps, for which I continued to send "return to sender" on the envelope. I then recieved a bill from the HMO for the 25 cancellation fee, at which point I sent in the letter with the pictures and told them not to even try sending me any further correspondence.

A few months go by and I get a call from a collection agency, at which point I was steamed...I then talked to my brother who is a lawyer, and had him draft me up a letter to the HMO stating a bunch of legal mumbo jumbo about services not granted and so and so. Eventually about a year later, and after the medical group stopped contacting me, and the collection agency stopped contacting me. I sent a letter to the medical office where this all began and stated "here is the 20 dollar co pay that you wanted, considering that you and your medical group have now spent in excess of probably a few thousand dollars in peoples wages, stamps, letters, collection service fees etc...I figured I'd help you out." I recieved a letter about a week later from the doctor that said "Dear Mr. X, I hope you are well, I just wanted to thank you for the $20 payment, and let you know that because of your actions, my medical group has revised it's policy on co pay's and scheduling. We now require a $50 copay, and at least 48 hours notice prior to cancellation."

Please send us a check or money order for $30.

-- A way Out, April 27, 2005

Thanks for the site, I would love to see this site have a uiversal patient intake form. i mean really, if i have to go to several different specialists,why can't i just print out aWord doc that has "the usual" (allergies, surgeries, list of meds, family history, etc. Do they really need to have this static info handwritten on their own forms?

-- Anonymous, April 30, 2005

Since 3 years, i have a pain. i had chechup serveral type of doctor but no body can cure my pain. Pain is unberable. Hard to work and live with such a pain. I can' lift even 1/2 kg things for sometimes as a result i have to face pain. will u pls suggest me what to do and whom to consult such disease to cure.. pls help me and cure my disease god will bless you if you do so.

-- Bikash Mool, May 16, 2005

Hi! I have a question. I went to the doctor because I have a terrible cough, chest pain and pressure that gives pain to my heart and left hand, it feels like something is wrong with my lungs. I went to see a doctor and paid a lot of money for the visit. However, she only prescribed a heartburn medication for me and did not even listen to my breathing. She just wrote down my complaints. Can a doctor prescribe medicine without physical examination and listening to my breathing when I have cough? I do not believe that I received a proper service for the money I paid.

Sincerely,

Alesia

-- Alesia, May 18, 2005

how do you cure boils without going to the doctor?

-- Anonymous, May 19, 2005

you have done a wonderful job,congragulations!!!

I'm studying medicine in turkey and i just finished first year

besides I'm a professional patient(?)when i was little i used to get ill very often i used to spend most of my time in hospitals

especially when it was holiday or when my parent took me outside

the doctors gave me pills fore my sore throat and send me back home!

Until we consulted another ENT specialist who found that i am allergic!

I'm allergic to everything except home made food and it's why i always got sick on holidays!

-- sevgi cenan, May 30, 2005

Terrific site! Just thought I would remind everyone that is past "childhood' that there are still vaccinations that we need as adolescents and adults. Ask your doctor at your next visit to review with you any vaccinations that you might need. If you havent had a tetanus=diptheria booster in the last ten years, get one. If you're in your teens, ask about the new meningitis vaccine that will protect you thru college and if you havent had a second measles (MMR) shot, get that also. Some may also need the Hepatitus B vaccine.

-- mhdj, June 2, 2005

I read the previous patient experiences and have

had similar nightmares with docs for 6 years. One

site I found that would be GREAT if EVERYONE that

has a good or bad experience would use is

RateMDs.com

You can rate any Dr you see, put comments, etc.

They are arranged by state, specialty, etc. The

more of us that contribute to this site, the more

these incompetent, rude doctors are exposed. It

will also help find the GOOD ones out there. Please

help all of us know where to go for good treatment

and which doctors to avoid by rating all the doctors

you have seen.

Almost 7 years ago, in my mid-40s, I was a

marathon runner, back in school for a masters

degree to change careers, traveling the U.S. with my

talented gymnast daughter, and enjoying biking,

tennis, hiking, skiing, etc. with my wonderful

husband when I was suddenly hit with a debilitating

illness that had me completely bedridden in

excruciating pain. For 3 years we sought

desperately for help. After the obligatory 5 - 10

minutes from most of the doctors the most

common diagnosis was that it must be some form

of insanity, hysteria, or a way to get pain meds for

an addiction since most could not easily diagnose

the problem within minutes.

A great rheumatologist actually did some research

and found I have a rare autoimmune illness. He

had read in med school the possibility of the

immune system malfunctioning in this way but it

had not as yet been identified in a patient. Even

with a diagnosis, many other docs and ER personnel

acted as if not only am I psycho but my doctor must

also be some type of psycho! My husband finally

took me to one of the Mayo clinics that basically

came to similar conclusion. However, the

experience was the worst of my life. I found the

place full of doctors with god complexes and other

employees with little care and concern for patient’s

misery. The only thing that made the experience

tolerable is that I can now mention "Mayo Clinic"

when I tell another doctor or hospital the diagnosis.

With no records or validation, they accept the

information.

My husband, my daughter, and I have all been

involved in the medical field for years and have

good friends and contacts that have assisted and

advised us. My husband is a chiropractor who

works closely with many orthopods, GPs, PTs, etc.

with numerous sports teams and injuries; I was

working on my masters in Physical Therapy; and my

daughter is a pre med student in college and

volunteers at a large trauma hospital. And yet,

even with the help of many in the field we have

struggled to find quality help, have been treated

inhumanly, and feel we have been totally abused by

many of the physicians I have seen. Finding a pain

specialist that has training in chronic pain and is

willing to work with patients with the condition

rather than tolerate them between their beloved

"procedures" has been especially difficult.

My condition is constantly changing and declining

so I am continually needing new doctors for

different symptoms & problems. I am finding more

incompetence than expertise, more rudeness than

kindness, and more arrogance than care in the

medical profession. Searching for help has become

a full time concern and has caused me to become

cynical, depressed, and often hopeless. If it were

not for my husband’s commitment, love, and

strength I doubt I would still be alive. Seven years

ago I was active, full of energy and excitement, and

could hardly wait for the next adventure and

challenge. I never sat still a day in my life ... until

this. Today I am tearful, mostly confined to bed,

and just plain SAD. It’s a shame that doctors have

an oath to “do no harm” yet have led many of us to

despair.

-- Jeanie, June 24, 2005

I just finished reading every letter on your web page and must say that I am in agreement with those who find todays "doctors" to be lacking in concern for their patients. It appears to me that they have a system to maintain and the patient be damned. For me, it is a fact that doctors have a god complex issue. After 62 years of life, I find myself in a situation that will only get worse. I have no insurance of any kind. The only way that I will be able to afford medical care from now until death is if I hit the lottery and I don't even play. After moving to a new city 18 months ago I went to see a new doctor and mentioned my joint and muscle pain during our first intake visit. FNP Steve then blurted out that the office was not writting prescriptions for pain meds. I had not asked for any so it really pissed me off that he would assume that I was an addict looking for my next bottle of meds. Needless to say, I flushed his sorry ass immediately. During my visit with a second doctor I attempted to go without mentioning the daily pain that I am allowed to experience. That doctor prescribed meds. for pain and then watched me like a cop at every refill. Even had to spend $82.00 on an office visit just to keep getting refills. He then wanted to send me to a pain specialist because he didn't want to continue treating me for pain. My solution is that I will drop his sorry ass too. From now on doctors (if I can find one I can afford to see)will not know about my pain because I refuse to be treated with such disrespect by them or their office staff. I am sure that I can suffer body pain better that I can suffer their stupidity and absolute disregard for the human spirit.

-- jerry, July 8, 2005

I would like to know if anyone that reads this

site has ever experienced going to the

doctor with physical symptoms and after not

being believed and perhaps having been

misdiagnosed, they have developed and

been treated for depression.

This is for a research paper that I am doing

and any answers would be thoroughly

appreciate.

you can answer at amvestal@msn.com,

when you answer please put as subject:

depression research just so i recognize that

it's a genuine e-mail and not junk mil.

I thank you in advance for helping me with

this.

Caterina

-- Caterina, July 24, 2005

Not all Physicians are egocentric - HOWEVER - I have time and again had to use reverse psychology on Doctors to get what I (or a loved one) knew I needed because if I had asked for it, inquired about it, suggested it, etc., they would have done exactly the opposite!!! So, remember; 1)Always keep your Doctor's ego in mind when in their presence and constantly stroke it. 2)Make veiled statements so they can make your suggestions for you. 3)NEVER demand anything unless you desire to get the opposite of what you wanted! I am not trying to be a smart-a**, but I have personal experience with making a correct decision (I have some Med experience) that was presented to a Dr. and was dismissed simply b/c "I" had thought of it first and NOT them! If you have a serious illness and an overworked, egocentric DR. with little time for your case - YOU BETTER HEED THIS MESSAGE, or the worst may come upon you.

-- 'Ardjuna', September 4, 2005

I am a 58-woman that has susdained Brain Cancer and a lot of other major illnesses. The problem is: the HMO I belong to ...now wants to treat my pain as pain addiction.. Why can't a person who has declined pain medicine in the past...now they offer it to them to get them off pain..just to take them off...I really wish I could find someone before this particular HMO drives me to my grave...As it did my mother-in-law, and mother. Please help.

Stevie

-- Stevie, September 28, 2005

Hey, I am 19 years old, and for the past couple weeks, I have had an awful toothache. Well, yesterday, when I got up, my right jaw was swollen...not much, just a little bit..and it went down some today, but is still swollen. I have never been to the dentist; I have never had to go. My aunt said that my swelling was caused by an abcess tooth, I read about that on a website,and now I am scared, bc I dont wanna go to the dentist, but I dont wanna die!!! Please help me out here...any home remedies to get rid of infection without going to dentist?

-- D.W., October 26, 2005

easy on the negativity, doctors are asses most of the time, but society put them head above the rest ages ago, and now we get to ride the wave. ok except that i must admit that i didn't guess the nickel allregy diagnosis. and i've got TMJ too, so the chick who's crying about it so much, pleeeease, its not THAT big of a deal, plus there are several ways of noninvasive treatment. i've got to write case history on a little girl with asd, vsd and pyloric stenosis. $20 to any med student who'll do it for me =)

-- natalia, February 17, 2006

best ways to loose weight after a hysterectomy i gained 65 pounds after 13 months in one week i gained 8 pounds please help i hate myself now and really don't want to even go out of the house but i go to the YMCA at least 2 days a week to aerboci's and on a high fiber diet and use equal but it is not helping Thank you Tonya

-- Tonya, March 23, 2006

Perhapas not all medicalpersons are egocentric as Arjuna suggests but the intellectual hubris of many works to the detriment of their patients and others. Physicians are owed respect. NOT deference and stroking their egos mat not get you better care. Egocentrism has its origins in the culture that confuses humiliation and belittling of people with education and eruidition. Medical students then interns/residents are subjected to a system that equates humiliation with learning ... then as licensed physicians they pass it on to their victims... unless we break the cycle!

-- sasha, April 27, 2006

Can an abcessed tooth cause pain in shoulder?

-- Anonymous, May 13, 2006

I'm a big doc-wiz. been like that all my life :-), lately i got in deepth all the "rate & review your doctor type of sites". i got 2 tell u, its fun !!!

you just give your doctor a checkup....

try it out:

healthgrades.com

mdjunction.com

locateadoc.com

Jane

-- Jane Brend, July 11, 2006