Who is my doctor?

I am a 3rd generation physician, which means that as a little kid I was given no choice as to what I was going to me when I grew up... "So, you are so smart little Johnny, I am sure that you want to be a doctor just like your father and grandfather and brother and uncle etc etc." You get the idea. My grandfather had his office in his house. He ate breakfast and then walked across the hall, opened the big sliding doors and Voila! he was in his office and its waiting room. What a great commute!

My father had operated on so many citizens of Quincy, Massachusetts that he was always leery of eating dinner at Quincy restaurants because so many people would rush over to see him that he never got to finish his dinner. Every Christmas we received hundreds of thank you notes from grateful patients. He was their doctor, they were his patients.

I have always tried to practice in the same way. I want to know who my patients are by sight. I want to walk out in that waiting room and pick them out from the crowd. Is this a crazy way to feel in 2008? Maybe.

Everyday I answer posts from patients who seem unable or unwilling to discuss their care with their "real" doctor. So they turn to the internet doctor instead. But I rarely have all the information that I need to respond in a really insightful way. Yet they are appreciative of the time that I take to discuss it with them.

Today I saw a new patient with a hydrosalpinx (blocked and fluid filled tube) and she had seen another fertility MD who (correctly) recommended a laparoscopy and possible removal of the tube if it could not be repaired. The patient wanted a 2nd opinion but really felt that her former MD had not explained why the tube may need to be removed. She is a very nice woman and I just don't understand why she wasn't treated better.

I want to practice medicine one patient at a time. To me it is not satisfying to perform 25 egg collections in a day on patients that I have never seen before. If I wanted that type of job then I would go work at Jiffy Lube (no slight intended on those who actually work at Jiffy Lube, but you get my drift). I just don't think that patients should be herded along like cattle and treated as just another statistic. You have to consider all aspects of the patient when planning treatment: financial, physical, emotional, spiritual and philosophical. One size does NOT fill all in terms of fertility.

So decide for yourself if it is important that you know who your doctor is....some patients don't mind fertility care by committee with a revolving door of specialists as long as they are well-trained. But don't expect to find me there. If I have to practice that way then I will pack it in and run my publishing company instead. Medicine should be practiced between a patient and her/his doctor.

I'll take my lumps when things don't work out but I hope that all my patients realize that I am trying my absolute best for them every day (including a lot of weekends).

So when all else fails, go ask your doctor and if you are not sure who your doctor is then consider whether you may do better in a different sized practice...

Not much medical advice today but it is Friday and it has been a long week...