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What I thought would be common knowledge for this physician-patient turned out not to be.A medical oncologist I work with named Dr. Smith called about a patient with a relatively uncommon form of cancer called a MALT lymphoma. He told me that the patient, Dr. _____ had recently retired after many decades at the Mayo Clinic. He moved back to our city, because his daughter lived here with her physician husband.At the appointment, I introduced myself to Dr.______ along with his wife and daughter. I began by reviewing his history. I do this when I am first seeing a new patient to make sure they understand the situation we are addressing. I had talked for a few minutes when Dr.____ asked “Now what’s the duodenum?” I’m sure my surprise was evident in my facial expression as I tried to think of what to say. During the pause, Dr.____’s wife said “maybe Dr. Smith didn’t clarify that my husband has a PhD in economics - he worked as a hospital administrator at the Mayo Clinic”. Just a little embarrassed, I started over with the vocabulary I would use for a “non-physician” patient and the consult continued.

When they start by complaining about their previous doctor or doctors office.While I was filling in for our nurse one day, a new patient came in. After taking vitals, I asked what we were seeing her for. Her answer? “Well the previous doc i went to was such a b****. Her and her nurse…just big b****es.” I tried to ascertain if she needed refills or just wanted to go over medical history. Every answer was b**** related. That tells me, most likely, the patient is impossible to please. Just wants to complain.Every patient leaves a doctor for a reason. And sometimes the bedside manner plays a role; other times it's the staff. But if a patient just wants to complain, that's how they're labeled. A complainer.

I am a pediatrician. I once saw a 16 year old boy with vomiting. Explosive vomiting. He had been seen repeatedly in the ER with no resolution. He came to see me. He was not my regular patient nor my colleagues‘. Just a new patient.He didn’t particularly look dehydrated for someone with this extensive history. He started heaving and retching in my office. I had to run all the way to the utility room to get the vomit bowl. He could hold it until I got back which was remarkable.Anyway, I thought there was a possibility this was a conversion reaction. But, from experience we rule out somatic disease . So I admitted him to the hospital to observe further. We still could not find a cause in the hospital. We decided to refer him to a GI specialist to scope him. I did mention to his mother that it could be psychological and might also need a referral to a psychiatrist. Mom was outraged at this suggestion.Lo and behold the endoscopy uncovered a small ulcer in the gastric mucosa and so eureka! The problem is solved. The gastroenterologist prescribed an antacid. There was prompt relief. And mom swore at me .I was suspicious because the response was so immediate. He took one dose and it all resolved.After a couple of months the gastroenterologist sent me a progress report that the patient had returned because he missed one dose and now it has recurred. He was beginning to wonder at how it can recur after missing just one dose. Anyway the mother had sworn me off. I was out of the picture.A month or so later he was back visiting the ER. The residents told me the boy would interrupt the mother and kept saying Dr. Lwin (me) says it was psychological ,but the mom kept shutting him down.So there it goes. Its very hard to bring up psychological issues as an underlying problem.