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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.

Several points, I believe:They don’t understand what major depressive disorder is. They may think it’s sadnessThey don’t understand the physiology of depression, and that it’s due to brain dysfunction.They don’t see depression as a psychiatric disorder, which it is. Calling it a “mental illness,” “mental health issue,” or some other euphemism, trivializes the nature of the condition, and leads people to believe that anyone with a “mental health” designation is the proper person from whom to seek treatment.Most people don’t understand that a thorough evaluation is first necessary, before a diagnosis can be made, and that can’t be made about oneself. It must be an objective third party. Most people assume they have a depression, and then immediately seek a treatment option, such as some form of psychotherapy.Most people don’t know what they don’t know. They don’t know that they may have bipolar disorder, low thyroid, alcohol related problems, medication induced problems, cyclothymia, and so on. There are an enormous number of conditions and situations that I rule out with every new patient during the one and one half hour initial consultation that I do with every new patient. Their entire medical history, social history, and so on.They think that antidepressants are no more effective than placebo. They don’t understand the nature of clinical trials is to use the lowest dose that separates from placebo to get the medication approved. In clinical practice, we use higher doses, along with adjunctive treatments, and get much higher remission results.They think that medications should “cure” these ailments, and they don’t. Very little in the field of medicine cures anything. We do a good job of treating the illness. Eyeglasses don’t “cure” nearsightedness, since the cornea doesn’t “learn” how to see better. Neither does the brain.Most people don’t understand how the brain works, so they don’t understand what happens when it doesn’t. The physiology of major depressive disorder is complex, and the result of genetically inherited vulnerabilities that cause dysfunction in various brain circuits.Major depressive disorder is the condition we are referring to when we use the term “depression.” Not sadness, not grieving, not loss, not a bad day, but a bona fide brain illness.

Yes. I’ve walked out of a doctor’s office because the doctor was being disrespectful to me.A Six Month Wait For A First AppointmentApproximately 15 years ago I made an appointment to see a female gynecologist. She didn’t deliver babies, but had partners in her practice who did.Medical Forms And Doctor’s Tools - Courtesy Of Hairboutique - All Rights ReservedI was referred to her from my long time internist who raved about what a great doctor she was.Even with a professional referral, I had to wait six (6) months for an appointment.Calling To Check On Doctor’s Timeline Before Leaving The HouseOn the day of my appointment I called the office the minute the practice opened to inquire if they were running on schedule.They were.I showed up 15 minutes early for my 10 am appointment with all the new patient paperwork filled out and all my insurance forms in hand.I was told by the office manager to take a seat and I would be called in very soon.Two Hours Of Waiting With No ExplanationTwo hours later I was still waiting with no obvious explanation from anyone why the doctor was running so late.I asked if she was helping with a delivery? Or had an emergency or a surgery?Just Running LateI was told that none of those issues were happening and she was just “running late”.One of the other patients leaned over and told me the doctor almost often ran 2–3 hours behind.Losing Time And MoneyBy this point it had cost me real money to sit for two hours in a waiting room since I was a consultant. If I didn’t work, I didn’t get paid.I went to talk to the office manager to ask if she could tell me exactly when I would see the doctor.Being Squeezed In After Hours Of Waiting And A Six Month AppointmentShe said she would “squeeze me in” next.I was ushered into an office for the initial consultation and left sitting there for another 30 minutes.By the time the doctor came into the office it was 1:30 pm. I had been waiting 3 1/2 hours.A Doctor With A Bad AttitudeShe walked into the office and obviously had an attitude.The doctor started by lecturing me about how inappropriate it was to pressure her office manager because she was “a little late”.She had fire in her eyes as she sternly chastised me and said I was “lucky” she had even agreed to see me.I was flabbergasted.Walking Out Without A WordWithout saving a word I stood up, turned and walked out of her office. I proceeded to walk out into the waiting room.As I left, I told the office manager if they dared bill me for an office visit I would “fight it to the death.”Reporting The Bad Behavior Of The DoctorWhen I got home I called and left a message for my internist who referred me in the first place.I told him what happened to me. He seemed shocked and apologized for hisreferral.I never received a bill for the office visit.Shortly afterwards I found a new gynecologist who was always on time or had her office call if she was running late.DISCLAIMER: I neither sell nor promote any companies, their products, nor do I have any online shopping outlet of my own to promote. What I write is based upon my own experience and belief in the techniques I share.