Primary Care, Second Rate Treatment

I’m beginning to think that finding a doctor is like dating, an adventure punctuated with high hopes and dashed expectations.  Sometimes, one gets lucky and feels simpatico right away.   Other times, one might — out of convenience, inertia, fear of the unknown — stay in a relationship that is OK but not great or avoid dating altogether.

Before I moved to Colorado, I had a wonderful primary care physician in the Boston area.   I found him by necessity (my health plan hiked the rate so I switched to another) and by accident.  I picked him out of an online directory using few criteria: he was close by, attended an Ivy League medical school and had admitting rights to reputable hospitals.  It was like playing Internet dating roulette;  people can have a tempting profile but, in reality, might be incompatible.  To my surprise, I fell for this physician on my first visit.  He was friendly, didn’t rush the appointment and defied elite stereotypes by sporting a long, grey ponytail and twinkly eyes.  I liked that he chose to serve minority populations;  frequently, I was the only white person in the waiting room.  When I decided to leave the area, I was sad I couldn’t bring him with me.

After relocating, I found my first PCP through an acquaintance whose husband was an experienced physician.  I called to make an appointment.  While he was no longer accepting patients, another doctor in his practice had openings.  She, too, was new to Colorado and, it seemed, a novice at medicine.  I didn’t feel an immediate connection but, I rationalized, if something serious arose I could get opinions from the seasoned doctors around her.  Later, I received a letter announcing her move to another office.  I didn’t follow.

I asked around for referrals, and a friend I trust recommended her doctor.  I made an appointment and, bingo, once again felt I was in good hands.  But soon trouble began.  After my first visit, her assistant shared my blood test results by phone.  She rattled them off, suggesting her job was to relay information, not engage in a dialogue.  I had questions, so I asked anyway.  She answered in a voice ringed with barbed wire.  Was she having a bad day?  Was she only supposed to spend one minute per patient?  I let it go.  On another visit, I had a long conversation with the doctor about a prescription.  The upshot was to try a different dosage, which didn’t work so well.  I phoned the assistant to switch to a similar drug, one I had taken before and seemed to work better.  I repeated the new information twice on her voice mail.  She notified me that she had sent it to the pharmacy, but when I arrived several hours later they had no record of it.  No biggie, I sighed to myself.  Maybe she had been distracted by an emergency or the information didn’t go through.

The next day, I asked her to call it in again.  A few hours later it was ready, but the dosage was incorrect.  I redialed the assistant who, instead of acknowledging the error, tried to gloss over it with an odd explanation that contradicted my discussion with the doctor.  I attempted to keep calm as I rehashed the logic with the assistant.  Maybe my voice wasn’t honeyed enough because she screeched that it was the second time she had spoken to me that day, as if I had used my quota.

Troubled, I wrote a letter to the doctor.  I stated what I believed were the facts.  I expressed my appreciation for her care.  I shared my concern about how the assistant seemed impatient, that I couldn’t always trust what she said.  I asked if, in the future, I could speak or e-mail directly with her.  Then I sat on it for days, wondering if these unnerving interactions were red flags or red herrings.  I put on my spiritual thinking cap:  Was there a bigger scenario, one I wasn’t aware of, that might explain the assistant’s behavior?   Should I take deep breaths, go with the flow, even if it meant lowering my standards?  Was my sensitivity exacerbating an unfortunate but common situation, stressed medical staff?

I liked the doctor, and wasn’t eager to search again so soon for another.  I tinkered with the text, debating whether to send it.  But I realized that, just as in dating, a series of miscommunications at the outset can be the symptom of deeper problems.  I wanted to feel confident that my calls would be answered with courtesy, that whatever I shared with the doctor would not, as in the children’s game of telephone, become distorted or fall through the cracks.  I mailed the letter.  After a few weeks passed without a response, I forgot about it.  Perhaps it had vanished when the office relocated.

Three months later, the doctor left me a voice message.  She apologized that it had taken that long for the letter to land on her desk, notwithstanding the move.  She said she assumed I’d found a new primary care physician by now.  I hadn’t started looking, but I will soon, now that this “breakup” is official.