Doctor Loyalty

Most of us know someone who is guilty of this: Their/your general practitioner/primary care provider is 65–70 years old, can’t remember their/your surname (medical receptionists are the best!), and their type of care hasn’t changed in 30 years. On the other hand, the doctor/physician could be young, full of energy, and a little too arrogant for your liking, but “they have great reviews, and they helped me in a bad spot a few years ago” so you keep going to them; not out of urgency but out of loyalty.

I get it. Not all doctors need to be Prince/Princess Charming and wow you with every sentence they make. You like who you like, but if you think about it, do you like your doctor because they are a good doctor or because they have good charisma? While often seen together, these two traits aren’t always mutually exclusive, and when this happens, arrogance and medical malpractice are not far behind.

My medical history is, uh, complicated, and the rest of my family members aren’t that far behind. I’ve seen about 30 different doctors in the past 25 years (when my complicated medical history started), and although I don’t speak to any of these primary care providers and/or specialists anymore, I can see how easy it would be to go to those who knew what they were doing at the time, even if they may have lost the plot since.

As humans, most of us choose not to disappoint those around us and most want to meet expectations. It doesn’t matter if the person in question is a professional and consults 50 people a day, that feeling of “But they’re my doctor. I can’t just leave them!” is a feeling most of us have experienced at least once. The potential disappointment of said doctor at losing a longtime patient is a strong feeling, one that most can’t shake off. This, obviously, doesn’t include doctors and specialists who are generally shitty people and/or bad doctors. Those doctors don’t need any of our sympathy or expectations.

My grandparents had this primary care physician, Dr. Bell (not his real name), who they knew from before they got married in 1966, and he was their doctor their entire married/adult lives. Their relationship was purely professional, but it was such a long-term one that my grandparents were very quick to deny or explain away anything Dr. Bell did that my mom (who also became his patient) disagreed with.

It wasn’t because my grandparents thought Dr. Bell was Doctor–God, they simply had a completely different relationship with him. This relationship was founded in a time where doctors weren’t questioned. At all. It was only towards the very end of his practice did my grandparents wizen up to his ailing health and judgment calls. A judgment call that could have left my younger brother with a lifetime of tests, operations, and diagnosis based on an old man’s opinion that turned into an out-of-the-blue cancer diagnosis.

At the time, my brother was 6 or 7. To be honest, I can’t remember what type of cancer Dr. Bell thought my brother had, but that untested, opinion-based, and fear-mongering diagnosis was the last straw that broke the camel’s back for Dr. Bell and we only saw him after that in dire circumstances. The trust my grandparents had placed in Dr. Bell had been tested by my parents and brother, and after all that, my grandparents still thought he was “such a great doctor, he never used to make mistakes like this!”.

The thing is, he was great. In his day and his prime, he was known throughout the town for his methods and bedside manner, and the wait list to see him could span for months. By the time my grandparents begrudgingly moved on to a different doctor, Dr. Bell’s patients were people from his generation. They had the same expectations; ideas (for the most part); stresses and triumphs, and in general, the (outdated) connection between soft-spokenness and surety. It paid Dr. Bell’s bills and it helped fellow old folk connect with a doctor on shared ground. It was almost as if their generation (the Silent Generation) believed loud doctors were compensating for something and could not be trusted.

The same thing happened to my aunt and uncle. My aunt had a doctor that her family had been going to for years and swore he was the best. Unlike Dr. Bell, he wasn’t old. Dr. Klumpke (not his real name) was just arrogant and, more often than not, wrong about basic things. He looked for a complicated diagnosis in an area where a simple one would have sufficed. I had to see him a few times when I was in the area and unable to get to my doctor, and I never understood why my aunt and uncle liked him. He was also a well-known doctor, but from what I understand, his methods for diagnosis were as unscientific and as opinion-based as Dr. Bell. The only difference was that his patients couldn’t blame it on his age.

Then, there’s my experience (and the reason I thought about this article). My husband and I moved to our current area nearly 13 years ago. Shortly after moving, I had to see a doctor thanks to my complicated medical history. I found one close by, and from the start, I really liked him (not like that!). He was the first doctor I’d had that listened to me first before giving his opinion, and when I told him about my history, he just wrote it all down and asked if I’m okay now. That was the first time a doctor had heard about my history and not (for lack of a better word) freaked out before asking 100 questions.

It’s not the questions I have an issue with. It’s that I assumed that most doctors were trained not to react with emotion while with a patient. When these doctors started treating me like a vase, I felt even more breakable. This doctor (let’s call him Dr. Diaz) wasn’t like that. He asked one or two medically related questions about my history, and then we moved on to the reason for my visit. Dr. Diaz has been my primary care physician for nearly 13 years and I don’t see him making the same mistakes Dr. Bell and Dr. Klumpke made. I understand these could come later, but I don’t see them at the moment but I also understand that I may be a bit biased. I too, could fall for the Doctor–God do–no–wrong trap!

Back to my experience: I had to see a specialist (yay for ophthalmologists!) a few months ago but my health insurance wouldn’t cover the referral to the ophthalmologist if I had gone to Dr. Diaz; he isn’t on my network. I can still see him as a patient twice a year and it’s covered, but I don’t have the option of getting a referral from him. Because of this, I had to find another primary care provider so I could go to the ophthalmologists without needing to sell both my kidneys and a spleen. The insurance-friendly doctor (Dr. North, not his real name) is also fantastic! I wasn’t expecting to find two great doctors that I clicked with and who met all my criteria: Answer my (many) questions without treating me like an idiot, don’t freak out when I give my medical history, and don’t be a dickhead.

Now, I’m sitting with a problem. Do I go back to Dr. Diaz because I know him and trust him with my medical history and medications because of how I felt when I met him and how I still trust him 13 years later, or do I go to this new doctor who also ticks all my boxes, is free (since he’s on my insurance network), and reminds me of a much younger Dr. Diaz? The guilt I feel when I think to myself “Dr. Diaz has been caring for me for such a long time, but Dr. North is more convenient.” is killing me.

So, to answer my question: Is doctor loyalty a shame, a sham, or a shining example? I think it’s all three, depending on the doctor. I still haven’t decided on whether or go back to Dr. Diaz for my general care; maybe it’s time for me to change anyway. If/when the time comes and Dr. Diaz starts following Dr. Bell and Dr. Klumpke down that winding, dangerous, and familiar path, I might not realize until it’s too late, and then it might be too late for me.