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Monthly Checkup with Intern Present
I went to see my GI yesterday for my 3 month tx checkup, and I couldn't wait to get there to see what my viral levels were (Monday). I had SO many questions and some concerns as I have been having respiratory issues, low wbc, riba rash & some other minor things. When I got there, he asked me if I minded if an intern was present (keep in mind he asked me in front of him) so what was I supposed to say? This is the third time he has done this to me. It's a very private issue for me as I made the decision not to tell anyone in my family other than my hus(my sister-in-law died 2 yrs ago at 50 yrs old from autoimmunie hep- so I don't want to worry my family needlessly if I can get rid of this). Therefore, I don't like the fact that he has strangers in there hearing my most personal medical info and concerns. They could be my co-workers kids or who knows what? Don't get me wrong -- I don't have a prob with up & coming docs learning because that can only be good for us --the more knowledgable they become the better for us. It just that when he has these interns in there, I feel he is more concerned about talking to them ABOUT me then he is to talking to me, the PATIENT. I just sit there like a cadaber on the slab as he discusses me & my probs with this intern. He does answer my questions, but I feel like the answers are directed to the kid. I feel rushed and leave feeling a little cheated of that monthly visit & that he never really listened to me. Would this bother anyone else or the riba finally starting to get its claws in me? Sorry for being so winded!
I agree with Mike and Kalio. If you want private time with the doc, that's not unreasonable. State your preference to your doc, if it makes you more comfortable. Rookies/observers can be a little off-putting. Several years ago my wife and I were invited to participate in an in vitro fertilization experimental procedure. It was at a univ research clinic/teching hospital. They were working on cutting edge 'micro-manipulation' of sperm/eggs. There were students all over the place including 30 student in operating theaters when they surgically removed a batch o' eggs from wife and sperm (from the source) from me. It was pretty scary having all those pimple-faced kids staring down through the glass. And all that pointing and giggling. But, it was free to us, the students hopefully learned something and we got a son out of the deal. For all those who may be faint of heart regarding a liver biopsy, one of the procedures I had at the time was a biopsy of the testicle, with an audience. In comparison, the liver biopsy was a peice of cake. The testicle biopsy was a piece of...nut, I suppose. And, my son and daughter are twins, born 5 years apart.
Sure, you're right but I question how many appointments/patients the doc has allocated to that hour so even if you need to discuss in detail they are always in a hurry for others who are waiting or what? It doesn't really matter just make sure you ask all the questions about your condition/treatment ya need. I'm sure they get tired of certain patients too. It really is not always what it seams...
Hope the pills are being kind!
Hope the pills are being kind!
This is pretty normal, especially at teaching hospitals, and part of an intern's/residents education. My hep doctor on several occasions has brought in residents/interns, etc., and yes, sometimes it results in less time with doc, but sometimes it results in more time as I become a "case" for discussion. As far as "privacy" is involved, I assume pretty much everyone in the doctor's office knows I have hep c and really couldn't care less because pretty much everyone else that sees the doctor always has hep c :)
That said, you have every right to ask the doctor (in front of residents or not) to be examined privately and to consult with him privately. You really don't need a reason and simply telling him you'd be more comfortable seeing him privately should suffice. Trust me, the interns and residents couldn't care less. My previous dermatologist, for example, often brought in a bevy of interns to watch me being examined, and several time I politely asked them to leave (mid session) for privacy reasons.
Going back to the divided attention issue. One strategy I've often used when I have some very specific and important issues to discuss, and the doctor asks if it's ok if resident A and resident B join him -- is to say, that would fine, but could I have five or ten minutes alone with him at the end of the session to go over some matters with him alone. This acknowledges the teaching aspect of his practice, but also covers your own needs for time and one-on-one with the doctor. If the doctor doesn't have a whole lot of time that day, most probably he'll simply dismiss the residents and you'll end up with the alone time you want.
All the best luck.
-- Jim
That said, you have every right to ask the doctor (in front of residents or not) to be examined privately and to consult with him privately. You really don't need a reason and simply telling him you'd be more comfortable seeing him privately should suffice. Trust me, the interns and residents couldn't care less. My previous dermatologist, for example, often brought in a bevy of interns to watch me being examined, and several time I politely asked them to leave (mid session) for privacy reasons.
Going back to the divided attention issue. One strategy I've often used when I have some very specific and important issues to discuss, and the doctor asks if it's ok if resident A and resident B join him -- is to say, that would fine, but could I have five or ten minutes alone with him at the end of the session to go over some matters with him alone. This acknowledges the teaching aspect of his practice, but also covers your own needs for time and one-on-one with the doctor. If the doctor doesn't have a whole lot of time that day, most probably he'll simply dismiss the residents and you'll end up with the alone time you want.
All the best luck.
-- Jim
thx, as always, for the advice - really helps. I didn't want to appear selfish or anything, but I guess this (illness/tx, etc.) is hard enough to deal with & I just want to be able to talk with him about my probs & have his full attention. I get distracted when they are in there (as does he) & I feel I don't get to ask all the questions I want to. (Reminds me of an earlier thread I read about docs the other day). I didn't mind an intern in there once or twice, but at some point I would like to meet w/him alone. I will definitely take your advice - thx again.
I feel your pain. Sometimes we wait anxiously for a month to see the doc or assistant who you feel may be in a hurry for the next patient. I sometimes wonder about there insurance billing - my guy bills my insurance about $160.00 a visit which is probably for the hour but unless I keep him there to address my concerns for about 40 mins we could end it in about 20mins and still they bill for the hour. I don't think it's the Riba, it's a valid concern. I had an allergist ask if I mind if the intern sits in and of course the intern was present. Like I was gonna say no - they have to learn the "trade" but yes you do feel cheated.
Been there. Try this, next time say, "Sure, I don't mind but I need some time alone with you." No problem, worked for me, Intern's feeling's are not hurt and your doctor appreciates your help and looks good to the Intern. (My patients NEED me.) I know what you mean about things being awkward in front of the Intern when you are asked.
Good Luck
Peace
Dog_Lover
Good Luck
Peace
Dog_Lover
If you are uncomfortable with the intern, tell the doc when he asks if it okay. Easy for me to say, I am always chicken when it comes to that stuff. Perhaps you could put it in writing to your doc and explain yourself. Give him a copy before you go next time, so it is in your file. Perhaps save yourself having to explain in front of the Docs.
Time is precious in the Dr office. I would find a way to let him know about this.
Time is precious in the Dr office. I would find a way to let him know about this.
Unfortunately, he didn't have them yet -- not sure why. Got my b/w a week ago. So I will find out Monday, hopefully. Really keeping my fingers crossed - my 4 week test showed it went down considerably to only 400 (from 6 million), so I'm trying to be pretty optimistic.
jm By the way, he's not a hepatologist and it's not a teaching hospital, it's small practice in fairly small town. But I do realize regardless of what size, it's good that he is bringing others in to educate them. I just wish it wasn't every time I get to see him. Will definitely follow everyone's advice next time - thanks!
jm By the way, he's not a hepatologist and it's not a teaching hospital, it's small practice in fairly small town. But I do realize regardless of what size, it's good that he is bringing others in to educate them. I just wish it wasn't every time I get to see him. Will definitely follow everyone's advice next time - thanks!
my "billable" hour was about 11 or 12 minutes - next time I am going to squeeze 15 out of him - lol!
I agree totally with Kalio. It's your dime and your liver and you should feel entitled to ask for time alone with the doctor. Sometimes I allow a trainee in with me but when I don't want anyone else present I have no trouble telling the doctor - and most of the time I don't want anyone else present. Assert yourself and don't get intimidated. Good luck. Mike
So what were your results? You just had a 12 week pcr? I'm hoping you got some encouraging news!
I know what you mean. Maybe this will help. There is supposed to be a doctor and client confidentiality thing. Hopefully that will help. I think that applies to Interns too. Not sure if you can make a consultation appt to talk to him one on one and explain your concerns. Just a thought.
You are right, they only way the Interns are really going to learn is by actually stepping into it.
You are right, they only way the Interns are really going to learn is by actually stepping into it.
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