Last week, I gave you the first ten of my 20 types of doctors to steer clear of. This week, I’m wrapping up the list! If you missed part one, be sure to check it out.
Without further ado, here are ten more types of doctors you should avoid:
11) The Negative Role Model: It happened to me once: Accompanying a relative to see a top specialist, we were surprised to spot an ashtray in the exam room. After a long wait, the doctor entered, trailing a cloud of cigarette smoke.
Worse yet, he was seriously overweight. Not that every doctor has to resemble George Clooney’s “Dr. Gorgeous” in ER, but physicians have a responsibility to be role models to their patients and exemplify healthy lifestyles. Needless to say, we left skeptical of that doctor’s recommendations.
12) The Narcissist: “You’re so vain, I bet you think this visit is about you.” When the conversation turns heavily self-referential, with the doctor bragging about his or her expertise, their marvelous acumen and professional accomplishments, you may be in the hands of a narcissist. Their fundamental insecurity requires them to puff themselves up and correspondingly diminish you.
A variant on that theme is the doctor, who, to every symptom or complaint you relate, exclaims: “Oh, I had that!” When applied excessively to feign empathy, it comes off sounding dismissive. Better they should just listen.
13) The Eccentric: Maybe it was that garish neck tattoo; or that credulous remark about aliens at Area 51; or perhaps that long digression on your dime about investing in BitCoin; or the Burning Man T-shirt your doctor is proudly sporting. Something seems off. The office appears a little untidy. It’s not confidence-inspiring. You may want to move on.
14) The Flirt: Establishing rapport is one thing, but leveraging sexual attraction is entirely another. The therapeutic relationship is fraught with the risk of transference; for many vulnerable people, the caring attitude expressed by a physician is one of the few forms of love they may experience in a bleak emotional landscape.
The health practitioner who exploits this tendency is as culpable as the prison guard, the teacher, the minister, or the boss who wields their power over their charges.
Exhilarating at first, the heady mix of confusing emotional signals can derail a therapeutic relationship fast.
15) The Misanthrope: They just don’t like people. Their social skills are abysmal. They might have missed their métier; there are NPC (no patient contact) specialties within medicine, much coveted by introverts, like diagnostic radiology or pathology. Better they should switch career paths.
16) The Inarticulate: Even some of the most brilliant physicians and surgeons may be maladroit communicators. They may be disproportionately science/math whizzes who whiffed on verbal skills. That may undermine their effectiveness in real-world medical encounters.
Alternatively, they may be among the growing ranks of U.S. physicians who are foreign-born and educated. Notwithstanding excellent clinical skills, language and culture may prove barriers, especially in primary care fields like OB/GYN, internal medicine, and pediatrics where communication is at a premium.
17) The Enabler: In an effort to “go-along-to-get-along”, doctors may be lax in condoning, or even aiding and abetting, harmful behaviors. Examples include inappropriate prescribing of ADHD meds to faltering students at their parents’ requests, freely dispensing powerful antibiotics “just in case”, or indiscriminately renewing prescriptions for addictive sleep or anxiety meds.
18) The Incurious: You’ve probably been there: You share an important piece of information about a therapy, dietary approach, or supplement that has benefited you. Your doctor looks up, distractedly, and mumbles “OK”. They seem to be humoring you.
“Don’t you want to find out about that?” you ask. “Uh, not really,” they reply.
Choosing medicine as a profession entails a commitment to lifelong learning. There shouldn’t be a firewall separating high-tech medicine from innovative natural therapies. Good doctors, even if skeptical, will listen and explore unfamiliar avenues that their patients claimed helped them.
19) The Alarmist: Medicine necessarily has a built-in negative bias. When confronted with even seemingly innocuous symptoms, it’s the doctor’s responsibility to at least entertain the worst-case scenario. We’re practicing the “rule out” game until we’re satisfied it’s only a tension headache, minor indigestion, or a harmless mole instead of something worse.
But some doctors flash their erudition by enunciating every possible dire condition a complaint may herald. They’re like a walking “Harrison’s Text of Medicine”, the encyclopedic disease bible. Patients leave the office reeling.
Whether it stems from diarrhea-of-the-mouth, braggadocio or passive-aggression, physician alarmism burdens patients unnecessarily. As Mark Twain once said: “I’ve been through some terrible things during my lifetime—and some of them actually happened.” Dwelling on hypotheticals is the doctor’s job, not yours.
An apt metaphor for medicine: “When you hear distant hoofbeats, don’t think of zebras.”
That being said, I’ve seen patients with whom, within minutes, I’ve developed the distinct impression they might have cancer or AIDS. But I gently withheld that conclusion from them, saying only that I had some concerns and wanted to order more tests. Only when the results confirmed my suspicions did I make that fateful call and invite patients to discuss options.
20) The Obsessive: Some doctors have obsessive tendencies; a little obsessiveness may benefit patients when it comes to scrupulous handwashing precautions, or tenacity in tracking down elusive symptoms. But it seems that some physicians act as if each new patient represents a looming malpractice case; the result may be excessive testing or overzealous treatment—“just in case”, or as a CYA.
It’s a delicate balance between appropriate concern and “wait-and-see”. Often the latter approach reduces the likelihood of costly and potentially side effect-inducing wild goose chases.
Did I leave anything out? Are there any other types of physicians you’ve run across that you might recommend Intelligent Medicine followers be wary of? Email us at questions@drhoffman.net and we’ll share your experiences.
