By Kelly O‘Brien, MD, FACP, CCHP
Posted on September 18, 2011 – What does it take to make a good neonatologist? Do you have to love children? Perhaps not, since you’re going to be injecting them and prodding them and making them cry. In fact, a real baby-hater might make a very good proceduralist -cool, collected, intent on his squirming target. Just don’t let him out of the NICU. However, most of us went into primary care because we do like people in general, so this next part will come as a shock for those of you new to correctional care: some of your patients may not like you. It won’t necessarily be because of anything you do. Sometimes it will be situations beyond your control [Really, our formulary doesn’t include Dilaudid.] and you may realize this any time during the course of the patient’s stay.
A bitter, middle-aged man looks at me as I come in to do his intake physical. I’ve not said a word nor dropped the chart, not even shoved my glasses further up my nose. He sneers, I wouldn’t let you treat my dog. – his way of telling me he’ll be refusing the exam. We’ve not bonded. I try to find some way to agree with him. Well, I wouldn’t let me do that either. I’m a medical doctor and not a veterinarian. Big disarming smile, showing that I don’t hold a grudge. He thinks this is incredibly stupid and we don’t get any further. Sometimes you don’t get a chance to make even that first impression.
Other patients you care for over time, and even though they hate everyone else, you think they can see what a special doctor you are. Then you get a note: Dr. O’Brien: I’m suing you for malpractice. God bless you. Bennie Culver. This is an actual note.* I gave it to the lawyer so we can, with the Lord’s help, see what we need to do next.
Of course, there’s the day they leave. That last visit. It’s a strange situation-much different from your standard bittersweet moments of development, like the first day of kindergarten or graduation. A patient just says, Hey, I’m leaving, doc. Hope I never see you again. This isn’t personal, of course [usually]. Then you have to find just the right way to say, I hope I never see you again either in a tone that expresses happiness and a wish for future success.
No, even in private practice, patients don’t always like you, but this undoubtedly happens more often in corrections. Thinking about it though, if you really need patients to like you, you probably wouldn’t be here. And if you really don’t like your patients, then you probably shouldn’t be here.
Kelly O’Brien, MD, FACP, CCHP, IwishIhadmoreinitials, is Associate Medical Director with the Wisconsin Department of Corrections, Bureau of Health Services. Readers may contact her at kellym.obrien@wisconsin.gov.
