Practice Perfect 925
When Doctors Are the Patients
When Doctors Are the Patients
Medical providers spend much of their time helping others, but what happens when we become the patients? As of the time of writing this editorial, I’m the patient, and it has reminded me just how difficult life can be when you have a medical issue.
Over the past month, I’ve been experiencing tooth pain at my bottom front teeth. My dentist initially thought I was grinding my teeth at night, causing the tooth pain. Anyone who knows me also knows that this is definitely not surprising for someone as high strung as I am. He prescribed a dental night guard for me to use when sleeping.
I couldn’t help comparing this to our podiatry version, the night splint, used for patients with plantar fasciitis. I was somehow also not surprised by the cost - $450 – which was not covered by insurance. I dutifully purchased the device and used it for two weeks…until the pain became worse. I went back to my dentist and new radiographs were taken; it was found that I have a tooth abscess with “resorption” of the bone below two of my teeth. As a person trained to read radiographs, I was able to see the radiolucency under a couple of my teeth. Of course, as someone with zero dental training, I did not understand what this meant.
As doctors, we often fail to remember that most of our patients have no education when it comes to medicine or the highly specialized field of podiatry. I always try to use non-jargon words and make every attempt within reason to help my patients understand their disease. I also sometimes hedge my bets when I cannot give definite answers, as my dentist did when he told me this could mean either a root canal or having to “extract” a tooth. He did his best to explain that this problem of mine, the resorption of bone, was most commonly due to oral trauma (of which I’d never had any) or prior history of orthodontia (of which I was the recipient of as a 13-year-old child). I had a sinking feeling that I was in trouble.
I was referred to an endodontist who obtained a CT scan of my teeth (very cool tech!), and much like any CT of the foot, I could see clear areas of disease. He pointed out erosions in my teeth and bone and explained that I would need to have one tooth removed (with later implant) and a root canal of another. My heart sank as I imagined myself without a front tooth and the need for more than one surgical procedure. My endodontist tried his best to deliver the bad news with kindness, but when he said “it is what it is”, I wanted to pull out some of his teeth. I hate that nihilistic phrase – although it’s true in my case. Tough luck, Shapiro. Suck it up. Next step, oral surgeon. Unlike many of my patients, I’m lucky enough to have a career that has provided the monetary stability to allow me to pay the expense of the care I’m receiving (which, of course, is only partly covered by my insurance).
Perhaps more difficult than considering the procedures I’m now scheduled to undergo is the havoc all of this is wreaking on my work schedule. My weekly schedule is jam packed with four full days of clinic per week, a day of elective surgery, and a number of meetings and other responsibilities. Dealing with the multiple appointments to my dental caregivers has caused me to cancel one surgery, adjust another surgical day, and cancel two half days of clinic (so far). I feel absolutely terrible moving all these patients around. I’m responsible for a good number of patients and rescheduling their appointments is very difficult on them. Additionally, my income relies very much on being in the office seeing patients. No patients, no income. Just what my family needs, a provider who can’t provide. Consider how difficult it is for all of your patients as they recover from your surgery. Not being able to walk or drive, much less bear weight, is so difficult, and many jobs do not allow modified work duties. These lost wages can be detrimental to families.
Driving home from my endodontist appointment, these thoughts crowded my mind. I kept returning to the comparison of my situation (clearly not life threatening) with my patients’. I wondered how I was perceived by those patients as I told them they would need an amputation. It’s a chest-tightening moment to realize you’re going to lose part of yourself. When I deliver news like this to my patients, I try to remain as positive as possible while remaining realistic about their prognosis. I also do my best to reassure them that I will be with them every step of the way. But is that really true? As I sit here writing this, thinking about my upcoming procedures, my doctors aren’t with me. We are never there in those quiet moments when our patients are alone, worrying about their outcomes and what they are going through. It’s easy for us caregivers to walk away, move on to the next patient. It’s an entirely different situation when we are the patient, and we should all consider that, at some point, we will be the patient. Perhaps keeping this in mind will make us all better and more empathetic doctors.
Best wishes.
Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor
[email protected]
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