There are criteria that make you pick a doctor: a recommendation from a friend, a referral from another trusted physician, internet research.
It’s also good to know when to UNpick a doctor.
Some of those are obvious: You stop seeing a specialist for cancer when you no longer have cancer. You stop seeing a pediatrician when you become an adult. You stop seeing a dentist when he refers you to an orthodontist.
Some are less obvious: structural (their approach to problem solving), or personal (their attitude). For me, these are revealed by moments that I don’t see coming, because there is no extrinsic reason to stop seeing that doctor—the care was perfectly adequate—and yet I had no desire to be in their presence ever again.
I can tell you the exact moment when I checked out of relationships with three former doctors.
***
Doctor #1 was a naturopath. We were working together on my diet, and figuring out what I foods I was sensitive to. The suggestion of removing foods that I loved put me on edge, but I knew I needed to be willing to listen.
He asked me what my health goals were. I said, “Big picture, I want to be able to live without insurance.”
Let me explain. At the time, I was taking a very expensive IV drug. My job had good benefits, but paid very little. Even with my employer-sponsored health insurance plan, health insurance was a constant worry for me, because without it I wouldn’t be able to afford the medicine. (We’re talking like $10k a month for the infusions.) My job was stressful, which aggravated my Crohn’s Disease, but I needed the job to keep the health insurance to keep getting the medicine. Without the medicine, I feared that my health would deteriorate to the point where I could no longer function.
So to me, improving my health through diet was the first step in becoming healthy independent of the medicine. If someday I could get healthy in ways that didn’t require health insurance, I would be free of that humongous worry.
“That’s not a very realistic goal,” the doctor said. “Everybody needs health insurance.”
This doctor immediately dismissed my main goal (which I’ve achieved now, btw). His reaction showed that he wasn’t really on my side—that he didn’t really want to help me in the way I wanted to be helped.
Sometimes, that alternate perspective can be useful. But when he later condescended to me when we were discussing the results of an allergy test, I was done.
I walked away from that doctor and never looked back.
***
Doctor #2 was a gastroenterologist. Because I have Crohn’s Disease, my gastro—or GI, as we call them—has always been an important person in my life.
My GI was the person who understands my guts better than I did at the time, so I depend on him to help “translate” what’s going on in my body.
Sometimes, we become friends. It happens—when there’s a doctor you see every few months.
But this time was the first time that my GI had called me personally.
We had been working on figuring out a weird symptom. I had gone in for a regular checkup, and mentioned some skin problems I was having. Since these skin problems were weird, he immediately referred me to his friend—a dermatologist with an office in the same building—and we got to work investigating the skin issue. To be safe, they started me on antibiotics.
The antibiotics didn’t do much for my skin issues, but they greatly improved my gut health—the exact opposite of what antibiotics are “supposed” to do. Usually antibiotics give you diarrhea—in this case my poop became inexplicably perfect.
Because this was so unexpected, I called my doctor.
He returned my call while I was on my way home from work. It was dark, and starting to rain, so I stepped into Powell’s Books to take the call. As I wandered through stacks of books and Moleskine journals, I brought my doctor up to speed and explained what was so puzzling to me. My symptoms were improving when they should have been deteriorating. I asked why.
“I don’t know why,” he said. “Be happy for your good fortune.”
In his dismissive words, this doctor me that he didn’t care about solving problems. He expected me to listen to him when he was dispensing medical advice, and wanted to be in charge of my health, but he wasn’t curious about the actual course of my disease.
If being on antibiotics caused so much improvement in my symptoms, I wanted to know why. I wanted to see if this information could help chart a new strategy for treatment.
I wanted to figure out how to get well, and this doctor didn’t want to figure anything out.
This moment was a pivot point in my life, when I truly embraced alternative methods of healing. I quit seeing that doctor, and started seeing Doctor #3…
***
Doctor #3 was a specialist in Small Intestine Bacterial Overgrowth (SIBO), and a naturopath.
This doctor helped me work through the puzzling symptoms that conventional medicine couldn’t (or didn’t want to) explain.
Turns out I had a massive load of harmful bacteria in my small intestine, which was causing lots of problems—including my skin issues. The treatment was a long course of herbal antibiotics (it’s a whole story).
During the course of treatment for SIBO, my skin symptoms morphed. I developed gnarly eczema on my hands, arms, and neck. It was red, raw, and painful. Sometimes I wondered if it was infected.
Because it was on my arms and neck, I couldn’t hide it when my skin was cracked, flaking, or oozing. My coworkers (and even my boss!) made comments about it: what is wrong with your arm??
(What I heard, instead: Eww, what is wrong with you?)
I was ashamed. Embarrassed. The eczema was painful, but the emotions—having to deal with a health issue so publicly—was almost worse. Crohn’s Disease is hard, but you can hide it. It is much harder to deal with a visible dysfunction or deformity.
One day, I asked Doctor #3 about my skin problems. This led to a whole floodgate of emotions, because I felt like he might be a person who would understand the struggle. I broke down and cried in his office.
His answer: “Why are you crying?”
I felt immediately dismissed, like I was supposed to regard the eczema as no big deal and we don’t really know what causes it anyway so just stop emoting in my office you silly person.
My rational brain recognizes that skin issues like eczema are difficult to understand and treat, and that medical doctors (even naturopathic ones) aren’t therapists. They simply don’t have the skillset to deal with emotional crises.
My emotional brain, however… let’s just say that the doctor broke my trust in him. Because that emotional trust was broken, I never went back.
***
Sometimes, it’s worth staying in a difficult relationship. I’m always quick to defend doctors with a brusque bedside manner, because—hey, sometimes you need someone to tell it to you straight.
However, there’s a difference between “working together to solve a difficult problem and pushing niceness to the side” and “I have no interest in you or your problems so just do what I say and stop bothering me.”
I’m sure it can be easy for doctors to view you entirely through the lens of your symptoms or your disease—which means that doctors are treating something abstract that is not you.
You are a person, not just a constellation of symptoms.
You’re not stuck with the doctor you have—keep seeking a doctor who will work with you. It may take some time, but the search will be worth it.
What I’m saying is, find a doctor who listens and who is willing to work toward your goals.