A Patient Filed A Complaint! | Wednesday Checkup | Doctor Mike

čas přidán 22. 11. 2018
For this week's Wednesday Checkup, I wanted to share a story with you about how a patient encounter did not go as planned in my office. I thought I did everything right but the outcome was not what I expected.
In life, there are many times when we have good intentions where the outcomes are bad. During those times we need to evaluate why that happened so that we can avoid repeating the same mistake over again.
If you have an idea of something you want me to cover in depth, please let me know because I take your requests seriously. We will be back with more Medical Drama Review Series this Sunday so please submit more names of shows/episodes you'd like for me to watch. Love you all!
- Doctor Mike Varshavski
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  • My dad is a Radiologist and one day a patient complained that (my dad) exposed the patient to unnecessary radiation 😂 and he himself (the patient) originally insisted on his GP to get more MRI 😂

  • I'm surprised that you mention literature about the mind-body connection... I figured most doctors would shirk from talking about that stuff (for fear of what their colleagues would think of them), but it's something that I'm interested in. Are there particular books you'd recommend?

  • Don’t change how you care for patients due to this one ... it’s hard to find a doctor who cares and wants to listen

  • I do research into the appropriateness of spine MRI orders, and you did the right thing here. The patient did not need an MRI. The American College of Radiology has a set of guidelines to help physicians make decisions regarding imaging orders, which it seems you may have referenced before given your algorithm for deducing this patient’s needs.

  • As a patient with about 9 chronic illnesses so am seeing a doctor 1-2 times a month (and that's me stable), you did everything right. It took years to find a PCP that met me at my level and believed me about my pain. He is the only doctor I can give a pain level and he knows to increase it by 2-3 points for it to be what a normal person feels. The reason I mention my PCP is that, with my health history, I often come into the office with a good idea of what's going on/what treatment is needed. There have absolutely been times where I'm way off about what I think is going on! But there have also been times where he has been wrong. One thing I really appreciate is that he will listen to my complaint, do a physical, recommend what treatment he believes I need, then asks me if I would feel better if we did the treatment I thought I needed. Most of the time, I just do what he says because he comes at it with a level head when I don't always. But there have been times where I have asked for both what he wants and what I want just to feel better emotionally. He is more than happy to write a referral for whatever test I think I need when that's the case (of course medication is a different case and that involves a lot of discussion and willingness from both of us to listen to each other). I believe that, if Dr Mike was my PCP, I would've been happy with my care! Believe me, I've had many bad doctors. Dr Mike was looking out for the best interest of the patient. Pain, and especially lower back pain, isn't easy and isn't going to be a quick fix. It takes work to heal and even then it doesn't always go away. Recommending PT was absolutely the right way to go.

  • Most people i assume don't like being told its all in your head, even if that wasnt the focus of the conversation, he may have latched on to a single line you said.

  • Half of the doctors here will be like " you want a an MRI!!! SURE " . . EASY MONEY

  • *Did he go to a chiropractor?*

  • Did yall see he had 2 watches on

  • Duh i would be really happy if I went to a doctor and he suggested me something that didn't cost too much money like surgeries, tests etc.

  • What if: there's this one complaint that reads: "Dude too handsome, made me sick again." 👀

  • As an mri tech, Im glad this doctor tries to figure stuff out, not like at my place of work, where some of our drs indications are weakness. So theyll order a full spine and brain scan and then discharge the pt.

  • The patient didn't hear from you, "Here is the medication and your pain will go away tomorrow." That was their expectation. Nothing you said was wrong. The patient was probably frustrated to want a quick solution to their issues after going through them for an extended period of time (since you said he was also mentally stressed from his job too) - My guess~

  • I learned so much from this, thank you for taking the time to explain in depth. I love that you break down medical terms making it so much easier to understand the methods/procedure of managing a patient's health. Wish all Doctors did this. You are a blessing to many. Thank you, God bless

  • Me: *Has back pain* *Doesn't go outside(AKA: I'm always in bed)* Dr. Mike: Spending time in bed makes it worse. Me: But what about a wheelch- Oh wait... I need help ;^;

  • Doctor Mike admittedly I am one of those people. I want a doctor to get to the point. I've found it best for me just to say as much. I also know a lot of people with lower back pain. For them, sometimes it seems that they are so frustrated with being in pain so frequently that anything but what could be a quick fix answer is not what they want to hear.

  • 12-14 hours what job do you have 😂

  • And cortisol stimulates apoptosis, Cells are programmed to die Apoptosis is cell suicide Cortisol and testosterone stimulate apoptosis. Lymphocytes increase Means inflammation High cortisol yanks out lymphocytes Cortisol is a antiflamatory. Burn your adrenals out,cortisol low,high lymphocytes alot of pain and inflammation. Lot of work,alot of exercise,alot of stress burns out your adrenals,insufficiency of cortisol production

  • Low back pain And cant find anything Leads you to adrenals Stress,stress

  • Dude I would love a doctor who makes the effort to sit down and explain to me what’s going rather than just a brief visit, it shows that they care!

  • Make a video on fibromyalga I have had fibromyalgia since I was 15 I’m 22 now

  • I'm supposed to review for my upcoming midwifery licensure exam, but here I am watching your videos 😂 I love your channel!! You're very informative! ❤️

  • You should rear the 4 Tendencies

  • When I had back surgery 5 years ago (I had a double microdiscectomy of the L4-L5, and L5-S1) and it was mainly to reduce or eliminate my sciatic pain. When I saw my neurologist 2 years ago with horrendous back pain they would not do any further surgery. After the back surgery I was left with permanent nerve damage on my left leg from the knee down, I have minimal feeling on my lower leg and top of the foot. And they had gotten me in quick. I had my MRI on June 5, 2014, saw the neurologists assitant on June 30, 2014, then the actual neurologist on July 12, 2014 and then had the surgery on August 13, 2015.

  • To keep the privacy of this patient I'm going to give details of a large amount of people.

  • ❤️

  • With them saying you are "too spiritual", I imagine it's because you suggested osteopathic adjustment and discussed the effect of the mental state rather than giving them pills and more surgery. I know when I talk about getting osteopathic adjustment, I get people telling me I've wasted my money seeing a quack!

  • more power and love to you Doc

  • I've actually been through kind of the same situation as the patient. One day after a run session, I felt pain in my right knee and I can't walk for far distance. The pain sometimes moved to my left knee. I told my complaints to my mom (who's a doctor) and I demanded an X-ray because I was so scared that it might be something bad. After my mom heard about my knee pain, how many times a week it happened, what activities provoked it etc, she then said that it might be because I was stressed out. I didn't believe her (enraged mostly because I thought she just pushed my complaints aside) and asked her to get an X-ray. My mom then agreed and we took the test. A couple hours later the result came out and just like my mom said there was nothing wrong with my knees. I felt terribly bad for pushing my mom to do the test and spent a good amount of money for nothing. After that test, miraculously, my knee pain never again appeared and as I learned more (I'm a medstud) that clinical symptoms and pains CAN be caused by psychological state and burden. So next time I will surely trust my mom's or other doctor's opinions about my conditions

  • i like when doctors meet with me longer the first visit. get the general history of me and my family. they gain my trust and after we can do the shorter conversations bc i trust what they say. so i think having a longer first visit always helps so they know you care or just even joking around a little

  • I liked the advice that you got from the behavioural specialist.

  • I’ve basically had this exact situation with a doctor-went in for an MRI for lower back pain, then the doctor recommended physical therapy and addressing stressors instead. 3 months of PT and stress management later I was doing so much better!

  • So true, really helpful video! I have been learning the same lesson recently, that different people require different "medicine" (as in the approach) in order to best help them. That even if I would prefer to have information delivered in a certain way, eg. I prefer people to be direct and not to hint at things, others prefer the exact opposite, eg. find it confronting or harsh to be direct and prefer subtle hints. Whereas I would perceive subtle hints manipulative, which is why I don't like doing it to others. But they may actually prefer this, and perceive my direct way as being aggressive. Basically, it's not about me and what I would prefer, it's them and what they would prefer, even if it feels wrong to me, it will better help them.

  • Would a chiropractic treatment help at that point? It did for me after years of bulging disk and now perfect back and a visit every 3 months... Only thing is I never had a back surgery.

  • 😂😂😂 people complain about me every day. You get used to it

  • •Do shoe inserts help? •Medical instruments left inside people. •Drinking from a garden hose. •Wallet in back pocket •The game Operation •Scoliosis screenings in schools (had this in middle school) •do helmets provide protection

  • I work in the patient complaint dept of a large medical group. I come across these types of patient complaints every. Single. Day. They come in insisting on things: MRI, controlled medications, disability paperwork etc. And when the doctor says no because it’s not medically appropriate they complain and jump to the next doctor, then the next doctor. I have one patient who’s filed like 11 complaints within 4 years. All similar situations, just against different doctors. 🤦🏻‍♀️ Sadly, many patients are controlled, many of them are rude and abusive to staff. I cannot tell you how many times I’ve been yelled at by people who think complaining to administration will get them what they want. My heart goes out to physicians. I know how much they care about their patients and want what’s best for them. It takes very special people to be doctors. Hats off to Dr Mike for remaining kind and professional and seeing this as a learning opportunity rather than a stumbling block 👏🏼💜

  • As someone who's been dealing with severe back pain for YEARS, I think the way you handled the patient was really great. I'd love for my doctor to sit down with me longer than 10 minutes and to actually talk to ME rather than just their computer screen. You just didn't give the patient exactly what he wanted and it sounds to me like he was pitching a fit.

  • Are you able to go in depth with hip sclerosis and greater trochanter bursitis. And what can be done to help, what treatments can help.

  • So... basicly, a doctor is more than a walking medical dictionairy. A doctor is like a guy who you can just reflect on every now and then😂

  • If I could do an 8-9 mile hike with my back pain, I'd be fucking thrilled. I'd be like, IT"S A MIRACLE!

  • This sounds like there is a problem, i think you should have done the MRI.... What would it hurt? Also, what about other diseases that cause pain. Pain is a vital sign..... is it possible the hip may be out of line somehow effecting lower back pain.....Especially after a lower back surgery. Was something possibly wrong in the low back from the surgery. Was it re injured? People don't just come in for no reason and complain of pain.....it sounds like you should have done both....PT and MRI your job is to fix the problem. you did not

  • I'm a nurse and honestly, some people just are never happy haha. I've had to grow a pretty thick skin being in this profession! I've been screamed at, sworn at, hit, complaints. you name it! and I'm good at my job, everything I do has a proper rationale behind it. I'm super polite, non-confrontational, and nice. Just... some people be crazy.

  • How dare you attempt to help someone in the best way.

  • You're only responsible for what you say, not what others understand. I think this person's issue was you suggesting the reading material, because all they took away from that was "it's all in your head". It might not even have been your fault. It's possible he's heard that it's all in his head before. Maybe he's just one of those guys who graduated from Google university and was cross that you would dare to contradict him and save him or his insurance having to pay for an MRI, not to mention the experience.

  • I understand where you are coming from, really I do. But as a young woman who as been having back and neck pain for years now I am so tired of hearing the words PT or "It's mental". It's not helping, no the physical therapy has never helped me and the doctors I visited just don't listen to me. Because Im young they think it can't be that serious. It took me years to find an ortho that actually checked if I had a disc or Scoliosis, turned out I have the latter. Also something very popular is "Do sports" - oh good thank you I never thought of that the last 4 years and it's not like I JUST told you that what the last doctor said and it didn't help! Gee, thank you so much for listening to me. It's nothing after all, I'm just constantly in pain and I'll just wait till I turn 40 or something. At that Age doctors will believe you have these kinds of problems. One even handed me a little paper with a youtube link on advising me to do that. Really? I'm just sick of it . My neck won't stop hurtin and I pretty much lost trust in doctors, I only ever go to a doctor now when there is no way around it.

  • even if it's not particularly 'scientific' ... to play sheldon from big bang theory for a sec ... necessarily provable, this could still be a good reference for you for your own sorting people out upon meeting them semi briefly. i am in between intj and infj depending on the bipolar 2. mostly the former . also if you ever feel like looking at sales videos - don't laugh - they can help you figure out how to read people in certain ways //www.psychologyjunkie.com/videos/

  • LOL. i PREFER explanations. i usually ask a lot of questions, and my endocrinologist got mad at me for not knowing enough about my rx mils etc. in my defense i'd been feeling unwell for a long time.

  • ugh. you're reminding me i have the neurologist tomorrow. i hate the neurologist. it's so stressfull. i don't like the tests. they make me stressed out. the lights bother me on the eeg. i DO NOT WANT.

  • i just paused at 3.02 ... i have back pain, have had for a long time .... i power through but i know my limits. fell of a bunk bed top bunk, in my sleep and woke up on the floor as a pre teen. i began having back pain, turns out i had compressed vertebrae, was on i can't even remember the drug but it was the size of australia. and i still get back pain. my back pain is in the MIDDLE though. can't massage that away on my own, can't lay flat on my back for too long even though that helps my current stomach issues and the thing that hurts THE MOST for that middle back pain. STANDING. not even really walking or sitting - just laying flat on my back for too long or just STANDING waiting in line or waiting on the train. painful. imma let you finish.

  • Dr, you're bang on here - I have a sore back but give me bad news/extra stress/bout of depression, and just wait for my back to go crunch. In 10 days or so I am right again, back to original soreness. I have noticed this pattern myself. Now my knees are rusty too, so at 62 it's not fun.

  • I work in a warehouse doing 12 hour days most of my day is spent on my feet and lifting heavy items,i often get lower back pain and I find stretching and wearing a back brace helps alot.

  • You're amazing. I love friendly drs and you took more than 5 mins with him too... Some Drs make me nervous because they seem rushed, but when they're chatty and friendly, it really makes me open up.

  • Wow, Doctor, you keep impressing us with your knowledge; we are so proud of you. I just like how he thinks and offers solutions to the problems. Doctor Mike is a genuine person, who cares for his patients, but some people like this ignorant patient don't understand it. You did an amazing job and don't feel bad. You did your best and sometimes that is all you can do, nothing else. I mean if I had a chance to have doctor mike be my doctor even for a sec my file would be complaint of his charm, not about his medical opinion because he knows how to do his job.

  • I have never in my life had a doctor sit me down and talk with my about my symptoms in such a caring and helping way as you had described doing to this patient. Usually my GP is in a bad mood and quickly briefs over everything so he could move on as quickly to the next person. I would be OVER THE MOON to be looked after and given the medical advice which you have given to this man. It's really sad that he responded in such a way but I believe people like that come into our lives to either humble us or teach us lessons. I don't believe you did anything wrong. People can just be funny sometimes.

  • Omg you didn't give him exactly what he wanted so he dissed you...I hate it when drug seekers or claim filers ruin it for everyone else.

  • Maybe what the patient heard Dr. Mike saying was, his pain was all in his head and it didn't really exist, afterall, he was still pretty active, and I'm going to send you to do more exercise (p.t.) that you'll have to take time and money for (which starts to hurt after i do alot of amyway) and then have you come back and see me again to take up more time and money all without any benefit or relief from his pain. So my guess would be this patient felt dismissed because he was young, healthy, and had back pain. Typically ,medical professionals aren't to interested in helping this type of demographic because they're labeled as drug seeking or lying for some other nefarious reason.

  • I didn't know you're a DO!

  • My favorite channel to learn English, I do know a lot more about health stuff, so thanks a lot Dr Mike

  • As someone with recurring back pain, I've been to doctors many times. I was sent immediately to orthopedist and got my spine scanned. Orthopedist said that she doesn't think any kind of surgery would help me. The solution from her and all other doctors is to give painkillers for two weeks and walk it away. To me, best medications for mild to moderate back pain is naproxen, for more severe pain tramadol and tizanidine. Don't know if the latter really does anything, but it helps me to fall asleep with sore back. My sciatica renews about every 2 years and 2 weeks of walking and swimming with painkillers always does the job.