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The Good, The Bad and The Ugly

dilaurodilauro ConnecticutPosts: 10,065
How can we forget Clint Eastwood, Eli Wallach, Lee Van Cleef in that movie... Well, at least for folks around my age!

I dont want this to become a bashing session or trying to knock down a professional, but instead, I would like it to be one that is constructive. I was reading an article from Beer Advocate the other day. The ending sentence went as follows:

Constructive criticism is a collaborative process, one that should be encouraged and should hopefully leave both sides happier in the end

In all of my doctor's offices, in the Rehab centers, Diagnostic testing centers, there is a Patient questionnaire that allows the patient to rate the good, the bad and the ugly.

So here, I would love if you could identify:

1 - What are the things, the traits, the actions, etc that made you feel so good about a doctor or a center.

2 - What the same as above that made you feel that there was thing missing or bad

3 - And of course, what where those traits that had you leaving mad and never to return.

Its always easy to identify a problem or even a compliment, but what is much better, is to state the recommendations that you have to address those problems. Even if your experience was top notch, what things would you want to see always the same.


Of course, following forum rules, No specific names of doctors or institutes, etc. Also try to look at things for both sides.
What I mean, is dont just knock down a doctor because they are not giving you more pain medications. They could be a very good reason why they are not. So, here instead of saying that doctor didnt give me enough pain medication, part of your recommendation could be that the doctor needs to explain why and also to identify other options.

Lets all make this one constructive.
Ron DiLauro Veritas-Health Forums Manager
I am not a medical professional. I comment on personal experiences
You can email me at: rdilauro@veritashealth.com
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Comments

  • anelsen15anelsen15 Posts: 119
    edited 02/13/2014 - 2:18 AM
    1. It really makes me feel asurred when a doctor tells me we will get to the bottom of the problem and actually seems legitamitly concerned. Calls me at home to discuss results. Takes time to explain and show tests to me. Is verbally thourogh and asks me about all my symptoms because he said they could lead us down the right road. He is a detective, I actually had one dr say thats how he feels about practicing medicine and Ive respected him and really learned alot from him in a short time. I love patient portals. I love when a doctor says this appointment will take as long as it needs to. Above all is that when he has exhausted testing and his level of knowledge he admits cant figure out and refers me to someone else, I respect a doctor more for that situation than anything.

    2. Not taking time with me when no diagnosis is made yet. I want a dr to put his hands on me and probe around my spine for tender areas or other things. I dont like having to correct a doctor about my results of testing in that I mean remembering results or things, not actual diagnosis.

    3. Telling me I am to young to be in this pain, to young to prescribe narcotics, you are always going to have pain and walk out without telling me how I work to get out of pain.. Telling me my verified issues should or do not cause pain because studies show that alot of people will have herniations or tears and have no pain, without even asking my symptoms or discussing and then asking what exactly can I do for you. Making fun of other pain patients in front of me. Saying I cant help you and not offering advice about who can or a referral. Telling me its all in my head go back to work. Telling me I am the doctor you are the patient, keep relationship that way and let me tell you what it might be.


    Things I would like to see:

    More online stuff and ability to get appointments online like you can do for resurants. I just want to feel like the doctor is treating the symptoms and not just the scan/test and get back to basics a bit and touch and ask the patient about pain/symptoms. Promote patients to learn about their problems more. I wish there was a database that patients were asked to describe their surgury and rate their success etc and you could speak with them, even if its for a charge for their time. I would pay that if I was going under knife with same surgeon.
    Herniated T6-7, multiple herniations in cervical, tears in T5-T8. Stenois at levels and smorls nodes from thoracic thru lumbar
  • anelsen15anelsen15 Posts: 119
    edited 02/16/2014 - 4:48 AM
    Kinda suprised at lack of response. There is constant issues all over spine health with doctors and clinics both positive and negative and here is chance to voice them and compare notes but no one seems interested? I'm interested to see some of the things others have dealt with or liked.
    Herniated T6-7, multiple herniations in cervical, tears in T5-T8. Stenois at levels and smorls nodes from thoracic thru lumbar
  • was a neuro who was notoriously late for appointments. i'm not talking an hour, i actually sat in the waiting room for this doc for like almost 4 hours. i got there a little early, because it was a decent trip from my house, and i had to drop my daughter at school. killed some time and went back. i checked with the desk a few times. i was told i was the next appointment at like 11:30. i think that was already well past my appt time. well hours later, i finally tell the desk that i have to leave in 30 minutes to get my daughter. even then, they couldn't get me in to see him. i ended wasting an entire day at the office, and never saw him. well, the next day i get a call from the office, saying he would talk to me on the phone. i sat on hold for 15 minutes and finally told the girl when she took me off hold for the 3rd time, that i wasn't waiting any more. i had someplace to be and was sitting in the car waiting for him AGAIN. well, i finally let my husband deal, all i wanted was to get off a medication he had put me on..... husband finally spoke to him, and no apology, nothing for the fact he wasted hours of my time, not once, but multiple times with the phone calls too. At least they refunded my copay that day, since i paid that upfront.

    needless to say, i will not go back to this doc. He's supposed to be one of the best in the area, but i'm not sitting like that again. it was beyond insane the amount of time they had you just sit there.
    Microdisectomy / hemi-laminectomy 6/2010 and revision 10/2010
    Cervical fusion C4-5 and C5-6 9/2011
    Lumbar Fusion L5-S1 6/2012
  • dilaurodilauro ConnecticutPosts: 10,065
    I am also really surprised. The amount of threads/posts that people discuss that their doctor doesnt listen, this doctor treats me like a drug addict, the pain mgt doctor doesnt believe me, etc
    anelesn15 said:

    Kinda suprised at lack of response. There is constant issues all over spine health with doctors and clinics both positive and negative and here is chance to voice them and compare notes but no one seems interested? I'm interested to see some of the things others have dealt with or liked.
    tran92 said:

    late for appointments. i'm not talking an hour, i actually sat in the waiting room for this doc for like almost 4 hours.

    .............. i ended wasting an entire day at the office, and never saw him. well, the next day i get a call from the office, saying he would talk to me on the phone.

    .....................I was really hoping for more comments, so that in general we can see what makes a good doctor and why were are annoyed at other doctors.

    ... husband finally spoke to him, and no apology, nothing for the fact he wasted hours of my time, not once, but multiple times with the phone calls too.


    These comments identify a type of doctor, I know I would not want to depend on.

    Come on, there has to be more of you out there that can answer about the Good the Bad and the Ugly.
    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • SarahLindeauSarahLindeau Posts: 766
    edited 02/16/2014 - 7:48 AM
    Here's my take:

    1. A doctor who takes a genuine interest in you, your pain and is committed to finding a solution. He never leaves you hanging and spends a good amount of time with you at each visit. He doesn't get perturbed by my endless questions and stays in the room until I have the answers I need. A good surgeon will not guarantee anything, but will be honest about outcomes and not force you into surgery. His office will be available if I have concerns while at home and I will always get a call back for any messages I leave. He will shake my hand when he comes in and shake my hand at the end of the appointment. He will remember me even after a year and pick up where we left off. I'm not a patient, but a person to him. He says "no"'to most of the people coming to him asking for surgery and his cumulative outcomes are positive as a result.

    2. A bad doc/surgeon will be late and not apologize because his time is clearly more valuable than little old me. He'll have to spend a few minutes having me remind him who I am and what my issues are. He'll make me feel silly when I ask questions that he thinks are obvious. His staff is a reflection of this lack of compassion. I usually leave with more questions than answers.

    3. The terrible doc/surgeon in my eyes is one that only wants to operate and never see me again. He's driving an expensive, flashy car that his operations bought him and his practice is a revolving door of people who probably were not good candidates for surgery in the first place.
    2015: Thoracic protrusions C7-T1, T3-4, T6-8
    Dec'13: 360FusionL4-S1 w/bone graft
    2013: 3x2-level disc injections: 12mo surgery postponement
    Dec'12: DiscogramL4-S1
    Sep/Oct'12: Bi-lateral Rhizo AblationsL4- S1
  • I agree with anelson about how frustrating it is to hear a doc say, "you are too young to feel this much pain and too young for a fusion." Yes, I was 28 when this all started but now having had my fusion I am very happy. I wish I had done it sooner. A good doctor will acknowledge the statistics, but won't be making a decision by them. Each case is unique.
    2015: Thoracic protrusions C7-T1, T3-4, T6-8
    Dec'13: 360FusionL4-S1 w/bone graft
    2013: 3x2-level disc injections: 12mo surgery postponement
    Dec'12: DiscogramL4-S1
    Sep/Oct'12: Bi-lateral Rhizo AblationsL4- S1
  • 1. the good. The doc that listens, gives me options, and doesn't push me into doing a 'procedure'.
    ACD&F c5/6; Lumbar DDD and bilat neuropathy..
  • ABurningPainAABurningPain Posts: 15
    edited 02/16/2014 - 2:15 PM
    The bad: the waiting. Waiting for the appointment. Waiting AT the appointment. Waiting for the 'tests'. Waiting for the results of the tests.
    ACD&F c5/6; Lumbar DDD and bilat neuropathy..
  • The ugly: I can say there are only two incidents that I feel would fit here. The first was after I had my ACD&F c5/6. I woke up from surgery with a new pain. Severe pain at about T5/6. The surgeon says "oh its just a muscle spasm, it'll go away." I was crying and twisting in agony. ( I think it surprised him). And the second incident just happened last week. I have had multiple tests for the awful neuropathy that is getting worse by the day and I am in mortal fear of losing my Job, my lifestyle, etc.. I called the Neuro doc to find out what the latest test result revealed. I am hoping for ANY sort of answer. The MA says to me "your bloodwork was normal. I don't usually call the pt if the results are normal." I felt dismissed. As if normal results would cure my pain.
    ACD&F c5/6; Lumbar DDD and bilat neuropathy..
  • Sorry I broke this up into parts.. but my first attempt I had a lengthy diatribe, and then (fortunately for everyone) I accidentally hit the 'back space' button and had to start over..
    ACD&F c5/6; Lumbar DDD and bilat neuropathy..
  • The good is the way that as said before they take time and explain why needs to be done and what results should happen. Taking time to answer questions. Explain recovery time and possible set backs. How long hospital stay for surgery and what to expect when waking up. What materials are being used and so on.
    The bad, never telling me how the cold would affect my neck and after out of collar how heavy my head would feel about 4 to 6 hours every day. Never thought to ask that question.
    The ugly. - pain management saying he doesn't believe in muscles and telling me they are more addicting then narcotics. Who knew and they do help the tense muscles in back of neck, now what.
    Also ugly the intense physical therapy that is needed after a 4 level fusion.
    Vicki
  • Sorry muscle relaxers. I omitted that.
    Vicki
  • i think more people might chime in if this were in the chronic pain section as that is where i see most of the talk about dr visits going negative
    Herniated T6-7, multiple herniations in cervical, tears in T5-T8. Stenois at levels and smorls nodes from thoracic thru lumbar
  • Chronic Pain for 20 years I have seen a lot of Doctor's:
    Likes: They listen don't cut you off. Want to know the details of your history build a relationship of trust.
    They are honest about their view or opinion, open to a two way conversation.
    Learn how and why you got to where you are today.
    Don't lie or pressure you to go their direction or else.
    Dislikes: Ask you for all your past history and when you walk in they dismiss it.
    Spend 15 minutes on your first visit, ask very little and make decisions based on nothing.
    To advertise a group of doctor's are there to find out and help you when that is far from the truth.
    Show compassion act just a little like you matter to them. Remember who you are and not
    have to ask the same questions, they should review your chart before the visit.
    Believe what you are saying based on History and current behavior.
    I could go on but I've said enough.
    Traits: Arrogant believe me you can pick them out.
    Act like your stupid don't want to hear what you know or think.
    Shove you off on their assistants never to be seen again. (Sorry wrong place)
    Use a tone of voice that is degrading. They can treat you anyway they want because they Have you then sign a paper if
    you get upset or show any anger they will dump you.
    I could tell so many incidents some positive but a lot negative which is truly sad for all those depending on them.

  • Hope3, i have had alot of negative exp. that I in the end was validated with many, but in my exp as a pain patient many times you are guilty until proven innocent. And there are many tests to prove truthful, but when those tests miss things that come out later you are guilty until its found. By this i mean perception. The sad thing is when they do proove you were right years later you get no compensation for being wrong and you suffering.
    Herniated T6-7, multiple herniations in cervical, tears in T5-T8. Stenois at levels and smorls nodes from thoracic thru lumbar
  • My surgeon never once pressured me into surgery. I walked out after my surgical consult with him and thought about surgery for a YEAR. Then, when I came back for a new consult, he remembered exactly who I was and my story. He welcomed the many, many questions about the surgery from the 3 people I brought with me to the new consult. He fully explained everything and never pressured us on time; he was available as long as we needed him. That was over an hour.

    After I decided to go through with it and got scheduled for my fusion, he actually called me the night before the surgery. Himself. He didn't have his nurse or his PA do it. I was very impressed. After my operation was done, and he went into debrief my family, my sister recorded the meeting on her phone. I was very happy he allowed it as I was able to listen to it myself when I had my wits about me again.

    After surgery, at my 6 week exam, he genuinely thanked me for "allowing [him] the pleasure of operating on [me]." I'd say he was pretty amazing. Bed side manners are not always linked to neurosurgeons!
    2015: Thoracic protrusions C7-T1, T3-4, T6-8
    Dec'13: 360FusionL4-S1 w/bone graft
    2013: 3x2-level disc injections: 12mo surgery postponement
    Dec'12: DiscogramL4-S1
    Sep/Oct'12: Bi-lateral Rhizo AblationsL4- S1
  • Wow! Great surgeon! Mine is very talented & very respected. He's my 'wait & see' surgeon. No pressure ..but I have regular checks. There is a sign in his waiting room stating 'I am a surgeon. My staff will great you with a smile, answer any questions, address your concerns, take care of your emotional & physical needs prior to surgery & after'.
    At least he acknowledges that he has a terrible bed side manner. He introduces his PA as his 'smiling face'. She literally translates what he says into 'nice & understandable' (their joke). Only after it became clear that I liked his no **** approach & understood what he was saying did she leave the room. She returned at the end of the appointment to ensure that I was happy & completely understood everything. I was!
    Is he arrogant & rude? Yes! But their little 'play' makes appointments a pleasurable experience. He understands that it can be very frightening & confusing for a patient...and he's the only 'doctor' I've ever seen who walks up & down with me while we talk (sitting is agony for me). My first appointment he snapped "get up! I can't stand to watch you squirm in pain!' ..so we walk. He refers to my MRI's & tests as the 'pictures' & relies on me for the 'text'. Most importantly, I trust him to do the best for me.

    I don't want my specialists to be my friends. I don't care if we laugh & joke. I am there for their expertise & treatment. I do expect to be treated with compassion & respect. I want to be physically examined & listened to. I need to understand my condition & treatment options. Before my pain journey began I thought this was a basic level of competency I've been truly shocked by the number I've found lacking in many of my expectations (particularly Pain Management doctors).
    Osteoarthritis & DDD.
  • Well due to the fact that my current surgeon works in hospitals that cannot control the
    pain after surgery (really?) due to my spine issues, I was referenced to our largest up-todate
    preferred hospital yeah!
    I just went to the 5th Doctor (Trauma/General Surgeon) for my stomach problems and he was everything
    you could want in a Doctor. Listened said he wanted to hear what I had
    experienced over the past 3 years, who I was, what effect it was having on my life,
    what I have done and other Doctor's to try to help the problem. Read all the notes
    and CT scan, then went over the results with me. Congratulated me on the
    current amount of meds. I was on compared to where I was last Sept.
    We talked for one hour that is the longest I have ever spent with a Doctor and
    I was so impressed with him. I have a few Doctor's that treated me as a
    person but not like this guy. I told him he is an example of what I Doctor
    should be like even if he only had spent 15 minutes it was his listening and
    showing respect that won me over.
    It is hard to discuss this stuff because I admit I do have a negative attitude
    towards the medical professions (not all) but I also have the same attitude towards
    myself for not doing all I could over the years.
    The current PM Doctor I have would be in the negative category. Anyone on here
    can disagree I respect that but I am the one who has dealt with him and know
    that he is cold, dis-respectful, uncaring, won't admit his mistakes and right
    it is in the eyes. I see it every time I meet with him. I stay there for one reason
    only I made a commitment to myself because of the tolerance I had built up
    on meds, I needed help to get down to something that would help. Little did I
    know he would cut me down more and more and not keep his plan that
    he would help my pain. His last idea is a spine surgeon and guess what he
    would not even take the time to explain why, said he had other patients and
    we will talk next time after your stomach surgery.
    Thanks Sherri
  • Great! I'm so pleased for you. Hopefully things can start moving in the right direction now. ;-)
    Osteoarthritis & DDD.
  • LC84LLC84 Posts: 599
    edited 04/04/2014 - 5:16 AM
    The good- Both my PCP and Surgeon show true concern about my well being. They have both re-assured me that things will continued to be tried until I find some relief. The last encounter with my surgeon was amazing, I told him I had a list of questions, he pulled up a chair, listened and answered all my questions. Then he did a thorough exam which is so important and sometimes doctors forget to actually put their hands on a patient to help figure things out. Then we devised a plan. A plan is so important in my opinion, my PCP has always done the same.

    The bad- My Surgeon's nurse. I'm a pleasant person when I go to my appointments, even though I'm in pain. She never smiles, she takes FOREVER to call me back when I have true concerns. It's either, I didn't get your message or I'm very busy with phone calls. To me it's unprofessional to tell someone you're too busy. I work ER at a 24 hour veterinary hospital, I could be running around with my head chopped off, but when I answer the phone I put on my professional, calm voice. I do the same when I go into an exam room , even though I have to rush and get 10 things done, I don't tell the client that, it's unprofessional in my opinion. This probably sounds harsh but sometimes I feel like I have a better understanding of spinal conditions then she does. When I ask her questions there is a long pause...... Meaning she doesn't know, but she'll pull something out that just doesn't quite fit...like- try ice, after I've told her that ice aggravates it more. I'd rather she just say I don't know, let me consult with the Dr. and I'll get back with you, IN A TIMELY MANOR. Isn't that how it's supposed to go?

    The Ugly- The Ortho that told me that there was a lot going on with my spine but there was nothing that he could do for me, I asked what my next step was, he said go back to see your PCP for further instructions.... REALLY, he's the specialist not my PCP, then I asked if it was possible that my MRI has changed since my symptoms have progressed, so he did at least order another MRI. Oh and he said I was too painful to do an exam, my back was "out" at the time, that's what I call it anyway, but I would have suffered through the pain to get an exam, an exam can be very useful. Plus you see I'm so painful and don't offer me some suggestion. I'm not talking medications, just some additional treatment of some kind, ANYTHING. Since he didn't want to operate, he brushed me off. At least my PCP sent me for physical therapy. NEVER will I go back to him. This was all prior to my most recent surgery. I do think things happen for a reason and I'm thankful he did not become my surgeon. So I guess the Ugly turned into the Good.
    Progressive DDD
    Osteoarthritis
    Chronic S1 Radiculopathy
    Discectomy L5-S1 2002
    Discectomy, Laminotomy/Foraminotomy L3-S1 January 2014
    Bilateral SI Joint Fusion and 2 level spinal Fusion October 2014
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