Article Date: 6/1/2001

Lessons Learned
Do Patients Sing Your Praises?
It depends on more than a good diagnosis.
By Jack Runninger, O.D.

"My back hurt so badly I couldn't even walk," a patient once told me. "So I went to see Dr. Kelly, and he told me he'd have me walking in no time."

"Did he do it?" I asked.

"He sure did! He charged me so much I had to sell my car."

I, too, had a recent episode of back pain. As so often happens, when friends heard of a problem, they phoned me with advice as to what I should do and whom I should see.

The physician's wife

"I'm sorry to hear you're having back problems," was one of the calls from an M.D.'s wife. "I've been there, so I can sympathize.

"You need to see Dr. X (who's a chiropractor). When I had a bike accident recently, I was in real pain with my back. My husband sent me to a neurosurgeon. He was very rushed and impersonal, and all he did was give me pain medication.

"I then decided to see Dr. X. The first thing he did was put his hand on my shoulder and say, 'I'm so sorry you're hurting.' It was the first concern anyone showed for my pain, and it made me cry. I'm still seeing him, over my husband's objections."

Questioning her further, it was obvious she was still having back problems despite Dr. X's treatment.

Also apparent was the fact that her being completely sold on him wasn't based as much on the help he'd given her, as it was on his having shown concern and sympathy, which the M.D. she'd seen, hadn't.

In talking with other friends, it has been evident that the concern shown by their practitioners was of the uppermost concern to them and that it influenced their advice to me about whom I should see.

High and mighty

I had an experience a couple of years ago with an ophthalmologist that illustrates the same point.

My spouse was having intense eye discomfort. We knew she had Sjögren's, but even punctal occlusion and frequent use of artificial tears weren't giving much relief. Finally, our local ophthalmologist suggested we see a cornea specialist in Atlanta.

He did a brilliant job of diagnosis when he looked beyond the Sjögren's and determined that she also had benign essential blepharospasm (BEB). The botox shots she has received for treatment helped immensely.

As a result, do I sing his praises and happily refer other folks to him? Not really. He was so uncaring, and such a south end of a north facing horse, that it canceled out most of my appreciation for his skill.

"I think I may know what's causing the problem," he said after our first visit. "But first I want her to try using Brand A artificial tears four times a day, and return in 2 weeks."

I explained that we'd already tried Brand A tears and every other artificial tear, and that Brand B gave her the most relief. I also mentioned that my wife needed artificial tears probably 44 times a day, not just four. I made sure to point out that we lived 75 miles away. So, I wondered if we could just skip that 2-week trial of something that wasn't going to work.

In effect, he made it clear that we lowly peasants shouldn't question him and that my wife wasn't too bright if she thought Brand B was best. Also, he wouldn't do anything until we returned in 2 weeks.

Exercise in futility

So after 2 weeks of futility, we took the long drive again. This time, he finally referred us to the clinic's lid specialist to confirm the diagnosis of BEB, which he could've, and should've, done in the first place.

Both episodes again prove the old adage, "Patients don't care how much you know, until they know how much you care." 

Jack Runninger, our consulting editor, lives in Rome, Ga. He's a past editor of Optometric Management.

Optometric Management, Issue: June 2001