Doctors Reveal 25 Things They Usually Don’t Say To Patients’ Faces

As a gynecologist, I don't want you to know that the real reason the nurse is in the room helping me with the procedure is that she's there to cover me in case you try to accuse me of anything. You would never do that? Neither would 99.99999% of women. But even the accusation could be career ending, so it's worth paying somebody to stand there just to make it that much less likely.

I don't want you to know how little I care about you personally. No, I'm not made of stone but if I let my feelings for you get personal I can't act objectively and I won't be the best doctor you can have. There's also the fact that I'm tired of getting emotionally wrecked whenever I find out patient X didn't come for his HIV meds because he kicked the bucket last week.

Well since even vet techs are chiming in I guess I'll have my say:

I perform ultrasound imaging. We're known in the medical community as diagnostic medical sonographers. Or ultrasound techs. We don't just scan babies, as most people seem to think. Heart? Check. Liver, kidneys, breasts, testicles, spleen, pancreas, vasculature, you name it, check!

What can't we tell you? The number one issue I have with patients is obesity. After that, hygiene. Your images suck? That's because you have too much fat for the beam to travel through. Chicken wing falling out of your fat roll? I'm gonna hurl as soon as I leave the room. I am simply disgusted by the vast majority of you. There, I said it.

That I was late to see you and/or can't spend as much time as I'd like talking with you about and managing your health because I probably have seen 1 or a few exhausting and unrewarding patients with pain and or psych issues that take a disproportionate amount of time and energy. All I want to do is help people who care about their health and will partner with me instead of treating me like a candy dispenser.

That we ourselves make the worst patients and seldom follow our own advice.

99% of the time, I do a physical exam (listen to your heart and lungs, push on abdomen, look at the back of your throat) not because it's going to change anything I do, but because it allows me to bill Medicare at a higher level. If you come in with knee pain and I listen to your heart, I'm just going through the motions. I really don't care what your heart sounds like. I work in an ER.

The reason doctors do this is because of the ridiculous way medicare reimburses things. If I spend 15 minutes with just your knee, examining it and talking about it, I don't get paid. I need to jump through the hoops of asking about and examining other things if I want reimbursement for my time. It's not like the doctor is being a fraud, it's just that he wants to get paid for his time, so I would just go with it.

You know how it takes me like 5 minutes to take your pulse?

I'm also watching your chest to count your breaths, but I don't want you to know it or you'll become conscious of your breathing.

Sometimes I think my patients are whining brats who seem to always want a quick fix with no real effort on their part. I really don't want them to know that I think that of them, but I do all day long.

Your doctor is almost as relieved as you are to get good test results back, and we lose sleep worrying about you.

Not much really. I wish they wouldn't know every one-in-a-million side effect of everything. It really makes vaccination and prescribing difficult if people place too much importance on rare events. We need perspective in these things or else we'd never even want to get out of bed in the morning for something that 'might' happen. I'm happy patients are better informed but it's a balance sometimes.

It's Health Business, NOT Health Care. The people doing the work do actually care and do their best but in the grand scheme of it the hospitals could care less about anything but money or bad publicity.

Veterinarian here, so that's a customer rather than a patient complaint: I don't want you to know that for everything I tell you, there will be dozens of lunkheads on the internet telling you the exact opposite. Unfortunately, that's pretty pointless, but there is just so little regulation of animal health claims that it can get effing annoying.

As a provider, I want them not to know how cruel and judgmental so called professional people can be or how many times protected information is discussed.

This is late and buried, but I'll throw in my two cents as a Radiologist. If you're too fat to image, I have no sympathy for the quagmire of medical illness you probably have. Radiology is one of my most utilized services by any clinician. If you have a symptom, there may be a scan for it, but by god, we're yoked to the mercy of the laws of the physics that have been harnessed into these machines.

So once, I get a frantic call from a FMG on call.
FMG: "I have this patient who has shortness of breath. I would like to rule out pulmonary embolus. He weighs 550 lbs."
ME: "No can do. Table limit for CT is 450."
FMG: "Can I get a scan from the zoo?"
ME: "Nope. In fact, we scan their animals for them."
FMG: "So what do I do?"
ME: (shrug) "Treat him. Looks like he ate himself out of a diagnosis."

The struggle is real. Obesity makes it physically impossible for you to be imaged. Either you can't fit in our machine or the laws of physics simply won't allow our various beams and energies to penetrate into the depths.

In that particular case, the patient would have undergone a not risk free course of anticoagulation which carries a serious risk of adverse bleeding.

Just seeing case after case of things like this has made me truly hate the obese. The truly super super obese. They outright disgust me. Take a walk once in a while.

EDIT: I see that many of you understand the limitation that super super obesity causes. If you think that sounds strange, why do I keep saying super super, then you may not realize that that is the actual, official classification for that kind of obesity: BMI > 60. For those of you wondering where my sympathy is, I'll be honest. The reason I loathe people that big is because I'm overweight myself. Not super super obese mind you, I'm 6'3" and weigh 260, but weight has been a struggle for me too. Where my hatred comes from is that people who are this obese are suffering from at its root, a psychological and psychiatric issue that becomes a huge physical crisis. Eat, eat, and eat the void away some more. But it never fills. It just deepens and worsens the cycle. I know that road. I've been down it and I turned back. I got healthier, I got wiser, and ultimately realized that I had to take control to make better choices. But the first right choice I had to make was deciding that I wanted to stay and live and thrive in this world. I found my reasons. Get busy living or get busy dying. When I see people that big, it's clear they gave up. I almost gave up too, at one point. I don't like to be reminded of it, so it fills me with deep revulsion for them and myself. But also, that goes into the psychology of me treating them: If you don't care about yourself, why should I? Why should we as a society?

Half the medicine we prescribe for CNS condtions excluding Parkinson's, epilepsy, and schizophrenia cause more problems than they solve in most cases. Little hyperbole, but not near as much as I'd hope.

Also, obesity makes treating someone insanely difficult most of the time. Have you tried to listen for a pericardial rub in someone with a solid 8cm of fat between you and their ribcage?

Your surgeon is terrible (possibly). look your anesthesiologist or nurse anesthetist in the eye and ask them if they would be ok with this surgeon operating on their family.
if they hesitate, proceed forward at your own risk.
we call one guy the Butcher of Baghdad.

1. If you / your SO / your family want to speak to me after the end of my shift I will pretend I am not there. The nurses will call me and I will not answer. I also have a private life and I also need to sleep/eat/shower. I stay there after the end of the shift to do the Bureaucracy.

2. If you are fat, you will get substandard care. I cannot perform a good ultrasound. I cannot place a venous line, I will most likely give you weaker oral medications than the IV that you need. I can not examine you from all the fat.

3. I know you when you are my patient, I know every single detail about your disease. I might even know your whole family. But when I meet you on the street or you come after a couple of days again, I will have to reread my previous letter before I can remember anything about you. I can not keep every single detail about 12-20 patients every single moment of time.

4. If you are not nice, if you think that you can behave like a jerk, you will get substandard care. I am sorry but a good relationship between us works 2 ways.

5. If you are an alcoholic I will assume you are lying about everything. You will also come second after all the really sick patients.

6. If you were an alcoholic who is recovering and trying to put your life in order, you will get 120% of care from me. You will get all the social and medical help I can offer.

7. Young come before old. I am sorry but your 95 Y/O grandma wont get the same standard of care as a sick 20 year old. She is also not going to be the first to get the CT/colonoscopy/ultrasound or anything other.

This will probably be buried by this point, but if you get a direct-to-consumer DNA test, such as 23andMe, don't assume that your doctor will be able to interpret the results for you.

Many doctors, especially older doctors and those that focus on family care, are not especially educated on all of the latest advancements in genetic testing and diagnoses. Always go for a second opinion.

As a geneticist, I'm always a little scared to realize that I know more than the doctor I'm sitting beside.

Medical scientist checking in. Your blood may be analysed by someone with no more qualifications than you. Scientists only check the results.

In an opt-out state, your nurse anesthetist may be so green, yet "supervised" by a surgeon, that they don't know the diff between a fiber optic bronchoscope and a colonoscope.
seems ridiculous, but I've seen it with my own eyes.
these are the people responsible for your life.

also I have nothing against seasoned CRNA's, but the rookies are flat out killers.