• Sometimes it’s easier for a doctor to write a prescription for a medicine than to explain why the patient doesn’t need it. –Cardiologist, Bangor, Maine
• Those so-called free medication samples of the newest and most expensive drugs may not be the best or safest. –Internist, Philadelphia
• Taking psychiatric drugs affects your insurability. If you take Prozac, it may be harder and more expensive for you to get life insurance, health insurance, or long-term-care insurance. –Daniel Amen, MD, psychiatrist, Newport Beach, California
• Ninety-four percent of doctors take gifts from drug companies, even though research has shown that these gifts bias our clinical decision making.
–Internist, Rochester, Minnesota
Bills, Bills, Bills
• Doctors respond to market forces. If the reimbursement system is fee-for-service, that results in more services. If you build a new CT scan, someone will use it, even though having a procedure you don’t need is never a good thing. –Family physician, Washington, D.C.
• I really do know why you’re bringing your husband and three kids, all of whom are also sick, with you today. No, they are not getting free care. –Douglas Farrago, MD
• Doctors get paid each time they visit their patients in the hospital, so if you’re there for seven days rather than five, they can bill for seven visits. The hospital often gets paid only for the diagnosis code, whether you’re in there for two days or ten. –Evan S. Levine, MD
• Twenty years ago, when I started my practice, my ear, nose, and throat procedures financially supported my facial plastic surgery practice. Today, my cosmetic practice is the only thing that allows me to continue to do ear, nose, and throat procedures, which barely cover my overhead. –Ear, nose, throat, and facial plastic surgeon, Dallas/Fort Worth
• Avoid Friday afternoon surgery. The day after surgery is when most problems happen. If the next day is Saturday, you’re flying by yourself without a safety net, because the units are understaffed and ERs are overwhelmed because doctors’ offices are closed. –Heart surgeon, New York City
• In many hospitals, the length of the white coat is related to the length of training. Medical students wear the shortest coats. –Pediatrician, Baltimore
• Often the biggest names, the department chairmen, are not the best clinicians, because they spend most of their time being administrators. They no longer primarily focus on taking care of patients. –Heart surgeon, New York City
The Darker Side
• It saddens me that my lifelong enjoyment and enthusiasm for medicine has all but died. I have watched reimbursement shrink, while overhead has more than doubled. I’ve been forced to take on more patients. I work 12- to 14-hour days and come in on weekends. It’s still the most amazing job in the world, but I am exhausted all the time. –Vance Harris, MD, family physician, Redding, California
• In many ways, doctors are held to an unrealistic standard. We are never, ever allowed to make a mistake. I don’t know anybody who can live that way. –James Dillard, MD
• Not a day goes by when I don’t think about the potential for being sued. It makes me give patients a lot of unnecessary tests that are potentially harmful, just so I don’t miss an injury or problem that comes back to haunt me in the form of a lawsuit. –ER physician, Colorado Springs, Colorado
• Doctors often make patients wait while they listen to sales pitches from drug reps. –Cardiologist, Bangor, Maine
• It’s pretty common for doctors to talk about their patients and make judgments, particularly about their appearance. –Family physician, Washington, D.C.
• Everyone thinks all doctors know one another. But when we refer you to specialists, we often have no idea who those people are. Generally, we only know that they accept your insurance plan. –Pediatrician, Hartsdale, New York
• In most branches of medicine, we deal more commonly with old people. So we become much more enthusiastic when a young person comes along. We have more in common with and are more attracted to him or her. Doctors have a limited amount of time, so the younger and more attractive you are, the more likely you are to get more of our time. –Family physician, Washington, D.C.
• Plan for a time when the bulk of your medical care will come from less committed doctors willing to work for much lower wages. Plan for a very impersonal and rushed visit during which the true nature of your problems will probably never be addressed and issues just under the surface will never be uncovered. –Vance Harris, MD
• At least a third of what doctors decide is fairly arbitrary. –Heart surgeon, New York City
• Doctors are only interested in whether they are inconvenienced — most don’t care if you have to wait for them. –Family physician, Washington, D.C.
The Sensitive Side
• When a parent asks me what the cause of her child’s fever could be, I just say it’s probably a virus. If I told the truth and ran through the long list of all the other possible causes, including cancer, you’d never stop crying. It’s just too overwhelming. –Pediatrician, Hartsdale, New York
• Most of us haven’t been to see our own physicians in five years. –Physical medicine specialist, Royal Oak, Michigan
• When a doctor tells you to lose 15 to 20 pounds, what he really means is you need to lose 50. –Tamara Merritt, DO, family physician, Brewster, Washington
• If a sick patient comes to me with a really sad story and asks for a discount, I take care of him or her for no charge. –Surgeon, Dallas/Fort Worth
• Though we don’t cry in front of you, we sometimes do cry about your situation at home. –Pediatrician, Chicago