I’m hesitant to be publically critical of doctors. They don’t like that, you see. And getting decent medical care can be dependent on how much your doctor likes you. In a perfect world, it shouldn’t be. But. It often is. So, as I said, I don’t like publically criticizing doctors. However (you could totally tell there was a however coming, couldn’t you?)…
The doc I wrote about meeting several weeks ago is… well… either he’s a flake or an idiot. I think I’d prefer thinking he was just a flake.
He was nice enough. Pleasant and friendly. Sat down with me to talk about the Celiac screening test I’d had done. And here, in bulleted list, were the things that bugged me:
- He looked at the computer screen more than he looked at me. I understand that my test results are important (duh) and that this particular medical group has shifted to electronic as opposed to paper charts (which is a good idea in many ways). But, if he’d had his nose buried in my chart to the exclusion of looking at me, I’d have disliked that, too.
- He was confused by my bloodtests. One blood test indicated almost no gluten antibodies and the second bloodtest (6 weeks later) indicated quite a lot of gluten antibodies. I explained to him that I’d been off gluten for a year and then did a gluten challenge for the second test.
- He told me that the second test wasn’t actually all that high in antibodies, and contradicted himself later within the appointment, noting that it was quite high and strongly indicated Celiac Disease.
- He tried to convince me to go back on gluten in order to do an intestinal biopsy (if you have Celiac Disease and are eating gluten, there should be very clear intestinal damage). This is actually not that surprising. But, eating gluten makes me feel like crap. And a gluten challenge takes 6-8 weeks. I had only done the initial gluten challenge in the first place to get the bloody blood test and make sure I had gone gluten free for a good reason. And I tried to schedule with him as soon as the blood test came back, so that we could get the bloody biopsy done.
- He told me that, had I told the receptionist the issue when I’d first called a month and a half earlier to schedule with him, she would have immediately gotten me in for a biopsy… I told him, I did tell her. In fact, I called twice and actually asked at the reception desk, in person, when I was in the building for an appointment with my endo. All three receptionists told me that there was no way they could get me in any sooner. One was quite nasty about it.
- He told me I should have advocated more strongly for myself. While initially he apologized for what happened with the receptionists and me being unable to schedule a biopsy to coincide with my gluten challenge, he changed his tune and said that my primary care doc should have known and told them. Then he said I should have tried harder. Really? Really?
- He told me that I didn’t have the standard symptoms of Celiac Disease. That it was quite unusual. That he’d never seen anyone with Celiac Disease who had symptom X. He hastened to add that he supposed it was possible. Now, let me tell you what you’ll find if you google celiac disease symptoms — symptom X. Frequently it’s the second symptom listed. Good job knowing your shit, buddy.
- He forgot to place the referral he promised me. He told me there was someone within the medical group to whom he could refer me who specialized in Celiac Disease. Which would have been great. If he’d actually remembered to refer me. As is, I had to spend an hour on hold talking to various departments getting that sorted out when I actually tried to schedule.
- He refused to order any of the vitamin deficiency tests he told me I needed, saying that he’d let the Celiac specialist decide what to do.
- He totally ignored my medical binder when I showed it to him. He even ignored the gluten sensitivity test the crazy docs had given me two years ago. Not even interested in seeing it. (I grant you, this alone would not be sufficient reason to doubt him. It would just be personally annoying).
- He didn’t ask for a family history.
- He didn’t address my questions about GERD.
- His secondary argument for the intestinal biopsy was that it would invoke a medical protocol that would get my relatives to get tested for Celiac Disease. After I’d already told him my Grandmother was diagnosed 42 years ago. That, really, is quite sufficient reason for any of my close relative to get tested.
- His main argument for me getting the intestinal biopsy was that it would convince me to lead a gluten free lifestyle. Anyone else remember the whole eating gluten free for a year thing? ‘Cause, wasn’t my reluctance to eat gluten again the whole reason for me not getting the biopsy?
Some of those things, on their own, wouldn’t have bugged me too much. The combination, however…
To be absolutely fair, and let us be absolutely fair here, he did give me some decent information. I just happened to know it already. Actually, I happened to know more about the condition than he did. I can let that slide for a PCP or a specialist in another field (although my endo did know a fair bit about it). But for a gastroenterologist not to know the standard symptoms of Celiac Disease? Really?
The most useful bit of info I got out of that was the existence of the Celiac specialist at the clinic. And, if that actually turns out well, I will forgive him. But I sure as hell won’t see him ever again.