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My mother's doctor dropped the ball on a key diagnosis Add to ...

The question

My mother has had the same doctor for many years. I think they are sick of each other. My mother is very high maintenance and a chronic worrier. Her doctor has dropped the ball on a key diagnosis and the situation has gotten worse. The physician works three days a week and keeps patients with appointments waiting for as much as an hour and a half. During my mom’s recent visits, the doctor has been spending time keying into her computer, leaving my mom with five minutes at most to talk [the doctor tells her to be quiet while she uses the computer] I was appalled when I heard. I suspect the doctor is hoping my mom leaves. What can I do?

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The answer

The public health-care system isn’t built for patients like your mother who need time to go over their multiple medical problems. Although it’s getting better, many office visits are brief and episodic.

Your concerns with the family doctor come under three headings: competency, practice style and communication.

The dropped ball on a key diagnosis is the most worrisome. If this doctor misdiagnosed or failed to do proper investigations – and this led to a change in your mother’s medical outcome – it is a deal breaker. But if this error is a mistake that did not result in a worsening of your mother’s medical condition, I would hope the physician has acknowledged and then apologized for it.

Examples of a serious misdiagnosis include a delayed diagnosis of cancer. That could include rectal bleeding not followed up or a lump not biopsied that turns out later to be more advanced disease. It could even be a laboratory test result that was not communicated to the patient.

“Dropping the ball happens very rarely,” says David Rapoport, a Toronto family physician with a special interest in geriatrics. “If the doctor really did drop the ball, they should go to a new doctor, which is not easy to find.”

Lateness is a common complaint of patients and your displeasure is compounded by a brief, unsatisfactory appointment. Lastly, your mother’s doctor does not like to talk while typing in the computer; I’m guessing the computer is new to her and she is trying to stay focused.

It may be that your mother and the physician are not a good fit or are simply going through a bit of a hiccup, which happens in any long-term relationship.

“Some patients we look forward to, some patients we don’t look forward to,” Dr. Rapoport notes. “But we treat them the same.”

You mentioned your mother is “high maintenance” and a “chronic worrier.” Does she have problems with anxiety that need to be addressed?

I think you should go back to this doctor, tell her your mother has a lot going on and you wondered if she could be referred to a geriatrician. This will be palatable to the family doctor.

Geriatricians are easier to find in big cities. Before you see that specialist, make sure you go with your mother and that she brings her medications plus a list of what is ailing her and a list of past illnesses. This, you can hope, will help get her the time she needs to go over all of her issues and get a care plan in place.



The Patient Navigator is a column that answers reader questions on how to navigate our health-care system. Send your questions to patient@globeandmail.com

 
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