Saturday, September 7, 2013

Bed-side Manner

Although I'm sort of having a small career identity crisis at the moment, very rarely have I second-guessed my decision to become a physical therapist.  Occasionally, I think that I should have gone to medical school, but that thought is often fleeting.  With the imminent danger of Obama-care looming, I'm often comfortable in my decision.

In fact, I often marvel that I was fortunate enough to figure out, at the age of 18, what I wanted to be when I grew up.  I went to a top-tier program and did fairly well there (once I figured out that attending class was actually necessary for passing said class).  While the economy was bad when I graduated, it took me less than a year to find employment, and I have been steadily employed since.  Often, I even have two or three part-time jobs in my field.

Sometimes, working in the school is thankless.  Just like any job, there are people who make your days more challenging.  And just like any rewarding job, there are the intangibles that you cannot put a price tag on.  The joy of a child's first steps.  The relief of new equipment.  The comforting words and care when there are no other options.  And in outpatient, there is often the immediate pain relief or return of function.

One of the aspects I enjoy most about being a physical therapist is the educational aspect.  Educating patients about their bodies and how their body is supposed to work (as opposed to how it is currently working), and how that relates to their pain and dysfunction.  Healing and re-learning skills and movement patterns takes time.  Being able to arm the patient with knowledge helps them to understand how and why quick fixes may not always be possible.  It gives me the time to help them heal.

When my son was just an infant, I went back to school for my doctorate.  The PT profession was moving towards a doctoral level profession in an attempt to gain professional autonomy (so that patients may directly access physical therapy services without first having to go through the rigmarole of physicians and specialists).  I agreed with the thinking, and pursued my degree.  I have a clinical doctorate (Doctorate in Physical Therapy, or DPT).  It earns me the title "Doctor" as long as I follow with the PT credentials.  It is a comparable degree to a Doctor of Dental Science (DDS), a Doctor of Optometry (OD), a Doctor of Chiropractic (DC), or a Doctor of Pharmacy (PharmD).  Although my doctorate has not been financially worthwhile, I value the education that I received, and I hope that my patients benefit from my additional schooling, in addition to my 14 years of practice.

So, this morning, I found myself at an "Immediate Care" medical facility.  An urgent care.  A doc-in-a-box.  I try NEVER to utilize these types of places.  I feel the care is not only substandard, but can, at times, be detrimental.  I have an excellent relationship with my physician, but alas, my body LOVES to become in need of medical attention on the weekends.  My physician  understands me and my medical background, and most often defers to my judgement.  He knows that if I'm seeking help, then it is a valid problem.  He also knows that I know what I'm talking about, and that I do my research. I very rarely see the doctor for myself, trying to treat myself with preventative and over the counter remedies when possible.   Alas, I have an infection that requires antibiotic treatment.  Being Saturday morning, I am forced into going to the doc-in-a-box.

The parking situation is not ideal.  The front desk staff is rude.  I put up with it, knowing that I need that antibiotic.  And as much as I hate to have to take an antibiotic, I know my condition needs one.  I also know that I am allergic to the three most common antibiotics used to treat my condition, and I know I'm going to get flack for requesting the specific antibiotic that I am able to tolerate and that has been successful in treating me in the past.  But what I did not expect was this ...

The nurse taking my medical history, on her last question, asked me my profession.  I responded, "Physical therapist."  She then asked me if I had my PhD.  I did not want to correct her and get into the whole clinical doctorate discussion, so I just replied, "Yes."  To which she replied, "Well, that's dumb."  I was taken aback and calmly said, "While it has not had the financial benefit that I had hoped, I don't regret the schooling I've had.  I can read my patient's MRI's when they bring them in, and explain them to them.  I can discuss with my patients how their medications may be effecting them."

She nodded, and said, "Yeah, I guess. My friend's boyfriend is just completing the PT program at ______ College.  He's been working so hard, and I'm like, 'That's so dumb, why don't you just be a real doctor!'"

I again calmly explained to her why being a PT was a valid career choice, including being able to balance family and career, and getting to see patients for more than 4 minutes, which is the average length of time an orthopedic physician spends with a patient.  I explained and validated myself way too much to this ignorant woman.  She left, and I stewed for a moment.

When the physician came in, after his lackluster exam, I asked him who the woman was who took my history.  He told me that she was an LPN and was working towards her BSN.  I told him what she said.  And, professional "real doctor" that he was, laughed.  He kept laughing, even though I told him that I was highly offended at her comments.  He tried to justify it, saying she was young and that she and her friends are in the frustrating position of having degrees, but are unable to find work.  He finally said, "Oh, I'm sure you are very successful at what you do" in a patronizing voice.

I guess, when you're in school to be a "real doctor," they don't teach you how not to be an asshole.

So, local readers, avoid the Urgent Care on Troy-Schenectady Road.  Unless you feel like being insulted.


  1. Hi Kathryn,

    Care, bed-side manners and treatment, are all just as hit and miss, here in the UK. The National Health Service is failing fast and heading nose-first, into an early grave!

    More and more of us are finding it necessary to take out private health insurance, to ensure that we will receive care as and when we need it. Many of the doctors who work in the private sector, are only there on the days when they don't work for the National service, thus depriving NHS patients of the care they desperately need and pushing waiting lists higher and higher, whilst private patients are getting priority.

    I hope that your treatment was successful and that you are now on the mend.


    1. The healthcare system in the US is another discussion for another day. I was just shocked at the outright lack of respect. I could *almost* understand it from the physician, as most do tend to be quite pompous. But to have that attitude from the nurse, who has a fraction of the education that I have...not to mention the basic lack of manners and courtesy.

      Initially, I had a lot of self-doubt about whether or not I could make it through a medical program. I now know, without a doubt, that I could have. I also know that I would have triple the debt from student loans, as well as half the time (or even less) to spend with my children. Having children was always more important to me than having the letters "M.D." after my name. Also, if I was a physician, I would not have time to pursue my writing, which I would like to turn into a second career.

      Thanks for the concern. I hope I'm on the mend!

  2. Every experience that I have had at Urgent Care places (varying locations) has been often and at times like you said-detrimental. My son, Owen ended up with cellulitis around his eyes after the doc prescribed crappy pink eye meds on a weekend visit. Went twice in Maine for an issue I was having-totally misdiagnosed and was in tears, so thankful, when the second doctor actually spent time listening to me, took me seriously and prescribed prendisone. But that took bringing my mother in law into the room with me as an advocate. This doesn't even touch the awful experiences we've had at Urgent care locations and doesn't even get into the whole issue with how they treated you regarding your doctorate. It's amazing how incompetent and rude people can be!


    1. I don't wish for my physician to spend any less time with his family. He works hard enough. I just wish I had his private number, because I always seem to get sick on the weekends!