“I’m worried that I might have diabetes, Doc.” He was here for a physical, a brand new patient that I had not met before.
“Tell me about that. What is happening?”
“I am super thirsty, peeing like crazy. I just don’t feel good. Everyone in my family has diabetes. I know all about it.”
“That certainly is suspicious.” He was overweight and admitted to a horrible diet. He was a young man with a new wife and a new baby and probably was here because he was scared and motivated to change. Kids do that to dads sometimes. That was a good sign. “We will get the labs done and if they show what we think they will show, we will get you started on meds and get you into diabetes education classes.”
“Oh, no, Doc. I don’t need classes. Like I said, I know all about diabetes.”
Sometimes you have to let patients prove they don’t really know everything, so I didn’t push it further then. We could talk some more at his follow-up once we had the official diagnosis.
Sure enough, the next day the blood work showed that he wasn’t just a little diabetic. His numbers were out of control.
I had my assistant call him and got him started on a medication, metformin, and scheduled a follow-up for two weeks.
Three days later, I received a call from his wife, whom I had never met.
She was livid.
She started off by telling me that I was a terrible physician for not making him come into the office to deliver his results face to face. I pointed out that generally speaking patients don’t like to wait until the next available office visit to get their results, particularly as it costs them time and money. Furthermore, he had told me he already knew everything about diabetes. I asked her if he was upset or if she was the one upset. She refused to answer the question.
Then, she told me that I should be sued for malpractice because I did not know how to treat diabetes and had almost killed her husband. This accusation was certainly surprising so I asked her why she felt this way. Interestingly her family was friends with a general surgeon in town. They had told him of the new diagnosis and medication to which the surgeon responded that I should have told the fellow to lose weight first because the metformin could make his blood sugar go too low and kill him.
Surely this was not the case. Metformin absolutely cannot cause hypoglycemia. Why would a physician say something like that?
Puzzled, I asked her if he had ended up having low blood sugar. Nope. “But what if he had?” she yelled. “He is going to change doctors!” The phone was slammed down on the other side. This was back when we all used real phones. Slamming certainly was gratifying. I miss that.
She was completely out of line, but I understood where she was coming from. She loved her husband. She was a new mom and did not want to be a single mom. She didn’t know me from Adam and given the opinion of a doctor she knew vs. a doctor she did not know, it was clear who she would trust. I also knew, being a woman, that people (particularly women) think they can get away with behavior with me that they would never try with a male physician.
Seething, I immediately called the surgeon’s office and was told he was in the OR. I left a message to have him call me ASAP.
Days passed. No call.
I left another message.
No call back.
I finally ran into him on the floor at the hospital as I was doing rounds before clinic. At first, I thought I would let it go and avoid the confrontation, but then the anger over how I had been treated on the phone by the patient’s wife got the better of me.
The man was sitting across from me at the nurses’ station, gray head buried in a chart, not acknowledging my presence.
He knew I was there.
“Hey. What do you know about metformin?” I asked.
He looked up. Mock surprise.
“That’s a medication for diabetes, right?” I could see from his face that he knew where I was going with the question even if he was playing dumb.
“Do you think it causes hypoglycemia?”
“Uh, I don’t know.” He looked embarrassed.
“Word on the street is that you told a patient of mine that it did.” I paused for effect. “It does NOT.” Another pause. He glanced off, uncomfortably, then looked back at me. “I got chewed out and lost a patient because of it. I would appreciate it if you would let them know you were wrong. I don’t care if they come back to see me, but I do care that they think I am an awful physician.”
“Well, I thought maybe he should try diet and exercise first.”
“Did they tell you his numbers?”
“Diet and exercise alone were not an option.” I closed the chart I was working on and stood up. “I have sent you a lot of patients over the years. What this tells me is that you don’t trust me as a physician. I want to send patients to specialists that are not going to undermine their confidence in me. There are plenty of other surgeons in this community. I don’t have to use you.”
I never saw that patient or his wife again. I don’t know if the surgeon ever admitted his mistake to them, but he never saw another patient of mine again.