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Your doctor prescribes a widely used medication for a chronic condition. You point out that the pills come with well-documented, sometimes severe side effects: dizziness, depression, gastrointestinal problems, headaches. Some patients say the cure is worse than the disease.The doctor looks surprised.
“What’s a little dizziness compared to staying alive?”
“Give it six months—your body will adjust.”
Or the classic: “It’s probably psychosomatic. You expected side effects.”
Meanwhile, you’re thinking: With these symptoms, I won’t be able to exercise. I may not be able to work, drive, or even shop for groceries. Dizziness means falling, which can be catastrophic. Six months? Do I put my life on hold for half a year with no guarantee things will get better?
Another example of this disconnect appears in a book by Danielle Ofri, Incidental Findings. As an attending at Bellevue, she encountered a 69-year-old woman who asked to stop dialysis. The patient had multiple serious illnesses and was simply done—with hospitals, procedures, and life as she was living it. She had children, but complained, “They want to put me in a nursing home.”
She was clear. She wanted to go home. Not to a facility.
A resident spoke with her, honored her wishes, and completed the paperwork to stop dialysis. When Ofri found out, she was furious. People have been on dialysis for years, she argued. She returned to the bedside, persuaded the patient to continue treatment, and arranged additional consults.
The patient agreed. A few weeks later, she was discharged to a nursing home, which seems to be precisely the outcome she didn’t want.
I’ve always wondered whether that woman felt relieved or betrayed.
What this episode reveals is not cruelty, but a difference in priorities. The doctor’s goal was survival. She didn’t fully consider the patient’s lived experience: noise, loss of dignity, loss of autonomy, and potential abuse.
I’ve hated nearly every encounter I’ve had with the medical system over the yearsl. And as I get older, I increasingly feel that doctors and patients are talking past each other.
There’s ample evidence that communication fails. In one small study at a Yale-affiliated hospital, 67% of physicians believed patients knew the name of the doctor in charge of their care. Only 18% of patients could correctly name that doctor.
The same disconnect shows up with medication. Patients are much more concerned about side effects than doctors; Dozens, perhaps hundreds, of articles report studies.
Here are five experiences I’ve lived first-hand.
1. “I’m sending you for a blood draw.”
To a doctor, this means clicking a box and spending five minutes reviewing results.
To a patient, it often means navigating an inconvenient location, waiting 45 minutes in a crowded, noisy room, dealing with a rude receptionist, and being stuck (literally) with a tech who treats sensitivity to needles as a joke.
At one prestigious clinic at the University of Pennsylvania, patients were assigned numbers instead of names—supposedly for HIPAA. Numbers were barked out like a butcher shop. I felt like a slab of meat. (PennMed has a problem with names anyway. Thanks to HIPAA, they say, I can’t be called “Ms. Goodwin,” let alone “Dr. Goodwin.” I can be called by my full first name or “Last Name Goodwin.” I kid you not. It doesn’t get our visit off to a great start.)
Doctors likely never see this. And if they did, many would shrug. When doctors are patients, they’re ushered through quietly, with minimal waiting and maximum courtesy.
2. “The waiting room is noisy? Just wear earphones.”
I’ve heard this more than once from doctors I met socially. When I point out I won’t hear my name, I’m advised, “Ask the receptionist to find you.”
I can’t repeat what the receptionist tells me in real life. It’s not exactly friendly.
Some clinics keep TVs on “for HIPAA,” which is nonsense. Plenty of practices maintain privacy without a TV. The noise doesn’t protect confidentiality; it just adds chaos.
People shout over it. Sometimes chairs are arranged so you can’t even see the screen so you get the noise but can’t watch even if you want to.. Families conduct loud conferences in the back.
You can’t read. You can’t think. You can’t prepare for your visit. It’s sensory torture.
The irony: after the noisy waiting room, you’re often placed in a silent exam room to wait for the doctor, often for a long time. Somehow, the same people who insist on TVs manage just fine.
3. “Why are you upset? My other patients aren’t.”
Doctors think in statistical averages. Some of us are several standard deviations away from the mean.
As you know by now, I despise TVs in waiting rooms; my blood pressure goes through the roof when I’m forced to sit through daytime television or a cooking show or a political discussion. Receptionists always say, “Some people like them.” Well, a lot of people don’t.
Some hate vitals; others don’t care. Some want every possible intervention; others want the minimum.
I hate being called “sweetie” or “sweetheart.” My 39-year-old male friend shrugs it off: “They call me sweetie, too! It’s no big deal.”
In general, if you’re not a 45-year-old married male, with 2.5 kids and a humble respect for the medical profession, you’re the “other.” It’s like flying super-economy instead of first class.
4. Doctors are only a small part of the medical encounter.
You interact far more with receptionists, techs, and CNAs than with physicians. And their behavior sets the tone.
I once walked into a beautiful specialist’s office and politely complimented. The receptionist snapped, “Sit down. There are two people ahead of you.” They weren’t visible. She didn’t greet me.
The techs were just as dismissive. I never returned.
More than once, a TSA-style tech will yell at people to “get in line.” More than once, I’ve said aloud, “Just like in prison.” People always laugh. The tech always frowns.
Doctors often underestimate how damaging these encounters can be. I once told a doctor that a tech stormed out after I refused vitals. The doctor shrugged: “Don’t worry about it.”
I did worry. I still remember.
5. Medical encounters are far more traumatic and memorable for patients than for doctors.
For many patients, a medical visit feels like a combat zone. Everything is unfamiliar, invasive, and frightening.
Doctors forget encounters within minutes. Patients remember a single five-minute interaction for decades. They’re encoded as flashbulb memories.
A joke. A snide remark. A question asked at the worst possible moment. I still remember being told, “It’s too bad you don’t have children to be with you for surgery.”
Someone wrote into a Facebook group, “The doctor and nurse made jokes about my marital status while I was in the middle of an exam.” She never forgot that one.
I know doctors work under extreme pressure. But they are not working on crash dummies. They are working on human beings—people who will carry these experiences long after the chart is closed.
So doctors get to close the chart…and the patient continues living inside it.
