Is industrial healthcare worse than cancer?

[SarcoPenyaJr]

I've been asking myself this question a lot lately.

Yesterday, my oncologist called me on the phone (highly unusual!) specifically to tell me that I am a burden to him and his staff.

He is in charge of the Cancer Center at the only hospital in my community, and part of his job is to advocate for me, especially with insurance companies.

But he is obviously angry at me, and this feels like a dangerous (and familiar) situation. Doctors tend to get angry with me, I have found, and that's a drag. I know I don't have to like my doctors, but I don't feel safe when they obviously dislike and/or express anger at me.

My plan is to see how he is at our next appointment. I know that he has personal issues (he weighs probably 300-350 lbs), and maybe he was just having a bad day.

If the appointment does not go well, I will retain a patient advocate (can't afford it, but will do it anyway) to take over some of the stress I run into dealing with personalities within the industrial healthcare system. They become as sick as the system because they are not allowed to make or admit mistakes, and their only choice is to gaslight you like it's your fault. I get it.

Also wondering if these disturbing situations will make me more likely to seek out "dignified death" options instead of going forward with more treatments, new cancers. It's not the cancer I'm afraid of and weary of—it's industrial healthcare and its inhumane consequences.

[Tall_Allen]

What do you think the doctor is perceiving?

[SarcoPenyaJr in reply to Tall_Allen]

Hi, Tall Allen:

I think the doctor is perceiving that I do not reward him with the same deference, praise, and unquestioning trust as others in this community do (per my observation). His staff, also, has the "How dare you question a doctor like __?" attitude about him and other doctors. I think he perceives me as a threat because I advocate for myself and ask questions about my treatment per normal expectations of informed consent. At least yesterday that seemed to be the case. For all I know, he is over it now. He is moody and irritable.

I honestly think it's about his weight. Last time I saw him, he loved me and wanted to do all kinds of things for me. He seemed to be almost manic. I could see that he had lost some weight recently.

But in the past few months, he has changed. He contradicts himself, and these contradictions have had consequences for my care. When I asked him to clarify, each time he became very irritated and dishonest: "I never said that." So he says one thing in his office, and sometimes a completely different thing in email communications to me and his staff. His notes do not always reflect what was actually said in the appointment.

He refused to meet with me and a patient advocate about his contradictions and their effects on my care. He had told me to ignore my gastroenterologist, for example, when that doctor wanted me to come in for a radiation consult when I was already on radiation for prostate cancer. He said he would fill my prescription from that doctor because that doctor refused to fill it until I came in for a radiation consult. He said, "No, don't worry, I'll fill that for you." When I sent a note reminding him to fill it, he became angry and refused to do that. He also forwarded my note to the gastro doc he had told me to ignore.

So I think he feels a bit exposed, irritated, a bit of a bruised ego. I am asking him to be accountable. I requested that he work with the other doctor he contradicted himself about (my healthcare system claims that my doctors are on a "team"), but he's refused to do that as well.

Thanks for not immediately going on the attack, as I guess should be expected when one complains about the way one is being treated. The assumption someone will always make is that it's your fault (doctors are happy to ditto that), the same thing women get told when they complain about inappropriate touching, which I have also experienced, and with that same response.

So I am familiar with that point of view already: I should monitor my own behavior with the doctor and showing the kind of respect that I would like in return. I mention the doctor's weight because I am straining to understand what he must be going through on a personal level to behave so abusively toward me after knowing him since 2020. My empathy and my self-awareness are functioning just fine, thanks.

I believe that the power difference in an exchange like this is also important to take into consideration.

[Tall_Allen in reply to SarcoPenyaJr]

It sounds like his ego is getting in the way. Is there any possibility of getting a female oncologist (women are sometimes, not always, less ego driven)? Unfortunately, whatever the cause, it is you who have to take responsibility (not blame!) for correcting the situation. I have "managed" a lot of doctors on visits with patient-friends and they usually love me. I've found that most oncologists are nerds and love to get into nerdy discussions. I can do that, but I know that not everyone is as nerdy as I am. Here are some clues that you may find useful:

prostatecancer.news/2017/12...

[SarcoPenyaJr in reply to Tall_Allen]

Thanks again, sir. Yeah, after exhausting pretty much all of that list, the "pump his ego" one is always worth giving another try. (All the active/collaborative patient stuff just pisses him off.) That's why he is still my doctor today. In response to his desire to fire me on the phone, I told him at length how much I appreciated him and why, and it was not the first time. I really do like the guy when he's not in ugly mode.

I seem to have strayed from my original intention in my post, which was to "blame" industrial healthcare! I believe that doctors feel obliged not to admit when they've made even a small error, and to never apologize because it's too fraught with legal and corporate worry/guidelines. The corporate structure of healthcare, I believe, contributes to the problem of gaslighting patients more than the individual doctors do.

I have fingers crossed that when I see Miss Thing next month, he'll be back to his normal kind self. Friends have also been warning me about "Mercury in retrograde." Plan B is an expensive patient advocate. Thanks again to you and MJCA for listening and for your responses.

[Tall_Allen in reply to SarcoPenyaJr]

Feel free to gripe all you want to. That's what we're here for.

[SarcoPenyaJr in reply to Tall_Allen]

Update: Turns out my oncologist actually was about to have a surgery when we spoke. I spoke to him again last week, and asked if he would agree he was "not himself" when we spoke before. He said "Yes, I was in a lot of pain." I asked the Cancer Center manager if it was a bariatric surgery, and she said, "Well, you never know!"

So he did not apologize, but he did accept some accountability. For a doctor in an industrial healthcare system, that's saying a lot, so I believe we're good again for now.

[MJCA]

Hi. I am not trying to find fault, but the one line in your post, “Doctors tend to get angry with me, I have found, and that’s a drag”. Cancer is stressful, possibly dealing with this disease has changed your attitude towards the medical community. The one blaring word I read was doctorS. Have you analyzed your behavior with your doctorS? I have had this disease 19 years. PCP - 25 years. MO - 6 years New urologist (last one misdiagnosed me twice) 3 years. You get respect when you show respect. If you are having issues, ask for case management within your own health insurance; it won’t cost you additional money. It appears you are quick to analyze others, for example, the doctor and his weight issues. Before getting a gastric sleeve, I weighed 350 lbs. I had a stressful job as a CFO. I was never angry at others - so I can speak from experience. Before pointing your finger at others, first look inward.