Tuesday, October 15, 2013

Dr. Compliance

Setting: A primary care office I was assigned to shadow at by my medical school during first year. Patient is a recent immigrant from India. Here for a follow up appointment for diabetes.

Dr. Compliance: Hello Mrs. Patel. How are you? Have you been taking your medications?

Mrs. Patel: Hi Doctor. I try to but sometimes I forget and I don't like to inject the insulin.

Dr. Compliance: Yes. I knew that because your labs were bad! Your hemoglobin A1c was 8.5! That tells me about the sugar in your blood.

Mrs. Patel: (Looks at her feet.)

Dr. Compliance: You have to take these medicines. If you don't you can get numbness in your feet. Or worse! You can go blind! Then your husband will find another wife to raise your child. Is that what you want?

Me: (Looking in horror.)

Mrs. Patel: No, I will try harder to take the medicine.

Dr. Compliance: Good. Now let me examine you.

He is friendlier to the patient for the rest of her visit. Later in his when it is just him and I.....

Dr. Compliance: So you remember what I said to that Indian lady?

Me: Yes?

Dr. Compliance: You see you have to do that sometimes. You have to scare patients to make them listen. Especially immigrant patients. The culture is different. I know this.

Me: (Some sort of shrug because I have no clue what to say)

He quickly changes the subject and we go on with the rest of my day. What was so weird was this doctor was an immigrant from somewhere in the Middle East so the line about "understanding the culture" didn't even make sense with the patient being from India. He was just really mean to his patient and I wasn't really sure what to say about it. I just chalked it up as a "what not to do" learning experience!

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