Mentholyptus

We had three or four disturbed nights here. Really disturbed. Like, Edward woke up around midnight on Sunday and proceeded to cry for four hours. I gave him Motrin. I offered milk. I coated his eyelids in Aquaphor mixed with a little Aveeno anti-itch cream. I refilled the humidifier. I rocked him and I walked him around and I sang and I said shush shush shush until I thought my voice would crack and still he cried. It eventually created an interesting question in my mind, namely: if it is three in the morning and you have a dreadful cold of your own and you are so tired you want to curl up like a potatobug and the kid is screaming whether you are holding him or not; do you return him to his crib with your best wishes for a quick return to sleep and high-tail it back to your own bed with your fingers stuffed into your ears or do you continue to clutch him to your body in as soothing a manner possible while he scratches his head and yours?  

I don't know the answer to this. I ultimately did a little of both. I put him back into his crib but I camped on the futon next to him saying SHHHHHHHHHH. SHHHHHHHHHHHHH. SHHHHHHHHHHH. at thirty second intervals. I also had my hand stuck through the bars of the crib in an attempt to provide a palpable maternal presence while still lying flat on my face. He continued to cry and I am pretty sure he bit my fingers at one point, but he eventually wept himself into exhaustion. Then Caroline woke up.

I felt like death the next day but Edward seemed better. Well, better except for his face.

 

Hmmm, can you tell how red and scaly his eyes are in that one? How about this one?

Eh, maybe not. But they are. 

I tried many of your eczema suggestions (namely Aquaphor and water) but it seems we are in the middle of a flare-up and might need bigger guns. So it occurred to me to call our pediatrician's office and ask one of the nurses (go figure) what can be done about itchy eyes. She said that the eyes are tricky and if they are swollen at all they really need to be seen because it is hard to tell what might be going on. This made sense to me so I agreed to bring him in yesterday and - as an afterthought - I brought Caroline in so that she could get her ears looked at again (we took her in on Thursday when she had the fever - nothing.) Not that I thought there would be anything wrong with her ears this time, just that it seemed like an opportunity to check.

The doctor took one look at Edward from across the room and said, "Ah. Pink eye. Now let's see what else he's got."

And I said, "Pink eye? Really? Are you sure?" because in my experience when someone has pink eye their eyes are pink. Also gunky. Whereas with Edward everything around his eyes is pink and it is his nose and his cough that are gunky.

Goes to show what I know.

Pediatrician Visit Totals -

Infected Ears: 3 (2 for Edward, 1 for Caroline)

Infected Lungs: 2 (borderline. both Caroline)

Infected Eyes: 2 (plus maybe Caroline; plus most probably Patrick who was not present but who looked like a white rabbit when he returned home from camp. I am dosing them all liberally with my tiny bottle of opthalmic clear gold.)

What we never discussed, stupid me, was the eczema around the eyes for which I thought Edward was there in the first place and although I am sure they are all related in a very direct way (nose runs. eyes itch. hand goes from nose to eyes. QED) I think we will still need to manage the skin inflammation in addition to all the infections. However, this particular doctor always flusters me so it wasn't until we were driving home and I was on the phone with my friend Noelle (who had kept Patrick for us) that I realized we had made no headway on the Edward's eyes/Uncle Fester thing.

Which brings me to a Washington Post article I read this morning and a quote that made me raise my eyebrows. I have been dying to discuss this with someone. I'll link to the article but I am pretty sure that the Post requires a login so if you don't feel like getting one the gist is that a number of doctors object to online physician rating sites like RateMD. They feel (roughly) that such sites give a biased impression of their skills and that they rely too heavily upon incidentals like clean waiting rooms and not enough on brilliant clinicianship. Some doctors feel so strongly about this that they have devised agreements for their patients to sign, promising that they (the patient) will not discuss their care in any online forum. Which... yeah. OK. Good luck with that.

But the quote was this:

"The people least capable of judging quality of care are patients," said District internist Nancy Falk, whose mostly positive ratings are offset by those calling her curt and intolerant of questions, descriptions she denies. "They don't know what we know."

I found the contempt in that statement quite staggering. Now, I have known (personally) a lot of doctors and almost-doctors in my day. I get that their patients can on occasion be total pains in the ass and that every idiot with access to google (myself most definitely included) fancies themselves as a crack diagnostician these days. But I like to think that good health care is, by necessity, a collaborative effort. When Patrick was hospitalized I saw a veritable flotilla of different doctors and we all sat there wracking our brains to figure out what, exactly, was wrong with the kid - they struggled to think of some question no one had asked, something that might be helpful; and I struggled to think of some detail from Patrick's recent and/or distant past that might unlock something for them. The fact that everyone treated my efforts with respect meant something to me. Not just to my self-esteem (which is completely beside the point) but to my willingness to keep trying to brainstorm (which is not.) It was relevant that he had been treated for Strep C five weeks before. It might have mattered that Patrick had gotten a tick bite just above his ear on the infected side two month previously. It wasn't as simple as standing back and letting the experts work their medical magic. How do you care for someone when you pointedly exclude them from the process?

I went through seven OBGyns in ten years. A few changed due to a move on my part or theirs but most of them I dropped because they were insensitive or patronizing or both. There was nothing anyone was going to do to save our unbalanced fetbryos. I knew that. I wasn't looking for a miracle worker as I trooped through thirteen first trimesters. I just needed to feel like I was being cared for and I needed a doctor who would always be honest with me even when, especially when, they had news I did not want to hear. Later, once we were lucky enough to have unaffected babies, I needed a good doctor to get us through the clotting and the preterm labor and I think I had one. Although I do wonder if my personal feelings for her have colored how I view the care I received. Like, I don't know why my OB didn't choose to deliver Caroline and Edward earlier than she did when Caroline was so weensy. I do know that I trust her and I do think there was a valid reason - perhaps to that DC internist's point, maybe I just believed that my doctor knew things that I did not.

Anyway, it occurs to me that if I had seen my actual pediatrician rather than Dr. AlwaysTooBusy yesterday I might have remembered/felt comfortable enough to sit there until I remembered to say hey, yo, what about all the scaly pink stuff around Edward's eyes? Not that I blame the doctor, it was my fault for not bringing it up again (I felt chastened after he said "pink eye" and who knows? maybe there is nothing else to be done or maybe the skin is reacting to the virus and it is not eczema at all and the drops will work just fine on everything. maybe.) 

I don't know. I am rambling here, trying to finish my thought before the finks wake up from their glorious post-amoxicillan naps. What do you think? Have you had very bad doctors? Very good ones? And are the ones that make you feel warm and fuzzy necessarily the ones that you think provide good care? And to return to the broader point of the article (if you read it) do you think doctors should be able to control whether their patients type out for a broader audience what they have no doubt already told their co-workers and friends? Just for fun I checked out some of my favorite and least favorite doctors on RateMD. I was amused to see that the guy I haaaaaaaaaaated, the one whose tie I wanted to staple to the exam table, got a very shabby overall rating - on a scale of 1 to 5 he was a total ass. 

PS I have an ad up for Hallmark. My theory is that bigger companies use bigger media buyers who are then used by other bigger companies and that if my blog generates nice a click-through rate for Hallmark I might get other ads in the future. Since I use my meager blog revenues to buy things like cheese this pleases me. So that's what's in it for me if you click on the sidebar link. What's in it for you? Well, the idea of having Hallmark send me birthday reminders (as mentioned in the ad) kinda made me yawn. I keep that sort of thing on a birthday calendar which is thumb-tacked to the bulletin board in the laundry room and my understanding is that there are any number of electronic devices out now which can be programmed in such a way that you need never forget a birthday or anniversary again. So, meh. But! I went to their website and discovered that in addition to e-cards (which I kinda like) Hallmark is offering actual paper cards that you can personalize online and they will address and mail for you. I think that's cool and I know that nothing excites people, especially the ten-and-under set, quite so much as their own name printed on something. So, happy (belated/future) birthday YOUR NAME HERE and click on my ad, won't you? 

PPS Thank you so much for the series suggestions. We had watched the first four seasons of Foyle's War but when you reminded me of it I checked to see if they finally released the fifth in the US and they have. So that is next in our queue. I also added, um, pretty much everything else you said starting with the new Dr Who. I shall become a pop cuture maven. Oh and Steve was appalled that I left Firefly off a list that reported to reflect his views as well. We loved Firefly.  

Comments

[kathy b]

Consider yourself clicked. Watching The Wire yet?

[SarahB]

My new PCM said, "Oh, we can treat simple psoriasis." After I went through five years of itching, toxic drugs, tubes of cream, and light treatments before finally getting to the decent shape I'm in now.

I do not like her. I would "dump" her were we not just leaving in a few months.

Also, after an intimidating first visit with a dermatologist, I do not walk into a doctor's office without a list of concerns, even if there are just two-three items on it. And I reference it in front of the doctor. Doctors notice.

[Jennifer]

Have you tried the Arbonne baby care line? I don't sell it or even really go for things sold like that, but my son had horrible eczema as a baby and the ped. wanted to try Elidell (sp?) but the Arbonne baby soap and oil cleared him up in just a few days. I would pour a little oil into the bath (slippery, but effective), then use more afterwards. He also tolerates California Baby lotion now, but nothing else. We found out later he had food allergies.

[Ruth]

I was lucky enough to have fabulous medical care in Chicago (although I know that my OB/GYN was an acquired taste ... her quirkiness appealed to me, and she was a crackerjack diagnostician), and we have always had great pediatricians.

During my last pregnancy, however, I switched practices in my fourth month because the doctor was such a complete and total ass (I won't get into the whole story; if you are curious, I blogged it here: http://woolyheaded.blogspot.com/2007/04/time-for-change.html). It was one of the best -- and hardest -- things I ever did.

[Jodi]

Of the people in my law school class, there are maybe five I would want to handle my own personal legal affairs. Medical school classes have to be the same, right? Just having the training doesn't make you a great practitioner. Practitioners who think they are great are probably so arrogant that they're incapable of self-critical analysis, which by definition makes them less-than-great.

I doubt that an agreement not to discuss a doctor's skill would be enforceable, even if the jackass could catch a patient violating it. I would love to see one try.

Hope everyone is on the mend and that you get some sleep tonight.

[Katerina]

Well! My sincere commiserations on the state of your offspring and especially sweet little Edward. On the other hand I was worried that something more sinister was afoot (I'm like that) so whew, too. Weirdly, I recently suffered something very similar to what Edward has around his eyes and none of the creams and ointments recommended by doctors worked. It eventually went away on its own but the improvement coincided with my switch to an all-natural, unscented facial cream. But I'm sure you're not using any harsh cosmetics on Edward anyway... so I guess I have no advice, alas.

I loved that article you mention: "District internist Nancy Falk [is accused of being] intolerant of question, a description she denies saying, "They don't know what we know." Totally! And let's keep it that way!

It just so happens that I love discussing doctors, and pediatricians especially. I have what I believe to be THE PERFECT paediatrician (for me that is; I should say perfect for my son as he is the patient but at this point it's really all about how *I* feel about the care.) Sorry if my valentine to dr. P may run a bit long but I need to get it off my chest.

Here's what she's like. NOT warm and fuzzy. She's not one to coo over my baby or joke around or, god forbid, baby-talk to me (she is gently humorous with Antonin). (I had an ob-gyn who would say things like "And now let's take a peek inside your tummy". Gah.) The quality I like about her best is that she's always very engaged with me and very focused on my son. She always listens to what I have to say and even when I was a completely new inexperienced mother and reported, with great alarm, things like "the baby breathes in this really weird way at night" etc., she not only didn't make fun of me or just brush it off but patiently listened to my agitated description and then took time to explain *why* this particular phenomenon would not be a cause for concern, at the same time making sure to point out how to figure out when there really is a respiratory problem. So, she's attentive and engaged and PATIENT. She never sugarcoats anything and once she has established that I can follow medical language up to a certain point, she uses medical terms which I like - makes me feel like an adult. We've been hospitalized twice in my son's first 6 months of life, and each time she stopped by the hospital to check on us. She will also call her superbusy doctor friends at teaching hospitals to get a second opinion, which is something that really impresses me - first that she admits wanting a second opinion, second that she will call these people while I'm still in the office, and third, that these are major experts in their fields, as I found out more or less accidentally. She also never underestimates any - even minor - symptoms, and she has never once shown annoyance at my late-evening or weekend calls. Of which there have been at least a dozen.

She makes me feel like we've really won the lottery with her and she's my blueprint for what I would like in any doctor. Some parents might find her a tad cool and too "scientific"; my mom (also a Dr. but not a paediatrician) feels that she's perhaps overcautious - but I don't. I can see that some parents would naturally prefer the other paediatrician in town, one who has a very earthy, soothing and common-sensical approach (using an awful lot of home remedies instead of drugs) but I wouldn't trade our Dr. P for anything.

I should mention that I don't live in the States now (the Czech Republic) but believe dr. P to be fairly exceptional even here.

And I totally use online rating systems for researching doctors. If you read the comments and not just the ratings it becomes obvious who's your guy and who isn't.

[Betsy]

I hate to be all "let's plug a retail product" here; but I have to add my vote to the suggestion of the Arbonne baby care products. Magic.

On the other subject, I have left an OB/GYN because even though she was quite probably the best doctor I'd ever had, her staff was so rude and disorganized that I couldn't overlook it. Actually, she was the best doctor I'd ever had until, by leaving her, I found my current one. It turned out to be a great switch.

[Jenorama]

I am self-employed as a medical editor, and I frequently have this conversation with the doctors I work with. I let them know that I choose my physicians primarily based on communication (their ability to communicate respectfully and intelligently with me) and their office staff (courteous, will they get my feverish kid in last minute on a Friday so we can avoid the ER?).

Sure, there are genuinely incompetent physicians out there. But barring complete incompetence, if we can agree that basically their knowledge is the same, then why wouldn't I choose the ones whom I like and who treat me with respect?

Also, this doctor quoted in the Washington Post (forgive me for not scrolling up for her name) is obviously not up-to-date on the latest medical literature (and, yes, I am: I edit a lot of it and also read a lot of it). The current "trend" among physicians *is* to engage patients in their own care, as a team effort, much like you experienced, Julia, when you were brainstorming for the doctors about Patrick.

The attitude that doctors have a monopoly on information is as outdated as thinking that people shouldn't learn to read or learn Latin so the priests were the only ones who could read (and interpret, enforce, impart) the Bible.

Long before I had really thought of any of this, I was a young expectant mother. My first child had ended up in a NICU because of my undetected (untested for then) Group Strep B. I interviewed a pediatrician and asked him what he would do if child #2 also had Group Strep B. He pointed to the series of degrees on the wall behind him and told me that HE was the doctor and who was I to ask him anything? And also, when pressed, that he would send my baby 90 miles away rather than deal with the issue. (The easy and correct answer is this: Give antibiotics to the expectant mother while she is in labor. Then you can bypass complications like the newborn failing to breathe unassisted).

I drove from that dr. to my ob-gyn, and they checked my blood pressure (it was high), dried my tears, and found me a great pediatrician who wore cowboy boots in the ER and joked with my husband, as he cut the umbilical cord, that it's good to catch the baby on the first bounce.

Sorry for a flood here-- that is one of my favorite topics. We are consumers. Drs are providing a service. There is no shortage of them (except in rural, underserved areas, but that's another entire rant), so for them to think that being an asshat is okay is ridiculous.

[Jenorama]

Forgive me again: But with regard to turning to Dr. Google, most physicians are now not only aware that patients do it, but also trying to direct their patients to quality online information rather than faulty. They are trying to work with the system, not buck it.

An agreement that they won't discuss their care in any other forum. God, who came up with that? As if.

[CA]

Julia I clicked your ad and I would 1000 times a day for the pleasure your writing (and cute kids) give me. Buy some Manchego or Campo de Montalban on us. Seriously, buy the Campo. You'll thank me.

I've seen a lot of doctors a lot of times in my 32 years, and I've had both excellent ones and horrible ones. Each can change your life in such significant ways, it makes me infuriated they don't want to be held accountable in a free market. God, the excellent diagnosticians who are dicks might actually have to improve their bedside manner and curb in their condescension! Horror! Although I do find that the best diagnosticians who actually SOLVE your problems ARE the ones that make you feel warm and fuzzy, because those invariably are the ones that LISTEN to you and make you feel comfortable enough to tell your whole story, both of which are invaluable to finding out what's wrong. Basically, what you said.

We're having our first baby in September and we think we found a great pediatrician in a great practice - fingers crossed. I couldn't stand some of the treatment I've gotten from doctors if it happens to my child - I'd lose it.

[erin]

Good doctors = the ones who treat me like I'm an intelligent human being. I've been lucky to have quite a few of them.

Bad doctors = the ones who clearly don't care.

I once went to a PCP about a potential incisional hernia (leftover from long ago abdominal surgery). I was quite anxious about it and she refused to answer any of my questions. She sent me for an ultrasound which came back showing no hernia. (The lovely radiologist spent a good deal of time explaining things to me.) When my PCP received the results, she sent me a letter in the mail that said "no incisional hernia". That was it.

[Helen]

You mentioned that you've changed OBGyns because the doctors were bad. Have you ever left a group of doctors located in the same practice because of one doctor? I had a horrible experience with one of them, and don't know if it's worth it to go somewhere else. There's at least 5 doctors at that office. Anyway, I was there getting examined and during the Q&A part afterwards, he somehow meandered to the subject how if he were my husband he'd be having an affair and all this *&% about sex. I was totally creeped out and only told my husband about it. This was last year. I'm definitely not requesting him in the future, but he's still part of the group of OBGyns.

It looks like your kids are feeling better, at least during the daytime while playing. That's good to hear, and see. :)

[Christiana]

My favorite primary car doc doesn't take my insurance, so i've had to move around and - oh my goodness have i had some bad doctors in my search for a new PCP. But I LOVE my OBGYN (and how many people can say that? I would have coffee w/ her - on the same day she gave me an exam, that is how much I love her) and I travel a much further distance than necessary to get to her.
Gonna have to try out that RateMD thing -

[Leigh]

No one will tell you this, but the best treatment for my excema has always been sunlight. (They used to use tanning beds for psoriasis) Just give him a little sun time each day without sunscreen. It will work wonders.

[Kate]

I go to a fairly progressive med school, and they spend A LOT of time training us to be good at communicating with patients, emphasizing that this is a vital aspect of good patient care. It is assumed that we will become good diagnosticians in whatever field we go into, but making sure we are good listeners is something that we return to again and again. As Jodi said, there are only about 5 of my 100 classmates I would want to take care of my own family.

[mdmdt]

As someone who is wrangling her way through the last of the pre-medical school requirements I can tell you that I am completely appalled by that excerpt you posted, and all the people I know currently in (or training to be in) the medical field would be too. That lady is completely out of touch and it's unfortunate that she's in a position to have her nonsense published in a newspaper.

That said, the problem with many online review sites is that people tend to use them when they're really ticked off more than when they're satisfied, so it's not really an accurate representation of a doctor's (or any business') clientele as a whole. This is changing as many people just routinely review anything and everything they encounter, but really people who are angry seem to be more inclined to want to spread the word in every way possible than people who are quietly content with the care they received. I can understand why a physician might be frustrated if she's losing business because one patient had a pet peeve about messy magazine stacks in the waiting room and then proceeded to give bad reviews on every site he could find.

[Cookie]

I'm sorry to hear that Edward and Caroline are sick. It's never easy, especially when you can do nothing to comfort them. I look forward to reading a blog post where no one is sick :)

As for doctors their manner is every bit as important as the care I or my children receive. We have a pediatric practice that we love, but we don't necessarily love all the doctors in it. There is one in particular that is very patronizing and assumes that what worked for him with his children will work for all parents. Most however, are very nice and listen to all our concerns, and provide suggestions or alternatives.

For myself it is essential in an OB/GYN. The first doctor I saw after I left the military was rude and unfriendly. Her office was a pain to deal with for follow up information. They would process no insurance paperwork. I saw her once and never went back. I now go to a large practice with two offices. I adore most of the doctors there. They are so sweet, listen to all my concerns, and never make me feel silly.

It's important to feel comfortable with your doctor and the doctor your child is seeing. It can ultimately lead to better care, since you don't get flustered or aren't afraid to bring up a detail or question that may seem silly, but actually be essential.

[Alexis M.]

There is a five night torchwood miniseries thingy that is on BBC America starting tonight at nine.

[Veronica]

Click click click.

Doctors. Heh. It took me 7 years to get a diagnosis (of a rare genetic disorder, but still!) and it's taken me changing doctors for someone to be interested in long term management plans. I don't have huge faith in doctors because of their 'if you hear hoofbeats, think horses' mantra.

[Diana]

I was going to make a comment about your doctor's reaction to "pink eye" and I'm so glad you brought up rating doctors.

My kids used to stay with a babysitter during the day (who is a stay at home mom). The babysitter took her daughter to the pediatrician and she brought my daughter (under a year old at the time) along. The doctor immediately told her that my daughter had pink eye...very matter of fact. In her very superior manner (like I said, they USED to go there) she informs me that my daughter has pink eye because her doctor said so. Having had pink eye before, and watching my son go through it, I was doubtful.

Soooo, I call my doctor and say, "Look, my kid has some weird stuff going on and I don't think it's pink eye, but another doctor did an on the fly diagnosis." They had me bring her in and my doctor said, okay, she's got a cold going on, let's put her on some antibiotics. I asked him, "What about this pink eye? Do I need eye drops?" He said, "Do you want eye drops?" Uhhh, not particularly... He proceeds to tell me that she has a generalized infection and the antibiotics will clear it up everywhere. No pink eye.

I love my doctor, and he's not a pediatrician. I have had nothing but bad luck and bad experiences with pediatricians. (Namely, freaking out over low level jaundice!) My husband and I and our 3 kids all see the same doctor. He is a former Ob-gyn and has 5 kids of his own, who are now grown. He had a daughter who was allergic to cow's milk AND soy milk so he helped me through my son's early problems with milk. He has a very practical approach to everything. He is not one to baby talk, but he does engage kids, and will take time out to make them feel better. When my son was bored while we were there for his sister, the doctor drew on the paper covering the bed and showed him how to say his name with a picture. It was a little thing, but it meant a lot. I could go on and on, but suffice to say, he's the best I know.

[jen]

Doctors. Oh my. My OBGYN was meh. Not great but good enough. I'm not sure if I will go back to her again for #2, whenever that may be. I still cannot find an acceptable Primary. My son's pediatrician though...I LOVE HER. I wish I could go to her. It really is all about taking the time to talk with patients. She gives us her time, listens and responds thoughtfully, and is up to date on current issues.

I don't see why doctors should have a problem being evaluated. If they have good service, they'll get a good rating. I actually hate that you go in blind when searching for doctors. You have to rely on luck and that is unfortunate. I think our healthcare system will become more consumer based and the old school doctors just won't survive.

[Kristin]

I hope all the various and assorted ailments clear up soon.

[Heather]

When my daughter's face was a mess due to eczema one of the ped. we saw in our group told me it was bug bites, from the fleas on my dog! Despite my telling him that there weren't any fleas, and if there were, wouldn't my husband and I have bites on our ankles? And also, the dog was too big to ever be in the crib? He assured me fleas were biting her face. Amazingly once her nose wasn't running, and her drooling (2 teeth at 4 months, add two more teeth every other month!) stopped a bit, her face cleared up. Guess the fleas didn't like a dry face! And, in case it isn't clear, there were NO FLEAS!
What helped us the most with her skin and now my son's eczema was "Baby Eczema Cream". We buy it at Target and various other targe type places. It has Winnie the Pooh on the tube. It looks worthless, especially compared to the fancy Airbonne tubes, but it is rich and creamy and really works. Aquaphor never worked for us and the Aveno only a little. But the literal named, "Baby Eczema Cream" does. Hope that helps.
Also, chlorine always made my childhood eczema go away. I don't know why, but it was such a relief each summer when the back of my neck and behind my ears cleared up the more I swam.
I wish I could offer some anti-infection lotion. Hope you all are healthy soon.

[Bea]

I think patients are very good at judging some aspects of their medical care, and very bad at judging others. As such, those sorts of rating sites are useful, but only when taken in context. If choosing a fertility specialist or OB, for example, I would look at those sorts of recommendations AND ALSO things like live birth rates.

Saying the patients are least qualified is staggering in its contempt, and also false. But there is a wide variation in doctor competence and sometimes the clinically less competent are more charismatic, and vice versa. I have definitely seen evidence of that.

Bea

[Julia]

Let's see....

Helen, yes, I switched within practices once. My very first OB treated us through four pregnancies but when the amnio his office conducted turned up a fatal defect and we terminated he never spoke to me again after he called with the results. So I saw one of his more liberal partners going forward and she actually came in on her day off to deliver Patrick, partly because the doctor on call that day was my first doctor. The problem with going with a different partner in the same practice is you never know who will be available in an emergency.

Mdmdt - yay! go you! I think your point is fair (as is Bea's) but I hope that most patients are savvy enough to sort through negative and positive feedback and find a truth that is meaningful for them. That said, and specifically to Bea, we looked up our last RE and he and his practice were SKEWERED on RateMD. Granted, I think many of the complaints were fair ones but by the time we got to him we were so jaded that a lack of hand-holding was immaterial and the fact that he seemed successful was all that mattered (see: Caroline and Edward all ladybug onesied and not sleeping upstairs.) However, I can easily imagine someone early on in the infertility process being scared off by the comments and who is to say whether they would have lost a decent doctor as a result? I think perhaps a happy medium: doctors should read their reviews and try to improve upon whatever is seen to be lacking and consumers should do their best to educate themselves using a variety of resources.

Or: what Bea said.

[Lisa B in Seattle]

I'll second the swimming in chlorinated water recommendation. I had horrible (really horrible) eczema as a child and the only thing that helped was swimming. I've read since that a very watered down bleach wash will do the same, tho I can't imagine you'd want to do that to Dreadward's eye area. But I went through years of shots, cortisone cream, bloody sheets from scratching 'til I bled in my sleep, and finally grew out of it. Thank god!

[Shelley]

You MUST see "Wallander" starring Kenneth Branaugh -- crack adaptation of a terrific detective series set in southern Sweden. Truly, it's gooooooooooood.

The worst OB/GYN I ever had (part of a group practice) told me about my first miscarriage while standing with her hand on the doorknob. Same doc was on duty when I delivered my daughter, and before she said hello, much less explain what she was doing, had her hand halfway to China.

[Toni]

Doctors have a very important job - to gain our trust. Many of them forget that this is the case. They think they are there to fix the problem and move on. But anyone could do that. A doctor is someone who spends the time with us - makes us believe that they have our best interest at heart and will make the right decision.

As humans, we need that trust factor for those who are caring for us.

I, like many others, have had good and bad doctors. There's the doctor who used the word "mental masterbation" WAY too many times for my liking (nice huh?) - he's no longer my doctor.

And there's the doctor who apologized for losing me in the hospital and always took the time to listen to my problems and come up with suggestions. He made me believe that I knew my body best and made his treatment plan WITH me - not for me. He's my favorite doctor and I will verbally tell everyone how awesome he is.

Now I need to log on to this website and do the same online!

[winecat]

In the last 4 years having been through a hysterectomy, breast cancer, a ruptured bowel, knee surgery and possible heart attack (I'm only 56) I have quite a bit of experience with doctors. Being blessed with the best FP doc I've ever met who is held in GREAT respect by her peers I get referrals to the best specialists. I simply worship and adore my oncologist.

She always gives me a run down on the new doc so I'm prepared for iffy bedside manners, etc. But I get the absolute best treatment which is the most important to me. As it turns out the 2 she told me had the iffy manners were wonderful once I was able to get through their shells.

Given the choice I've always said I'd take knowledge over manners but having read some of these stories it gives me pause. At least I have the ability to report back to my regular doc so she's aware.

She has a strict don't fuck with my patients policy and every specialist in the county knows she means it.

[Marsha]

Docs should probably make themselves comfy with the idea that being good at what they do isn't really sufficient anymore. That's true for many of us, right? I'm very good at my job but if I were a complete bitch in the process and no one wanted to work with me it wouldn't take long for my colleagues, clients and employer to leave me on the wayside. Doctors shouldn't expect a pass on customer interaction metrics just because they're doctors.

Then again, on that RateMD site, I'd take any frowny or smilie face with a grain (or two) of salt if it has been generated by a small number of ratings. Everyone has a bad day once in a while and no patient-doctor relationship is going to be a sparkly courtship of champagne and butterflies. If we start to get into double digits of reviews, though, then the information presented starts to get useful.

[Just Me]

I am bipolar and this diagnosis seems to strike deep fear into family doctors. I had many bad experiences in the initial years of diagnosis, including one doctor who repeatedly prescribed a medication that was contra-indicated with another of my meds (I wound up reporting him to the medical board after the 3rd incidence of this in a 2 week long monster sinus infection), the same doctor refusing to prescribe a medication I needed for severe cold sores despite a fight that went on for some long my psychiatrist finally prescribed it, another doctor having a secretary take a list of my meds on the phone and refusing to even meet with me because I was taking an antipsychotic, and on and on. I finally found a wonderful doctor who never treats me like I'm stupid because I'm mentally ill, who is careful to always check my meds for interactions, and who actually believes that my bipolar disorder doesn't mean that everything I know as a healthcare professional is moot. He moved an hour from here a year ago, and he is surprised that I am willing to drive an hour to see him. What he doesn't realize is that if he moves out of state I may be right behind him.

[Jen]

I don't care how good a doctor is, if I don't feel comfortable, I will switch. I have not been unfortunate as you in the baby department, but the one miscarriage I had, I went to the doctor, he said, "I'm sorry" and walked out. That was seriously the whole visit! 3 days later his office called, apparently I was supposed to get blood work to determine if I needed a D&C...he didn't tell me that, he didn't tell me anything...He may have been the best doctor in the world, but I found a different doctor to do the bloodwork. Bedside manor is just as important as knowledge and competency...

[shriek house]

It's got to be frustrating talking patients out of their conviction that they have ebola. But doctors have to be diplomats, balancing their clinical knowledge with the fact that while patients may have overactive imaginations, they aren't entirely stupid either. The internist you quoted should be disbarred or whatever it is they do to put doctors in the corner -- her utter disregard for patients as people with ownership of their health is appalling.

When my son was in the hospital, our pediatrician sat with me and helped interpret what all the specialists were talking about, what it meant, what the risks were, etc. Normally I appreciate this sort of thing -- you know, assuming I am reasonably intelligent and can grasp these Complex Medical Concepts in simplified terms -- but that time I just said, "I can't make sense of this right now, I'm too scared. What should I do?" And our beloved pediatrician told me, and gave me a hug. I trusted him on faith that time, because every other interaction had demonstrated his skill, his smarts, his compassion, and his sense of his patients as whole people, not just a clinical problem.

It doesn't seem like it should be that hard to be a doctor AND a human -- but I'm sorry that your run-in the other evening with Dr. Fluster wasn't comfortable. I hope at least the pinkeye drops help with the crusty weirdness somewhat and everyone is better and sleeping soonest.

Oh and I will click the Hallmark ad. May I suggest La Tur, it is expensive and stinky but quite possibly one of the most delicious things I've ever tasted.

[Katrina]

My general doc referred me to an OBGYN last year when I had to have surgery for endometriosis. He was the most insensitive, paid-for-by-the-drug-companies JACKASS I have ever met in my life. And, hand to god, his name was Dr Shady.

The second he walked in to meet me, he said, "I think we should get you started with Mirena." I was already on a birth control I could tolerate with vomiting, and my partner and I have talked about children within the next few years, so I politely declined and asked what my other options were. He briefly went over them, then gave me a pamphlet for Mirena, and scheduled me for surgery (which I was also trying to avoid, but understood I'd probably have to have).

When they called to confirm my surgery date, the nurse said, "And it also says here you're going to be getting Mirena."

I was flabbergasted. I told her no, she must be mistaken, and she said she'd mark my file.

Lying in the hospital bed, being prepped for surgery, Dr Shady stormed in and snapped, "You REFUSED Mirena!? You know this is for your own good, right?!"

I started to cry. I was scared already, and he was practically yelling in my face about a birth control option I didn't want! I told him I understood, but liked what I was on, and didn't feel the need to change it. He stormed out of the room in a huff.

I never saw him again.

He didn't deign to discharge me from the hospital. The "one day" recovery he promised at the first visit, turned into two weeks of infections and misery. We didn't know the extent of what he did to me until I was in the ER four days later in excruciating pain and they told us from the surgery notes. When I called his office to find out about the results from the tests they ran in the ER, they said he was out on vacation and to call back next week. When I called back the next week, after a hellishly painful and fever-ridden five days, his nurse asked if I had started the antibiotics they prescribed.

Yeah, the doctor hadn't bothered to tell me that I had an infection before he traipsed off to the Bahamas, or wherever the Mirena drug reps sent him.

That was the worst experience in my life, and the reason I'm afraid to tell my doctor the pain is coming back.

[Denise]

My dog has been to the weekend emergency vet twice, and on each of the following Mondays, his regular veterinarian, who had been informed of the visit by the emergency vet, called to see how he was doing.

The kids and I have been to the emergency room on weekends multiple times, and none of our primary care doctors has EVER followed up with us on Monday morning.

Basically, I would just like a doctor who lives up to the standard of care delivered by my dog's veterinarian. Do you think that's too much to ask?

[Laura]

District internist Nancy Falk can bite me, and I do mean hard. What arrogance.

That said, I've encountered many a warm and fuzzy doctor (I want to make out with my pediatrician, seriously, and it's not 'cause she's so cute), along with a mercifully tiny subset of douchebags. The latter were all, curiously, orthopedists. A douchebag subspecialty? Is there a screening test?

Off to click on your Hallmark.

[Lindsey]

Poor Edward! I had a major eyelid eczema incident last week, and I weathered it with emu oil and vitamin e oil. I also try to get a lot of flax and flax seed oil in my diet and when I get lazy with supplements, I get itchy.

Also, a word of warning. Someone recommended that I use chamomile tea bags on my eyes, that the chamomile would soothe the skin and help with any eye irritations. I had high hopes up until my face broke out in hives. Please don't try chamomile tea bags.

[kris]

i had a dermatologist that i trusted completely. i have had many (about 20 now) bcc removed over the past 7 yrs... i was going for a skin check every 3 months for a long time. do you think the guy ever looked at my feet.. no, so a melanoma growing under my toe nail (looks like a dark line from an injury almost) was there for almost 2 yrs before my regular dr told me to have my derm look at it. he (the derm)was in the process of moving out of state so he couldn't be bothered. that's a bad dr...though technically a great mohs surgeon. i wish i had sued his ass off.

[haus]

I was raised by a nurse, worked in medical records in a small hospital -- I know that a dr's personality doesn't always dovetail with their competency. You can't judge a book by how chatty its cover is. But the really good docs always seemed to be the ones who talked to you like an adult and listened. Carefully.

We have great family docs right now, but it's the nurses who keep us coming back. Our peds office nurses have talked me off a few proverbial cliffs. My internist's wonderful nurse practitioner, bless him, is there when I fall apart and the doc is booked. But my nurse midwife is my favorite nurse of all - wouldn't trade my experience with her for the fanciest OB/GYN in my university-hospital town.

In fact, I think I'll send her a Hallmark card. Thanks for the idea!

[bethany actually]

The best doctor I've ever had was professional, engaged, friendly but not familiar, and LISTENED to me. She never ever was dismissive and when I asked stupid questions she never laughed or brushed away my concerns. She was always willing to spend five extra minutes talking to me and in fact never left an exam without asking, "Did you have any other questions? Anything else you wanted to talk about?"

Because she was so great, I was far more willing to actually GO to the doctor and take care of those pesky annual exams and get those strep tests done, etc. When I have a doctor I don't like (and I don't always control who my physician is, since my husband's in the military) I have a much harder time making myself go to the doctor on a regular basis.

[Kristen]

My ob/gyn is beyond words. I've never met a dr. who was so kind, compassionate & dedicated. He was our partner during our infertility & a huge support during a subsequent adoption. I love that man.

I am in search of a ped. or a family dr & I am really dreading the whole process. I think I'll have to check out the ratings site.

[april]

In the last year or two, I happened upon a GP who I just instinctively liked right away. She listens. She thinks out loud.
Last year during my annual physical, she was continuing the conversation we'd started earlier in the appointment about teachers and ap exams, rambling very charmingly in a nervous mother way about how she was sure her daughter would be fine in calculus in the end. I agreed while thinking of England, you know, appreciating the attempt to distract me. Just as the good doctor was elbows deep in the middle of the pinchy part, a very bershon "MOMMMMMM?" sounded through the exam room door. Her daughter, fresh from school, had heard every word of our conversation and was age-appropriately mortified. As I laid splayed like a turkey awaiting trussing, the doctor shouted to her daughter that she was with a patient and couldn't talk, all the while looking at me agog and mouthing "DO YOU THINK SHE HEARD ME TALK ABOUT HER?"

This resulted in me loving that doctor even more and feeling totally vindicated in my initial assessment of her awesomeness. Also, she apologized about 1000 times, which never hurts. I'm almost looking forward to this year's visit!

[Minneapolismama]

I have a fantastic doc now, but one thing about her is that she doesn't claim to know everything, and she definitely sees us operating as a team. I don't think she would mind being reviewed online--I think the only ones who would care are those who have something to worry about.

Just a suggestion for the pink eye: when it comes to our house, we redouble our efforts to use hand sanitizer. It really seems to make a huge difference in getting rid of the stuff. And, I'm not big on hand sanitizer.

[MsCellania]

Last time one of our boys had pink eye, our dermatologist suggested Johnson's baby shampoo! I suds'd up the kids head, then purposely got a bit in their eyes - it obviously doesn't sting as it's got some 'cain in it (benzo or lydo - I can't remember).
I second the food allergies - dairy, or wheat. Or something exotic, with your luck. (Sorry to take a poke at a tired woman...)
And I will again repeat getting some high quality evening primrose oil down his gullet. Take those bambinos to a naturopath--they get to the cause v. treating symptoms.

[Skye]

I understand the internist's comments. I'm married to a doctor and it's incredibly annoying. There are a lot of times that I want him to do something ("just call in the goddamn antibiotics already!") and he has a whole host of reasonable studies and incidents to cite on why that would be incredibly unwise.

Another case in point, surgeon schedules biopsy for Saturday afternoon and surgery for Monday morning. The only problem is that the pathology won't be ready until Monday afternoon. Surgeon, rather than admitting her mistake, tells patient that pathology screwed up. The patient feels that she has a doctor who went to bat for her when in reality her doctor kinda sucks.

[terri c]

My fave doc is my neurologist. Not everyone's cup of tea--opinionated, runs late, reschedules, but an excellent diagnostician and she listens. Also her sense of humor is as sick, twisted, and warped as mine.

[Channa]

There was an article in the NY times a few months ago about all the medical complications that can arise from the arrogance of doctors. I'm not so good at linking, but maybe here it is:
http://www.nytimes.com/2008/12/02/health/02iht-02rage.18329263.html?_r=1&scp=1&sq=doctors%20behaving&st=cse

My late grandfather, who was a good doctor, used to say: "If you listen to a patient talk for long enough, he'll give you the proper diagnosis. If you listen to him for even longer, he'll probably give you the proper treatment too." That kind of medical care is rare but is probably the best kind.

[Rett]

Okay...not that Edward doesn't have pink eye...I personally am skeptical, because of my daughter's own misdiagnosis three times of pink eye.

As her mother I know that when she has a cold and yellow goo comes out of her eyes it is NOT pink eye but clogged tear ducts indicating to me to run (don't walk) to my pediatrician's office because her EARS are infected. (You know all those little tubes being, well little and full of infection...but not the bacteria that causes the gooey, crusty, pink eye that needs antibiotic ointment worth its weight in platinum).

The three times I have seen other doctors not OUR pediatrician (two in her practice and one on vacation) they all said, "Oh gooey eyes...it's pink eye...here let me write you a prescription for that."

Our pediatrician says, "oh it is you guys again with a cold and gooey eyes...lets check the ears...yep infected...here is the liquid stuff that should kill the infection, but good luck in getting any of it into her it tastes horrible...come back in 2 weeks blah blah blah..."

I have one unused tube of pink eye medicine in our medicine cabinet, because it didn't hit me until I was home from the doctor and pharmacy that it wasn't really pink eye, but clogged tear ducts from the raging infection in her head. I was also about a hundred dollars lighter in the wallet and totally ticked. I have two prescriptions for pink eye medicine unfilled somewhere on my desk.

I am also skeptical of doctors because I did have to diagnose myself (thanks Google) and take my findings to a new doctor who was thank God was willing to listen to me...he didn't prescribe what I asked for the first time, but changed it a month later to the internet suggestion for treatment, that then finally worked and helped me.

So, I always take doctors with a big grain of salt and then read up on my own. I didn't work my way through grad school as a research assistant for nothing...lol

[peeks]

i found the torchwood 5 night children of earth thing a bit harrowing and i am well tough. approach gingerly but do watch it, is very good, if INTENSE.

[Crystal]

I found the parting comment by Ms. Falk, wanting a website to rate/complain about patients to be very telling.

Personally, I'd like Channa's Grandfather to become Medical Education Czar.

I've had some good, some bad, some great, none were perfect. Those who were closest in my eyes were the ones who could acknowledge such, and try a new approach.

Some were horrifyingly awful. Although we're going through another round of that now, and it's proving to be worse than ever, yet very politically relevant. Yay brazen shit-head MDs. And technology. And Obama.

Hope the latest round of healing goes quickly. I always joke I need a vacation from my vacation, but sheesh. This sucks.