by Luke Sleiter
It was easy for me to complain to my mom and brother when they picked me up outside the clinic about all the things I disliked about my experience at the clinic. But the real challenge comes when I try to imagine what I would have actually wanted to happen during my medical consultation to make me feel healthier and more satisfied.
So I’ve devoted a lot of thought to what I would imagine a productive and health-affirming visit to look like. And I must admit that I’ve hit a wall. I’m so accustomed to feeling dissatisfied and powerless in my interactions with physicians that I haven’t really given much thought to how I would stage and direct a clinic visit. My imagination simply stops there. I don’t know if it’s a symptom of cynicism or pessimism or lack of creative visualization, but I can’t for the life of me figure out what I would like to get out of an interaction with a physician that would actually leave me feeling better. I keep writing different scripts in my head and can’t seem to land on the right one. Here are some ideas that arose out of my most recent experience:
At first I thought it may have been nice to have been asked what I would have liked to have gotten out of my visit. Well, that would have left me stumbling over my words and unsure of what the physician was really asking me. I would have wondered if I was being tricked into suddenly being responsible for something I wasn’t able to deliver as a panic-stricken patient. This scenario becomes a health-related consumeristic conundrum–the desire to be treated as a passive customer, while at the same time wanting to feel empowered to express what I need in order to feel better. Perhaps a more collaborative approach by the physician would have changed this.
Then I thought about what it would have been like if the physician had flat-out asked me what he could have done to ensure that I left the clinic feeling healthier and happier. I would have needed more time to put together a list–and that list would have included things that reach far beyond the scope of what any physician would be capable of doing for me. Could a physician make me feel more financially secure, or find me a rewarding job when I graduate, or calm my fears about long-term adverse effects of my medications? I seriously doubt it. Feelings of health and happiness extend far beyond a visit to a clinic. This brings up all sorts of confusion about how well I know what is best for me and what the physician might know that is best for me. I don’t know where to draw those power-knowledge lines. I guess it’s a lose-lose for the physician.
So I imagined whether I would have liked the physician to have snapped on those purple latex gloves, touched the bug bites, and closely examined my skin. I mean, it’s certainly not the most comfortable thing to have a stranger’s hands on my body, searching for answers through poking and prodding. There’s an acute awareness of the existing power differential when I’m passively standing naked in front of someone who’s fully clothed and examining my body. It makes perfect sense that this sort of vulnerable experience doesn’t exactly get people running to their next medical appointment. But at the same time, I was upset that he didn’t touch me or really look closely at the bites. I thought that was what physicians were trained and paid to do. Even after the awkward partial strip-tease I went through to show him the bites, I left indignant that he didn’t do a more thorough exam. I was conflicted.
I then wondered if I would have felt better had the doctor asked me a list of questions pertaining to my presenting symptoms rather than me feeding him a long list of questions I’d typed up on my smartphone. Leading our discussion should have felt empowering to me, but instead it left me feeling like I was doing all the work and wasn’t being met with an equal level of effort. On the one hand, I was glad I could share my own medical theories. But on the other hand, I felt that he wasn’t actually hearing what I was saying. Even if the he was hearing the actual words coming from my mouth, he wasn’t concerned about the emotions behind them. I was at Urgent Care, after all, so I was obviously feeling a sense of urgency, if not outright panic. But he didn’t once acknowledge that my long list of possible causes for the rash or my eagerness to jump in and offer solutions to the problem could have been symptomatic of my anxiety and need to leave the clinic with a better collaborative understanding of my condition and concerns. Maybe some basic empathy or sensitivity could have turned things around a bit.
My final wish was to have left the clinic with a prescription in hand in case I needed to fill it later. After all, it may have been comforting to leave the clinic holding something in my hand–proof that someone had taken the time to write something down or given me a backup plan. But, then again, I may have interpreted the act of writing a prescription as a typically dismissive pharmaceutical response to an unanswered question. How dare he just pull out a prescription pad and hand something off to me to pacify me! Yet another example of a no-win situation for the physician. There were obviously other needs that weren’t being met in order for me to feel so conflicted about not having a prescription I wasn’t even sure I needed.
And so the confusing script continues. It’s pretty obvious that a lot of soul-searching is required to fully understand the complexities of just one visit to an urgent care physician. Maybe that’s where the problem lies–that imagining a healing and satisfying visit to a clinic is far beyond the scope of my experience.
That’s precisely where I need to start when thinking about new standards for medical visits–in a creative and imaginative place.