I am grateful to Dr Philyerboots for his post on "Heartsink" patients, for it opened my eyes. I think most patients - if they know the term exists - regard heartsinks as the moaning hypochondriacs who plague a GP practice on a regular basis - I did, that is, think that, not plague a doctor!
But this is not only the case; a heartsink is also "...the most common one is of patients under my care who steadily deteriorate despite all that I and modern medicine can do", it is the "very few I object to on a personal level", it is "the patient that has consulted Dr Google before coming", it is "those who ask the same question, again and again an again. It is as if they ask the question often enough that I will tell them that I have a miracle cure", it is "the insane", it is those "who seemingly just want a chat" or those "who have complaints about BGH, or about my colleagues or their GP..."
I think that most of us, as patients, regard doctors as super-human who are void of negative emotions. If they are cool/cold with us - it offends us - it certainly offends me! We are the patient - they are the doctor. Forget the heartsink patient who is the eternal hypochondriac and let us think of ordinary Joe who visits the surgery with perhaps, a minor complaint. He has a minor problem which he wants nipped in the bud.
Say Joe has not visited the surgery for three years - he is a seldom attendee - and he has a wart on the end of his nose and wants it removed. Request over - he is met with a barrage of questions required to meet the QOF. He is asked if he smokes - yes he does - but he thinks what the hell has this to do with the wart on my nose? and internally, becomes angry. He then has his BP taken and it shows he is hypertensive (white coat and anger) and he is asked to return and have his BP rechecked and his bloods ta\ken. He leaves the surgery in a state of angst.
After three visits to check his (white coat) hypertension he is commenced on meds and also meds for high (who says - Big Pharma?) cholesterol, and suffers side effects which are viewed as another problem and he is prescribed meds for this and that, and this no meds man suddenly takes home a carrier bag full of drugs from the chemist all due to the wart on the end of his nose.
But this entire aside, what if the patient is Jessie who has multiple comorbidities? She likes Dr Smith for he is kind to her and treats her with compassion. She needs to see a doctor, but the only doctor available is Dr Jones. Nobody, but nobody wants to see Dr Jones, for he makes a patients heart sink. Dr Jones meets the definition of a total w*nker!
Yes! There are doctors that make a patients heart sink! Whether in a GP or hospital setting, patients leave thinking what the hell did I do to deserve to be treated like that!?
Then there is Janet who is also a seldom attendee who visits her doctor as she knows that something is not right. She doesn't know what it is as she is not a doctor. She has all the usual investigations and nil is found. She is told she is anxious - for after all she is a woman - and is left on the outside looking in. But she knows that something is wrong and consults Dr Google - for that is all she has left. He does not listen - but he talks to her in the written word. She is not stupid and discounts all that does not apply to her. But then, she finds her illusive dx and consults her GP with a printout - bad move - for a sure sign of hypochondria! She also takes a list of symptoms as NHS sites suggest that she should - but GPs and hospital docs hate lists and must take control of same and a list is another sure sign of hypochondria! But months down the line - after much professional abuse (?) by doctors - she is proved right.
I need two pairs of hands to count the number of close family or friends who after routine investigations have been told there is nothing wrong with them, only to discover later down the line that there is - at times with terminal consequences!
Doctors are not perfect and neither are patients. We need to meet in the middle!
Rant over! I love doctors really!