Wednesday, June 18, 2014

Pediatric Endocrinologists Suck: a reply that was lost in the ether repeatedly.



a rough approximation - one can probably understand why a baby would scream at the sight of him

I made it reasonably far into three responses to the post about my awful day with the receptionist of my pediatric endocrinologist and how she tried to bill me fro being late for an appointment that she rescheduled at the last minute, and even threatened me with law enforcement when I refused to pay for the missed appointment before leaving. It seems that it would be less foolish to type the response as a separate blog, because I can at least save what I've typed after every paragraph so that I'm not stuck re-typing the entire freaking message, not that it's entirely worth saving. Nonetheless, here it goes. Perhaps, however unlikely,  there's something in this story that  I or even someone else may wish to recall at some point.

Amelia and OzDoc, thank you for your kind words, which came at a time when I most gravely needed to read them.

Knotty, I saw this pediatric endocrinologist for the first time either two or three days after my first birthday. I've been told it was a true case of hate at first sight. At my one-year-old fighting weight of fifteen pounds, it took two separate adults besides  the pediatric endocrinologist to restrain me just to the point that the man could as much as  touch me.  The relationship never seemed to get much better.  Since the man had chosen the pediatric branch of his field in which to practice, one might have assumed that he had the magic touch or some other form of rapport with children, but such appeared not to be the case.  From the screams I remember hearing both in the waiting room and from the exam rooms while waiting in the reception room to be called during subsequent appointments at which I was old enough to remember, it seemed that my fellow pediatric endocrinology patients were not significantly more impressed with the doctor than I was. And it's not as though excruciating  procedures were typically being performed in the office. Those sorts of things were normally done at one of the area hospitals. All the man apparently had to do to induce shrieks of sheer terror from his patients was to routinely poke or prod, or in some cases even to look at a patient. 

Considering he's in a pediatric branch of the field, one would think he would have at least average rapport with youngsters, but such is not the case. In retrospect, there must have been a dire shortage of pediatric endocrinologists in the region if parents were willing to endure their children's screams every time they entered the office building from the moment they hit the elevator buttons until they were finally outside the external exit door.  The man is probably so lacking in interpersonal skills yet slightly self-aware,  and was able to discern  that his only prayer of a successful practice would be one consisting of a  clientele in which at least one-third of them could not yet talk.


As I grew older, the situation changed from one of my screaming every time he looked in my direction to one of his blatant lack of diplomacy. My dad would usually be at the appointments, and the doctor would talk to my dad as though I were not even present. he's say things like, "No breast development to speak of, huh? I wouldn't even call her flat. Her chest is concave. She's WAY behind on that. Is her mother especially flat-chested?" he'd comment without any regard to the idea that the conversation would embarrass a sixteen-year-old girl.

"Maybe you need to meet her mother," my dad responded. "She's not exactly Dolly Parton, but I have no complaints in that department, and I've never heard anything negative about her in that regard from anyone else."

My dad tolerated the man's eccentricity to a degree largely because of the fraternal concept of research physicians sticking together, and because the man was reputed to be knowledgeable in his field. The tendency is for physicians to seek out the very best in medical care for their children when specialists are required. Dad realizes after the fact that  signs were present that he should have observed much earlier that this researcher was not worthy of another researcher's  tolerance or loyalty, and that no level of competence in a field would justify such insensitivity toward a patient.  My dad always ended up stopping on the way home and buying me either ice cream or jewelry, depending upon just how outrageous the session had been.


Then once I turned eighteen, adolescent girl modesty, combined with legal rights, took over, and I refused to allow either parent to accompany me into the exam room because I was no longer a minor and felt I didn't need a parent in an exam room with me. In retrospect, that was a mistake on my part. No eighteen-year-old girl should have been on her own in a room with such a  psychological behemoth with no support person to act as a buffer.  A female staff member would, as required by law,  be present,
which spread his staff a bit thin and -- if possible -- sent him into an even fouler mood. Under those circumstances, he would typically examine me without  saying a word. I could never tell from the scowl on his face if he thought development was coming along suitably if a bit slowly, or if the delays had grown more pronounced, or if I was showing signs of developing the fastest-acting form of cancer currently known to medical science. He said or did nothing to reassure me in the least. If I did ask a question, I'd get a one-word answer that didn't really answer my question.

The presence of a nurse or other female staff member would presumably have prevented any
abuse of a physical nature, but psychological mistreatment is more insidious and harder both to define and to spot. Such would be particularly true when the paycheck of the person charged with spotting and/or preventing  mistreatment of a patient was signed by the very person from whom she was charged to protect patients. Then he would  examine me and say nothing. 


My issue is that right now the pediatric endocrinologist is really not doing a thing for me.  even from the pure pleasure factor, I derive no joy in being poked and prodded all over my body, nor do I want more than my share of needle pricks (no pun intended). I 've been  diagnosed as having no syndrome other than benign idiopathic but presumably hereditary growth delay with a prognosis of presumed ultimately small-normal stature and bone structure.  At this point, other than the most routine of nutritional supplements and a common-sense high caloric diet, nothing can be done for me. I'm already well into the small adult height range, and I'm not far off in the weight range. He's not helping me. Instead, I'm supplying data for his research.

Once he looked at my pubic region and blurted out, "Is there really absolutely no hair down there, or are you waxing yourself or using electrolysis?" Even the nurse gasped at that one. There I was with no hips, earliest stages of breast budding, so little body fat that I couldn't have floated in the dead sea with floaties, skinny little eyebrows that had never been plucked, and no one other than a doctor who would ever have looked  -- at least since I had been out of diapers -- at the region where my pubic hair would have grown in had their been any, yet he thought it necessary to ask that question.  The question begged by this is why I ever returned after that appointment.  The reason was that I was too embarrassed to tell my parents what had been said at the appointment.

My issue is that right now the pediatric endocrinologist is really not doing a thing for me.  With my diagnosis of benign idiopathic but presumably hereditary growth delay with the prognosis of presumed ultimate small-normal stature and bone structure, this doctor needs me more than I need him. It's a mystery as to why my insurance carrier is covering appointments and procedures anymore. Medical insurance companies are usually right on top of this sort of thing and are quick to question why they should be asked to pay for medically unnecessary  procedures. Medical research around here, other than that which occurs along with necessary treatment, is usually funded through grants or other means. It's not typically financed by patients' insurance carriers when patients are not receiving treatment.

My dad found out about the debacle when he got home last night. My mom arrived about an hour later and heard all about it. My mom's issue is more with my brother and his role in the missed appointment, which is in and of itself unusual. Matthew can't usually do much to dissuade my mother that he's not the Christ Child, and it usually takes my father's persuasion for her to see the error of Matthew's ways. Such was not the case last night. She started ripping into him at 8:30 last night and still hasn't finished with her tirade. She's concerned about the situation at the doctor's office, but she's going to let my dad handle it.

My dad called my Uncle Steve, who is my primary care physician. Uncle Steve agreed to have  a chat with both the doctor and the receptionist. He's considered threatening the doctor with insurance fraud for billing for purely research purposes. My Uncle Steve said he'll send his patients to Los Angeles or even to San Diego in the future if it's the only way to avoid the pediatric endocrinologist in question and if the office staff cannot conduct itself more professionally. Another pediatric endocrinologist is an associate, and from all accounts he conducts himself professionally (the psychological behemoth is also considered competent in a medical sense but lacks the interpersonal skills required to be considered "professional") but one cannot be guaranteed of seeing him him, and furthermore, the two share an office staff. He is equally responsible for the lack of professionalism of the receptionist and others in the office.

My mom was appalled when she heard the story of the doctor asking if she was flat-chested, and both my parents and my uncle were horrified at the question as to whether or not I was waxing away my pubic hair. Of course everyone is mad at me for not having mentioned it at the time, but they'll all get over it. Then they'll feel sorry for me and buy me presents.  That's the way things work around here.

I'm still not sure what my brother's consequence will be, but my mother is angry enough that there most definitely will be a consequence. Moreover, my mother has promised never again to schedule an appointment of any kind for me unless I'm too sick to make the appointment for myself, and even then, she says she'll inform me immediately and write it down for me. It's unlike her to so quickly accept responsibility for her part in any cataclysm of sorts, so perhaps either she is changing for the better or she's tacitly acknowledging my adulthood.

As for the pediatric endocrinologist, I'm finished with him. He'll need to find his research subjects elsewhere. In the unlikely event that I'm ever in the need of pediatric endocrinological care, I'll seek it elsewhere in the future.

5 comments:

  1. Under the circumstances, I think it's best if you found a new doctor. That guy sounds like a major jackass.

    ReplyDelete
  2. I second knotty--new doctor now!

    ReplyDelete
  3. Wait! At least, post a photo of him! I don't want my granddaughter to ever be exposed to HIM! as she has a growth delay. Please!

    ReplyDelete
  4. If my dad says it's OK, I'll give his initials.

    ReplyDelete