To reveal -- or not to reveal -- my "MD" status

Last evening I went to a clinic for what I was 100% sure was contact dermatitis, contracted when I stupidly pulled a few weeds barehandedly the morning before. I decided against putting "MD" after my name on the forms or mentioning it to the nurse and physician.

Later, at the sign-out desk, the nurse said, "I didn't know you were a doctor." In response to my surprise, she reminded me that my insurance is through the medical association.

I felt as if I'd been caught in a lie.

All I wanted was to be evaluated and treated like a regular patient, because:

• They did not need to know I am a physician to properly interpret the history I provided or diagnose the classic rash.
• I hoped to make their job easier. 
• I wanted them to explain the diagnosis and treatment to me, instead of assuming, "She's a doctor, so I don't need to go over that."
• I wanted to go to the gym, and my husband thought I shouldn't until the rash was better. Now I could tell him, "The doctor said it's absolutely okay."

Healthy Survivors know that not being a medical professional has its advantages. On rare occasions physicians may put too much weight on their doctor-patient's descriptions or suggested diagnoses, or hesitate to prescribe painful or embarrassing diagnostic tests or therapies. Clinician objectivity is a wonderful thing.

Comments

[wendy]

You're right on with this post! My husband is the physician in the family (not me). And there are times when he chose to be an a-hem "ordinary person" rather than a physician.
Unfortunately, he is in hospital, in the palliative care ward (no not ca., it's copd.)

And even in his weakened condition, his physician will ask "do you think a course of Cipro is appropriate? Or would you like something else? Shall we up your medrol? Or wait?

Just wanted to let you know what an inspiration you are to me right now. I just found your blog, (through Word doc) and have listened to your video clip. Wow - you are amazing! I need to explore the rest of your webpage.

[Wendy S. Harpham, M.D.]

Dear Wendy,
I am sorry to hear that your husband is seriously ill with COPD. I'm glad you found my blog and look forward to hearing your voice on future posts.

Should clinicians talk to their clinician-patients like they are professionals or like regular patients? I wrote about this challenge in "Square Pegs" at http://tinyurl.com/OT-041007

With hope, Wendy

[Judy Goldthorp, RN, CHPN]

As a hospice RN, I encounter physicians and nurses as family members. It's always a challenge to figure out just how to speak to them as colleagues AND family members. How much do they understand? What is their background, i.e. if their background is dermatology, their knowledge of palliative care / hospice may be limited. I don't want to talk to them as I would talk to a family member who had no medical / nursing background. But I don't want to *assume* that they know about hospice / palliative care if their area of practice is far removed from hospice / palliative care. It's a challenge for sure. I would rather know from the start that someone is a physician or nurse, rather than figuring it out after several visits. When my mother was on hospice, I let the staff know up front that I was a hospice RN. Her RN was able to speak to me as a colleague, but reminded me that my role was that of a daughter, not a nurse.

[Debby]

As I read above list, I was thinking a Chinese menu of 1 from column A and 1 from column B. So many choices. Each one's background and life experiences brings their own challenges.

hugs
Debby

[Wendy S. Harpham, M.D.]

Judy,

I agree. In this case, my medical problem (poison ivy) was simple and limited.

I would mention my MD status if my problem were anything more complex or severe, such as abdominal pain, headache, chest pain. In these cases, most physicians have talked to me as your mom's hospice physician did: Addressing me like a medically educated person, but reminding me that my role is as a patient. And if I felt they are assuming too much, I requested they please talk to me as if I were a regular patient. With hope, Wendy

[jonnie hickman]

I served as a hospice nurse too before diagnosis. I hesitate to tell medical professionals that I have been a nurse for about 20 years. They sometimes speak to me like I have a medical degree and my specialty is Non-Hodgkin's Lymphoma. To be honest before my diagnosis, I knew very little about NHL. I must have been asleep the week we covered it in nursing school. It was all so over-whelming just dealing with a stage 4 cancer and trying to absorb that I was sick... I needed them to speak to me like I was 5 years old and only knew that doctors gave you lollipops.

In my career, medicine changes so rapidly that if I had a patient with a diagnosis I wasn't familiar with, I would spend time researching it so I could give the best care. When they told me I had NHL, that is all I could handle.

Slowly I began doing my homework, but because I was in such a frail mental state, I started with allowing myself only one hour a day to be my own nurse. I started with my ANP book.

I have also had some negative experiences in hospital emergency rooms when I tell them I am a nurse. They place judgements on the way I handle my cancer. Usually after they contact my doctor and things are straightened out, the er visit goes better, but I would rather see the team that knows the ins and outs of my diagnosis and how I am coping without the judgements.

It has been a hard struggle to changing from nurse to patient. I have always been the caregiver. Thank you for your posts.

[Wendy Harpham, M.D.]

Dear Jonnie,
Thank you for sharing your story and perspective. What I'd like to see is some training sessions on "clinicians as patients."

I, too, could not open a textbook for a couple of weeks after my diagnosis. I just couldn't read anything with the objectivity needed for the information to be useful.

One tip that has helped me has been to be up-front and tell the treating physicians and nurses, "Please talk with me as if I am not a professional. I would rather you tell me something I already know than assume I know something that, maybe, I don't. Thanks!"

With hope,
Wendy