Okay, let’s start with a little quiz. Which would you prefer:
1) a doc who’s an expert at medication and data analysis, but who expresses little apparent concern for his patients, treating them by ranking their symptoms numerically and by adjusting their medication in a scientific though detached manner; OR
2) a doc who’s a loving, caring person but also a bit incompetent

As I wrote before, we apparently went with number 1. To summarize a typical experience thus far: the doc would stand the entire time, run through some numerical data sheets that we or the nurse had filled out, ask Carrie or me a few follow-up questions (sometimes after getting me to take Isabella out of the room), snap his fingers at the nurse, write a prescription, then bolt out of the room like his backside was on fire and the water bucket was down the hall. That was his routine – clinical detachment to the extreme.

Well, we recently had a follow-up appointment, and I had a brilliant idea. Because it was a pain to pull Isabella out of school early, drive her to the doc’s office several suburbs away, keep her occupied (usually with the assistance of Mr. Gameboy) while we waited, and take her out of the office so the doc could ask his follow-up questions out of her earshot, I thought it would be easier, more efficient, and less stressful if Isabella didn’t come to the appointment at all.

Flashing forward past the drive to the appointment and the long wait due to the doc being behind schedule, Carrie and I stood with slack jaws as the office manager lady told us smugly that it was illegal and unethical for the doc to talk to us without Isabella being present.

“Legal” I can understand. But ethical? If that’s unethical, I suppose that it would also be unethical to prescribe her medicine without talking to her, right? Part of the conversation with the office manager went like this:

“blah blah blah legally and ethically blah blah nonsense,” the office lady said with a tight joy-free smile that begged to be rubbed off with a brillo pad.

“But she’s only 7, and he never talks to her,” Carrie said. Steam was coming out of her ears so fast I had to step back to avoid being scalded.

“Well, he’s visually assessing her.”

“He’s never even looked at her!”

“Well, I’ve never seen a parent not bring in their child during an appointment.”

“I’ve never seen a doctor not look at a patient.”

I thought about that last one later, out in the car. Instead, I had said something similar though not as clever. Our point was, if it was so important for her to be there, then first, the doc’s office should have made that clear when booking the appointment. Second, he should actually talk to her or at the least observe her during the appointment. Third, the office manager should apologize for not making that fact clear if two parents leave work and drive through traffic and waste an hour and a half out of their day for nothing. (The nice receptionist did apologize, though.) And fourth… I’m so flustered I can’t remember 4 through 9.

I just wish people would cut the BS sometimes. They first come up with a rule, then when it becomes obvious that it’s a stupid rule under certain circumstances, they make up stuff to try to disguise the fact that it’s stupid. Like I said, “legal” I get. But don’t tell me that the doc was visually assessing my daughter while looking over the shoulder of the nurse at some numbers on some paper. Unless he can see out of his eardrum or he’s got some Hippocrates-sanctioned ESP mojo.

Let’s have fun with this a bit more, since I’m still riled at the monumental waste of time. What if the patient was sleeping under a blanket in the room, would that have made it more ethical? What if she was invisible? What if she was in the room five minutes prior, but then left? What if I had a picture of her… would that make it better? What if she was there, but the doctor was blind. Would that count? Okay, now I’m just getting stupid.

Again, I get that it’s the law. And yes, ethics are important. But it’s ridiculous to follow the letter of the ethical law while missing the purpose behind it – namely, to engage your patient before you prescribe medicine for them.

Maybe we should have gone with option 2 above. Or better yet, we should look for an option three -- a doc who’s both caring and competent.

Sometimes a good rant makes you feel better. Sometimes it doesn’t. I think I could use some medicine myself.