Yes, I’m on the soapbox today, so if you’re not up for that, you may want to read this another day. But after wasting the better part of 2 hours, I’m a little bit more than peeved and I plan to talk about it!
As you may have guessed, I had a dermatologist appointment today. I have a spot on my arm with has been growing larger for about 4 years or so. My primary care physician finally decided that a specialist should look at it. I hesitated about going – I been to 2 dermatologists in the past with results I’ll describe in a minute. First, a bit of health history on me.
I have had eczema since I was an infant. In fact, it was very severe until the age of 2. My mother took me to all kinds of doctors, used every salve known to man and tried every folk cure friends and family suggested to try to alleviate my discomfort — with no success. Finally, in desperation, she took me to a “quack” — we’d probably call him an herbologist today. He gave her a black salve that had the smell and consistency of tar and that may have been what it was. (Say goodbye to those diapers!) It worked! Today, there are medications that use a derivative of tar to treat eczema. “Quack” 1, doctors 0.
Needless to say, we know a lot about skin in my family. So I never needed to see a skin doctor again until I was in my 40’s. I had a scratch on my forearm (thanks to a sleeping cat who freaked out in a dream and pushed off my arm to run away). It would heal over, get infected, get treated, heal over . . . again and again. So I went to the first dermatologist — actually the most “normal” one. He was still an odd duck, but I attributed that to medical school and all those hours of staring at skin cells in the microscope. At least he fixed the problem without too much effort. Injected it and it never occurred again.
As I got older, my skin does what most people’s skin does — it got drier, thinner and more marked up. I actually had to start using a facial moisturizer on a regular basis. What I didn’t expect was that it also stopped healing as quickly as it had. A scratch would scab over but the scab seemed to take ten times longer to fall off. That puzzled me.
When I first got the bump on my left forearm, it didn’t warrant more than simple observation. It was a small, hard white bump about the size of half of a sesame seed under the skin. Then the bump grew a little bit. The skin on top of it got dry, flaked off and left a raw spot on my arm. This process had repeated itself periodically over the past 2-3 years. I was really getting tired of it, not to mention getting just a bit concerned about this thing that won’t go away.
I have read information about skin cancer (I worked as a medical tech for a while — I’m not a medical ignoramus). I watch moles on my husband. I believe in preventive medicine. So last year I got a referral to dermatologist number 2. That was an experience!! When I arrived at the office to fill out the “new patient forms” we all know and love, I was struck by the fact that there was so much literature around the waiting room. What was more impressive was that it wasn’t literature about how to prevent and detect skin cancer. It was almost all about cosmetic procedures. Even the forms asked what procedures you might be interested in.
I was scheduled with a nurse practitioner (NP) for that appointment. No problem — that is, until I met the guy! He was orienting a new NP and was showing off to the cute young girl. He was also probably high from sniffing too much liquid nitrogen! The guy was daft! He barely looked at my skin. I had a few spots I was concerned about. “No problem, ” he said. “We’ll just say they were precancerous.” With that said, he proceeded to spray the spots with liquid nitrogen like he was spray painting graffiti — here a dab, there a spray. And that was it. Any place I asked about got sprayed. I decided to stop before there was any real damage done. “Great, you’re all set then.”
I should mention that his body check had not included any part of me hidden by the “gown” I was wearing. I was afraid of what else I might lose! I paid the $25 co-pay and left as fast as I could.
Several years later the spot on my arm is still there, growing slowly and getting raw before healing over again. So with some hesitation, I mentioned it to my primary care doctor again. He gave me a referral to a different dermatologist — I wasn’t going to see the guy who had hired Tinkerbell to work in his office.
That long story brings you up to my visit today. I took my husband with me this time because he hadn’t completely believed me when I told him that dermatologists all seemed a bit odd. I went with as open a mind as I could have, considering the office had told me the doctor schedules a patient every ten minutes. Ten minutes? Has this guy seem any other overweight person for a body check before?
We got to the office early, knowing that the obligatory “new patient forms” would have to be filled out. My appointment was for 11:10 AM. We were ready, with my forms all submitted by 10:55 AM. We were taken to an exam room at 11:30 (the doctor’s already 2 patients over, apparently) and I was given the cheapest paper “gown” I have ever encountered. And I have had many in the past 57 years! It was one-size-fits-few, stiff and did not bend with me when I sat on the end of the exam table.
The doctor showed up about 5 minutes later (another half-patient’s worth of time). He briefly looked at the chart (which had little info anyway, though it did contain the questionnaire I was told “he asks all his female patients to complete ) and asked what I was there for. He didn’t read it? I told him. He did the body exam (somewhat better than the last one — he did look at most of my body. The spot on my arm? Nothing to worry about. But why does it do that? It just does – it’s not dangerous. What about infection? Cross that bridge if it comes.
Try another question. Why won’t things heal properly any more? Well, those spots on your legs have been scratched and legs heal more slowly than other parts of the body. I haven’t scratched them. Yes, you have! It might have been in your sleep, but you scratched them! I look at my husband — he rolls his eyes. Why do legs heal more slowly? They just do. If I scratched myself playing soccer when I was young, it would heal quickly but now it would heal more slowly.
After more of this, I gave up. The doctor gave me a prescription for the “fat rash” (my term, not his) I get under my breasts when it’s really hot and I perspire a lot. He said it should work practically overnight (we’ll be the judge of that). He left and I got dressed. I asked my husband how long we had been with the doctor. About 10 minutes. Hmmm….
One of the reasons we are so disgusted with this visit is that our co-pay for specialists has risen to $40 per visit this year. $40 for 10 minutes!! That means this guy is getting paid $240 an hour to tell people that legs heal slowly. I get paid a whole lot less ($0) to tell people things that are a whole lot more important (like “I’ve found someone to help provide food for your family).
There are other reasons I was unhappy with this visit. The whole staff seemed . . . er, flaky. (I had found that to be the case at the last office too.) The doctor didn’t seem to place any value on our time (we didn’t get to deduct the value of our waiting time from our co-pay — which would have left him owing us instead!). The doctor didn’t listen to the questions that were being asked. He had stock, almost flip answers ready. Since there was nothing seriously wrong, he seemed to brush us off. I have had enough of that with fibromyalgia. I don’t take it anymore.
By the way, in the waiting room every free space was filled with literature showing beautiful women touting cosmetic procedures. When we sat in the exam room awaiting the doctor, there was an office-made sign promoting a “fall special” of 3 chemical peels for $125 each with the fourth one free.
I guess I was not a big money-maker for the doctor. My $40 co-pay was chump change to him. To me, that $40 could have purchased a lot of good food for the family I sponsor on Pine Ridge Reservation.
So, I decided today that I have had it with dermatologists! My skin is going to have to live with what I and my primary care doctor can provide.
Do you remember that form the doctor asks “all his female patients to complete”? That form asked about what lines, wrinkles, spider veins and the like the patient is bothered by and what procedures such as Botox, peels, etc the patient is interested in.
That is, all the female patients.
Maybe dermatologists aren’t odd ducks. Maybe they just like to prey on women’s insecurities.
They picked the wrong woman here, I guess.