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I love love love this and the honest depiction of it all. Thanks for sharing this! I'm definitely one of the outsiders too. It took a personal toll for a while, until I decided what mattered the most -- and that's my patients and the quality of attention I can provide to them. Human, caring, empathetic attention to work as a team is what I believe in. Patients deserve to be listened to more than anything. I have so many opinions about this all, and yet, I can't change the system right now. But what we can do is precisely this: actually Care. 💜

Thanks for putting this all into words!

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You get it!! 🥂to all this en who actually care!!

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So many in medicine went into it with the (often I acknowledged) goal of gaining the approval and external validation of others. The “making myself feel important by belittling those around me” attitude is pervasive in medicine. Especially academics. Largely, as you point out, due to the intellectual bludgeoning that is so normalized in the Ivory Towers.

I love your voice! I’m excited to follow your work!

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THAT is something we can collab on!!

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I’ll shoot you a DM! This is a juicy topic!

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Juicy for sure 😅😅😅😅😅😅

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My PCP is an ultimate “outsider” as an ARNP. Works great for me, because she has time for me and validates my concerns! But then we have to navigate “insiders” who invalidate her concerns.

I have more than once had to advocate for *her*! But at least we have our team of 2! I actually feel pretty lucky to have that many team members!

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Wow that’s great to have!! Yes I have had a patient who had to advocate to an ER doctor that I indeed was not incompetent. Imagine!! A sick enough patient who ends up in the ER and yet having to defend her family doc who was getting bad mouthed by the ER doc!! What burden and how damaging!! I can’t believe it.

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ER doctors are the worst, imo. Unless you have a visible wound or fracture, that is.

Particularly in a ski-town, which is where I was when I went into the ER because of excruciating pain on my scalp and outside my insurance network. I later learned it was shingles. Untreated for about a week. (Although my HZV reactivated due to a drug treatment and I since been vaccinated despite being “too young,” I hope frontline providers learn that it can also reactivate in young people from Covid.)

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This is wonderful! I can admit--I used to care about academic prestige more than humility. That is, until I developed a serious chronic illness that seems to have countless tentacles unfurling one after the next. I was able to see a top specialist at an Ivy League university hospital. He felt certain I had disease A, and when a year's worth of me remaining bedridden while he followed his hypothesis and ordered me countless scans and labs and ultrasounds turned out to disprove his theory, he--a big wig doctor well into his 70s--ghosted me. His office simply wouldn't schedule me and he never answered an email from me again. What's a big name if they've got to much pride to say, "I was wrong about your diagnosis?" Having doctors who will collaborate or even communicate amongst themselves is a gift. I don't take it for granted. Having severe mental illness and a complex and serious chronic condition is enough--every sick person is dealing with enough--we shouldn't have to be mediators and moderators and pageboys and all the rest for our doctors just because there rather not put in the effort for our wellbeing. Our system makes us feel this is "extra" to ask of a doctor--to please connect with my (specialist) regarding a med that can impact more than one condition. Everyone deserves doctors who do the best they can... There should never be any "extra" attached to that!

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You certainly shouldn't have to, in addition to everything else you mentioned, pacify a doctor's bruised ego! This is such as good example of the attitude "me vs them," if one person is right then the others must be wrong, and so on and so forth. And your story is a prime example of the harm it brings!!!

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Thank you for being Team Patient! We need more doctors like you!

My wonderful PCP is definitely Team Patient and Team Kelly and I would be so lost without him. I hate thinking he might be treated badly by hospital staff - but he too would be considered an outsider.

Thank you for shining light on this. I long for the day where doctors, other healthcare workers AND patients will all be treated as equals and can begin to work collaboratively for the benefit of the patient.

Those of us with chronic illnesses will benefit so much from that kind of approach.

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There is so much to fix!! SO MUCH. And we can't just sit around and suffer, or complain, without doing anything. Because whats the point, right? Let's keep writing Kelly!

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My fingers are flying Dr Zha! We have to keep shouting out - and hopefully things will start to change!

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As an ex female family physician in Australia, it's not a mystery why you feel the need to write this..🙄😒

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😒😒😒😒

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I’m really encouraged to hear that you, Dr Zha, are truly #teampatient, and I hope your patients know how valuable that is. As someone with a rare disorder that could really use a PCP to be the captain of my medical team, my experience is that no physician has ever been willing to do anything more than write the routine prescriptions I need. I coordinate all my own medical care, including all tests, procedures, prescriptions from the 10+ specialists who treat me. The sad reality is that I'm too disabled, cognitively and physically, to do this job well enough to maintain my health, but I have no other options.

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I wish you could find someone to be your medial home!!

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Thank you. ❤️ I've looked, asked, begged at some points, but it seems I'm on my own.

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It has taken years (& still ongoing) to get an adequate medical care team coordinated for my young adult who has been chronically ill for 15 years. We live 90+ miles from any academic secondary level medical system. Even so, there is very little communication between our specialists because everyone "stays in their lane." Additionally, we have specialists @ two Different University Systems.

EPIC EHR does not help since most doctors don't want to even access outside their own system!

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I was essentially put back “in my lane” and I wish it didn’t have to be like this!!

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This is so true. as a healthcare professional in the industry for almost 30 years and mainly in the intensive care units and doing travel nurse, and I’ve worked at several academic hospitals the last one being UF health in Florida. You’re right about the hierarchy.

Will try to make this a short story mom was in the hospital which I would never leave her one second alone. We were there for 10 days s/p fem-tib bypass. The lead fellow and yes, a female doctor comes in the room throws the lights on it. 05 45 doesn’t introduced herself walks over to my mom doesn’t say what she’s doing before she touches her rips the dressing off the right leg shouting to the resident and interns and I stopped her right then in there.

I said Dr. so-and-so don’t you ever walk into a patient’s room at this time in the morning without First announcing yourself letting us know that you’re here then asking for the lights to be turned on addressing my mother by name she’s not a number she’s not the surgery that was performed on her Then you ask her permission to touch her and you take the dressing off in a way that is appropriate. I said, if you do this again, I will go to go to your attending, and to the chief of your specialty, who I know personally, and I will make a complaint against you.

She looked at me and astonishment, like who the heck are you? Picking up on this I said my name is Kathleen Thorne. I am a registered nurse who did intensive care units and travel for almost 30 years. This is my mother and you will not come into this room or should you in any room and be disrespectful I’ve heard that you’re known for this, and it will not happen here not again, not ever. You will respect us as patients and I don’t care how skilled you are in the OR. If you don’t have Karen compassion which cannot be teach then you might consider another profession and I said it in front of the 12 people entering the room and I said it respectfully, but it really pissed me off.

The next day she came into the room, quietly, stated who she was asked to turn on the lights, called my mom by name, and proceeded to do the same thing she did the day before, but appropriately.

I think that there are healthcare professionals out there that act this way, and they continue to act this way because they continue to get away with it and nobody called him out on it. if I could just make one difference with one healthcare provider, which is what I tried to do my whole career then I’ve done something good.

Thank you for being who you are and speaking out. I really respect you for that.

God bless you, please be safe and stay well 🤗💕🙏👩🏻‍⚕️

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