Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The special privilege of being a doctor

Amy T. Hou, MD
Physician
April 2, 2015
Share
Tweet
Share

“Samantha is your next patient,” my medical assistant informs me in my primary care clinic.  Samantha is a Caucasian woman in her late 40s, and I typically find her in the room with well-groomed blond hair and a cheerful outfit, such as a pink blouse, a flowery skirt, and golden sandals. She has been my patient for over a year, and I know that her life is anything but cheerful. Because she is guarded and puts her best foot forward, I had to gently dig for her to open up to me, but now she trusts me, and we have a doctor-patient relationship that is quite special.

She is divorced and a single mom fighting to make ends meet. Her adolescent son, who means the world to her, began to act out recently via vehicle collisions, drugs, alcohol, verbally abusive language and questionable physical abuse towards her. She did not feel safe at home with him, so in desperation, she asked her ex-husband’s father, her son’s grandfather, to provide shelter and support to her son for a short while. Thankfully, he agreed.

Samantha had never had asthma until she got a steady job. She found a reliable income cleaning houses, but the job exposes her to strong chemicals. She now suffers from severe occupational asthma, which requires multiple inhalers and nebulizing treatments daily and has even led to pneumonia and hospitalization. A pulmonologist follows her and prescribes steroids for difficulty in breathing. Unfortunately, the mask I provided her made her feel claustrophobic and triggered an anxiety attack. We discussed the possibility of her changing professions, but she couldn’t because the salary pays her bills. When she’s not cleaning houses, she’s often at her friend’s cancer treatments as his health care proxy.

When I first started seeing her, she never cried and never shared. She has no time for friends, and she hates “getting in touch” with her emotions. However, she carries a heavy load. Due to the trust that we’ve built, she allows me to ask how things are going. When she shares, it comes out raw, and when it comes to her son, she always cries. Sleep evades her, and depression plagues her. She declines any help from counselors, psychiatrists or anti-depressant medications. However, she is willing to see me in the clinic frequently to address her medical issues, and I hope she has come to see it as a safe haven to offload some of her heavy burden and check-in about her stress and emotions in the midst of everything.

I recently received a message from her, “Need to speak to Dr. Hou about a personal matter.”  When she came in, she told me she had a new onset of severe spasmodic torticollis. This rare, painful condition causes the neck muscles to involuntarily contract and twist. The neck either freezes in place or twists with tremors and causes severe arm pain.  She was diagnosed by a neurologist who treated her with Botox injections that have been ineffective.

She tells me that she cannot work. A social worker suggested disability insurance but forewarned that it is not easy to obtain. She suggested that Samantha identify a medical provider who would be an advocate and put her case in the best light. She listed me.

Samantha told me, “I’ve refused disability in the past, and you know me, I will fight and find a way.  But now, I don’t know what to do…” As her voice started to break, I told her that it was very reasonable to consider disability insurance during this difficult period and that we need to seriously consider other options for work. She exclaimed, “Thank you, Dr. Hou. I was right. I told the social worker that you may be the only one who might understand and advocate.”

I had felt powerless before when I was helping Samantha manage her severe asthma and knew it could be prevented if she changed professions though her life circumstances didn’t allow for it. It strikes me that after my long road of medical training, I am now deemed by the federal and state government as having the credentials to identify appropriate candidates for disability insurance.  As her primary care doctor, I take on several roles: a listener, a counselor, an advocate, and one who diagnoses, treats and walks alongside patients. This is the special privilege of being a doctor — to be an insider in the lives of our patients and to use the power granted to us to advocate the best we can.

Amy T. Hou is an internal medicine resident who blogs at Primary Care Progress.

Prev

ER physicians can help meet the triple aim

April 2, 2015 Kevin 1
…
Next

Boarded to death: When will testing for doctors ever end?

April 2, 2015 Kevin 12
…

Tagged as: Primary Care

Post navigation

< Previous Post
ER physicians can help meet the triple aim
Next Post >
Boarded to death: When will testing for doctors ever end?

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More in Physician

  • When the white coats become gatekeepers: How a quiet cartel strangles America’s health

    Anonymous
  • The man in seat 11A survived, but why don’t our patients?

    Dr. Vivek Podder
  • When did we start treating our lives like trauma?

    Maureen Gibbons, MD
  • Medicalizing burnout misses the real problem

    Jessie Mahoney, MD
  • Why some doctors age gracefully—and others grow bitter

    Patrick Hudson, MD
  • The hidden incentives driving frivolous malpractice lawsuits

    Howard Smith, MD
  • Most Popular

  • Past Week

    • 2 hours to decide my future: How the SOAP residency match traps future doctors

      Nicolette V. S. Sewall, MD, MPH | Education
    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
    • When did we start treating our lives like trauma?

      Maureen Gibbons, MD | Physician
    • In a fractured world, Brian Wilson’s message still heals

      Arthur Lazarus, MD, MBA | Physician
    • When your dream job becomes a nightmare [PODCAST]

      The Podcast by KevinMD | Podcast
    • How doctors took back control from hospital executives

      Gene Uzawa Dorio, MD | Physician
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why shared decision-making in medicine often fails

      M. Bennet Broner, PhD | Conditions
    • My journey from misdiagnosis to living fully with APBD

      Jeff Cooper | Conditions
    • Why we fear being forgotten more than death itself

      Patrick Hudson, MD | Physician
  • Recent Posts

    • When your dream job becomes a nightmare [PODCAST]

      The Podcast by KevinMD | Podcast
    • Finding healing in narrative medicine: When words replace silence

      Michele Luckenbaugh | Conditions
    • Why coaching is not a substitute for psychotherapy

      Maire Daugharty, MD | Conditions
    • When the white coats become gatekeepers: How a quiet cartel strangles America’s health

      Anonymous | Physician
    • Why doctors stay silent about preventable harm

      Jenny Shields, PhD | Conditions
    • Why interoperability is key to achieving the quintuple aim in health care

      Steven Lane, MD | Tech

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 94 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • 2 hours to decide my future: How the SOAP residency match traps future doctors

      Nicolette V. S. Sewall, MD, MPH | Education
    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
    • When did we start treating our lives like trauma?

      Maureen Gibbons, MD | Physician
    • In a fractured world, Brian Wilson’s message still heals

      Arthur Lazarus, MD, MBA | Physician
    • When your dream job becomes a nightmare [PODCAST]

      The Podcast by KevinMD | Podcast
    • How doctors took back control from hospital executives

      Gene Uzawa Dorio, MD | Physician
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why shared decision-making in medicine often fails

      M. Bennet Broner, PhD | Conditions
    • My journey from misdiagnosis to living fully with APBD

      Jeff Cooper | Conditions
    • Why we fear being forgotten more than death itself

      Patrick Hudson, MD | Physician
  • Recent Posts

    • When your dream job becomes a nightmare [PODCAST]

      The Podcast by KevinMD | Podcast
    • Finding healing in narrative medicine: When words replace silence

      Michele Luckenbaugh | Conditions
    • Why coaching is not a substitute for psychotherapy

      Maire Daugharty, MD | Conditions
    • When the white coats become gatekeepers: How a quiet cartel strangles America’s health

      Anonymous | Physician
    • Why doctors stay silent about preventable harm

      Jenny Shields, PhD | Conditions
    • Why interoperability is key to achieving the quintuple aim in health care

      Steven Lane, MD | Tech

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The special privilege of being a doctor
94 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...