Being a doctor involves hearing a person's narrative and working to direct it in the best direction possible. There are some people for whom I have become a significant part of their narrative, and others whose narrative I know better than anyone else. It's a bond that doesn't happen anywhere else.
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This insecurity is the biggest challenge in my practice: getting people to change their behavior. Somehow I have to somehow get people to pay attention to their health when they'd rather ignore it, to be taking medications when they'd rather not, to be exercising when they don't want to, to lose weight when they love cheeseburgers, and to be checking their blood sugars when they'd rather not know how high they are. After trying lots of things over the past 20+ years, the one thing I find almost never works is what is usually done: lecturing the patient.
The real question I am asking here is not if this care is good or bad (the answer to that is, yes, it is good and bad), but whether it is patient-centered.
This should be a silly question, like asking if car-repair is car-centered. But it is clear that much of the high cost of care in our country is due to the huge number of unnecessary procedures, medications, hospitalizations, and services given to/done on people. Unnecessary care is, almost always, not patient-centered.
It's been a very slow week in my office. Today we almost pitched a no-hitter, having only one patient come in toward the end of the day. Overall, we've been quiet in nearly every way - few phone calls, few patients stopping by, few appointments, few secure messages.
When I say we need more tech, I am not saying we need more computerization so we can produce a higher volume of medically irrelevant word garbage. I am not saying we need to gather more points of data that can measure physicians and "reward" them if they input data well enough. The tech I am referring to is like that I used regarding my father. I want technology that does two things: connects and organizes. I want to be able to coordinate care with specialists and to reach out to my patients. I want my patients to be able to reach me when they need my help. Technology can do this; it sure did for my dad.
"I'm kind of stumped here," I confessed to her, going through my list of possible causes. Together we discussed the possible options of diagnostic testing and treatment. While we talked, she continued showing a glimmer of fear in her eyes. It wasn't that she thought she'd die from this, and I don't even believe it was a fear that I couldn't help her; it was a fear I would tell her the grass was not green. Maybe her reality isn't real. Maybe she is crazy.
Doctor and patient. Insecurity meets insecurity. Weak helping weak.
A local business that does MRI scans is doing a promotion on their Facebook page, asking people to nominate their doctor as the "Best Doctor" (in celebration of "Doctors' Day", which is Sunday). So yesterday I put this up on my Facebook page:
Hephzibah, by the way, is a working-class part of greater Augusta, where I live. The response I got was overwhelming, with comments and likes going up on the business' website immediately after I posted my request. I am amazed and touched by what was written. As much as it does matter what my colleagues and readers of my blog think about what I am doing, the only opinion that actually matters is that of my patients. They are why I do it. They are the measure of the true success of my business model.
Here's what they wrote:
Another vote for Dr. Rob Lamberts!! When I heard of his innovative approach to move away from the traditional insurance centered doctors office, I knew I was in! When I met him, I knew I was there to stay!He truly works FOR his PATIENTS! I've never had a doctor who spends the amount of time that he does, or has been more accessible for any and every question, no matter how small. The peace of mind being a part of his practice has given me and the rest of my family is truly priceless!
EVERY doctors office should be run this way. Period.
Dr. Rob Lamberts has my vote. He has one of the best bedside manners I have seen. He is running his practice in a way that serves his PT and not himself.
Dr. Rob Lamberts! I’ve never had a doctor sit down with me for so long and actually take the time to not only discuss my medical history, but get to know me as well. Dr. Lamberts is also a truly innovative individual, as he has strayed away from the traditional insurance driven approach to running a practice, making it much easier on his patients. I know that I can contact him with any problem I might have, and he will answer me both directly and promptly, which is truly a relief. His main focus is keeping you out off his office, not to keep you coming back.
Dr. Rob Lamberts has my vote. I have suffered from fibromyalgia for over 20 years and my previous doctor could not diagnose it. I ended up extremely depressed and checked into the University Hospital Mental Health Unit. There I met a woman who had the same symptoms as mine and said that she went to Dr. Rob Lamberts. I immediately switched to him, he diagnosed me, put me on medications, and has monitored me through the years. He definitely is more concerned about his patients that lining his pockets and has shown that over the years. I'm proud to call him my primary care doctor!
Dr. Rob Lamberts has my vote as well! Since he opened his own patient focused practice I have become more acutely aware of the excess and absence in other Dr.'s offices that I have to go to. I wish they would answer the phone and talk to me rather than their nurse giving me 2nd hand information after waiting the entire day for a reply as opposed to getting on my computer and utilizing a direct message system to Dr. Lamberts himself he replies within in minutes. His focus is on keeping his patients in good health and out of his office - he is definitely the best Doctor in Augusta!
Dr. Rob Lamberts--wonderful dr--cares about his patients!!!
Dr. Rob Lamberts has my vote! He has worked very hard getting his practice up and running! My favorite thing about his practice is that I can speak with him any time of day because he utilizes current technologies! He makes health care hassle and stress free!
Dr. Rob Lamberts is the man!
Dr. Rob Lamberts, of course. No contest.
Dr. Rob Lamberts!!! He actually cares and will do anything needed to keep you from having to go to ER or hospital for anything.
Dr rob lamberts is the best, he always is easy to reach and takes time to answer all my questions. A joy to work with for a busy working mom.
Dr. Rob Lamberts has my vote. I have been a patient of Dr.Lamberts even before his "New Concept Practice." He is a caring and a dedicated physician always availalbe for his patients. I can say Dr. Lamberts is not just a Dr. to his patients, but he is also a friend. I am truly blessed to have him as my Dr.
Dr. Rob Lamberts is the Top Doc! He and his team care about their patients in a unique way that involves them in their healthcare.
Dr. Robert Lambert!
Dr. Robert Lamberts. I trust what he says and believe he is honestly giving me his honest opinons and I trust him. He is the best.
Dr. Rob Lamberts because he is caring and just a good doctor!
Another vote for Dr. Rob Lamberts. So grateful to have him!
Dr Rob Lambert of course!! Down to earth, pulls NO punches, tells it like it is, compassionate, have known him for years. A good man and a great doctor.
I have to agree with all the comments above on Dr. Rob Lamberts but of course ! He is real, down to earth, very compassionate, and just overall the best! Been our doctor for many years and will be our doctor for many years to come!!
The better way to go to the doctor. Answers email and phone calls, less hassle. The way of the future!
Dr. Rob lamberts
Ahhhh ! I loveDr. Rob Lamberts !!!! He has known me and my family for more than 20 years and has always taken care of us. I'm thankful for his as my Doctor. He's definitely the best !
Dr. Lamberts is the Top Doc in Augusta, he has been my doctor for nearly 20 years. His approach to patient care is innovative to say the least. He cares about the patients overall long term health and it shows.
Bonus- he has a great sense of humor.
Dr. Rob Lambert's!! Augusta Georgia!! I cannot express how much he has helped me .
Dr. Rob Lamberts is the absolute BEST!
DR Rob Lamberts. He is innovative in the way he is handling his practice. Great doctor.
My vote is for Dr. Rob Lamberts . I was a patient is his while he was in another practice and am glad that I am seeing him now in his new practice. He takes the time to explain issues to you while coming up with a plan to correct it, not just treat it. Great doctor that is not afraid of technology and moving into the new age of communications! Easily accessible and doesn't mind answering questions. He puts the patient first.
Dr. Rob Lamberts hands down! I have always dreaded going to the doctor and avoided it at all costs. I hate everything about it BUT having Dr. Lamberts has dispelled all those fears. He listens, I mean really listens then he acts. He is a problem solver. He isn't trying to shuffle you through as a numbers game. He really cares about your overall health.
No question about it... The Top Doc is Dr. Rob Lamberts! He is compassionate, intelligent, creative, and thinks outside the box. These qualities (among many more) make him the best doctor in town!!
Dr. Rob Lambert is the best!
I don't know Dr Lambert but all that I have read I vote for him and I am pushing my son to come to him....no insurance
No votes for other doctors (and none from my mom). These are the genuine emotions of my patients! They not only like me and my staff (we are awfully likable, after all), but the like the technology, the innovation, and they feel like they are saving money.
I can't say it better than they did. All I can say is: thank you!
I will think of all of you when I use my flamethrower.
As an incurable compulsive introspect, I tend to brood, ponder, contemplate, and (of course) muse on "big ideas," such as:
- What makes people choose things which cause themselves harm?
- Are some people better people than others, or are they just more skilled at hiding their problems?
- Is pain really a bad thing, or is our aversion to it a sign of human weakness?
- Do dogs watch Oprah?
- Does God ever wear a hat?
- Why is "big ideas" in quotes?
Lately I've been contemplating the nature of human awareness:
- Is self-awareness (the ability to think of ourselves in the first person) a uniquely human trait, and is lack of self-awareness the essence of mental illness?
- Is empathy, or other-awareness the highest of human traits? Is this what the biblical idea of being "made in the image of God" really means?
Yeah, that's a lot deeper than about dogs watching Oprah.
A note of thanks from a grateful doctor.
I take care of patients of all ages, but a substantial amount of my time is devoted to routine pediatrics. I try to make a good impression on the kids, knowing that my care will be a lot easier if they aren’t terrified by my presence. Those who don’t do pediatrics often say the reason they don’t want to care for children is to avoid “all those screaming kids.” I want to avoid “all those screaming kids too,” but I do it through good PR. I joke with them, tickle them, find peanut butter in their ears, and other tactics to make them comfortable.
This approach has an added benefit regarding the other reason doctors don’t want to see kids: the parents. If the kids like me, the parents are much more likely to listen to me. One of my favorite things to hear is for a parent to say how their child wants to come and “see Dr. Yamberts” when they are sick. I periodically have kids running to me at the hardware or grocery stores, throwing their arms around my legs in a tight hug. It’s my tranquilizer/blood pressure drug of choice. Life is good when my patients love me.
It is strange to think about me being the image these children have of my profession. When the word “doctor” comes up, they picture me. They think of doctors examining under their arms for fictional problems as an excuse to tickle. They think of doctors having Scooby Doo stickers on their stethoscope. They think of the doctors office as a place where they can laugh and where they are cared for.
OK, it also helps that I am juvenile in my humor and that I actually enjoy playing with them. It’s not just PR; it’s self-indulgence. It’s definitely a win-win.
But I was met with a different reaction from one of my regular patients recently. I was joking around with this intelligent boy who was at my office with his mother for her visit. He was telling me about school and about how he likes math problems, but doesn’t like taking the tests. I started teasing him about the girls in the class - something I take great pleasure doing to boys of a certain age. They react as if girls are covered with radioactive Ebola virus. It’s hilarious.
Perhaps it was out of spite, or perhaps he was just being a typical guileless kid, but he interrupted my teasing: “You know what, Dr. Lamberts?” he said, sounding serious in his tone.
“What?” I answered, waiting for his words of wisdom.
“You really need to take care of something…a situation,” he continued.
“And what is that?” I asked.
“You need to cut your nose hair.”
His mom let out a yelp and I started laughing, suddenly self-conscious about my hirsute nares. He sat there, still serious, as if he had said something profound.
“I’ll take care of that as soon as possible,” I responded when I caught my breath. “Thank you for letting me know about that.”
Upon leaving the room I went immediately to my office, got a pair of scissors, and trimmed the locks in my schnoz. It wasn’t all that bad, was it?
It left me wondering how many kids had noticed this and not told me. How many kids were disturbed by my nasal foliage? How many kids out there didn’t see me as the funny doctor, or the one who tickles, but the one with the creepy nose hair?
I’ve been obsessing about it ever since.