Challenges of Treating Patients Who Are Also Physicians and How to Overcome Them

C. Blake Simpson, MDSome of my favorite patients have been physicians or healthcare workers … [but] there’s always more pressure for the physician-patient to have a good outcome. —C. Blake Simpson, MD

“The other specialties, like internal medicine, pathology, and psychiatry—as you might expect—tend to be more conservative. They come to me armed with data or research studies, and they may ultimately arrive at the same decision as the procedural doctors, but as a general rule they want to talk it out more. I enjoy that—they make you think.”

Dr. Khariwala said he’s impressed by physicians’ resilience and work ethic in the face of difficult health issues. “The ones I’ve treated have been resolute in their desire to get back to work,” he said, remembering a physician-patient who had a second primary in the head and neck area. “He was in his 60s, was treated years ago, and had a new tumor develop. On our first visit, he told me he wanted to get back to work. He underwent a big surgery, had free tissue reconstruction, and got back to seeing patients within a few months.”

What if the physician-patient shares your specialty? According to Dr. Simpson, otolaryngologists can be great patients. “It hasn’t always been rosy, but they understand the field better than anybody and can relate to the particulars of our practice,” he said.

One of Dr. Simpson’s colleagues was diagnosed with thyroid cancer. During his surgery at a well-respected institution, his vocal cord was paralyzed. They agreed he would need medialization laryngoplasty.

“He was awake during the surgery, of course,” he explained. “He wanted to see the image of his larynx on the OR monitors. He was joking around, saying he didn’t think the implant was big enough, [telling me] to carve another one to his specifications. The whole time he was critiquing the procedure, but no one else realized he was joking with me. I thought it was a scream, and, fortunately, he did very well. But I’ve never had input in the middle of a surgery until that patient.”

Do You Know Who I Am?

Influential patients commonly request special medical treatment, a phenomenon known as “VIP syndrome” (Allen-Dicker J, Auerbach A, Herzig SJ. Perceived safety and value of inpatient “very important person” services. J Hosp Med. 2017;12:177-179. doi:10.12788/jhm.2701). These patients, who may be wealthy, famous, or leaders in a field, often pressure the healthcare team to bend the rules (Guzman JA, Sasidhar M, Stoller JK. Caring for VIPs: nine principles. Cleve Clin J Med. 2011;78:90-94).

According to Drs. Chandrasekhar and Simpson, these kinds of exceptions can include: