“Do You Really Need This Appointment?”

“Do You Really Need This Appointment?”

 

Scott Abramson, MD

Perm J 2018;22:18-102 [Full Citation]

https://doi.org/10.7812/TPP/18-102
E-pub: 10/01/2018

A version of this article was previously published in 2004 in the Kaiser Permanente Greater Southern Alameda Area (GSAA) Physician Health and Wellness Newsletter.

Dawn called me for an appointment. Her story is a sad one. At age 35 years, this once-vibrant executive secretary and devoted single mom was diagnosed with multiple sclerosis. During the 2 years preceding her request for an appointment with me, the disease had ravaged her nervous system. She was now wheelchair bound. She needed help dressing, bathing, and even feeding herself. Her mother, who had moved in to be her caregiver, was now changing her diapers.

I will be honest. I did not want to see Dawn. I knew there was nothing I could do. At past visits, I had asked my usual neurologic questions. I had performed my cursory neurologic examination. I felt powerless. The thought of seeing Dawn in person again, frankly, saddened me.

So, hoping to avoid the face-to-face visit I was not looking forward to, I had my nurse call Dawn with these questions:

Was there any change in her condition? Dawn replied, “No.”

Did she have any specific concerns? Dawn replied, “No.”

Could we handle this appointment by phone? Dawn replied, “No.”

Did she think this appointment was necessary? Dawn replied, “Yes.”

Dawn and her mother came to my office for the appointment.

There was nothing new.

There was no change in her condition.

I asked my usual medical questions.

I did my cursory neurologic examination.

Yet, strangely enough, Dawn and her mother seemed pleased with the appointment, an appointment, frankly, I had considered a waste of my precious “doctortime.”

Upon leaving, Dawn turned to me and smiled. She said, “We knew there was nothing you could do for me, Dr Abramson. We just wanted to hear your voice.”

The healing power of our presence.

It matters.

Too bad we physicians and healers too often forget.

Mea culpa.

Disclosure Statement

The author(s) have no conflicts of interest to disclose.

How to Cite this Article

Abramson S. “Do you really need this appointment?” Perm J 2018;22:18-102. DOI: https://doi.org/10.7812/TPP/18-102

etoc emailClick here to join the eTOC list or text TPJ to 22828. You will receive an Email notice with the Table of Contents of each issue.

The Permanente Journal advances knowledge in scientific research, clinical medicine and innovative health care delivery. It is a peer-reviewed journal of medical science, social science in medicine, and medical humanities.

The Permanente Press

The Permanente Press publishes The Permanente Journal and books related to health care. For information about subscriptions, missing issues, billing, subscription renewal, and back issues, Email: permanente.journal@kp.org.

Circulation

27,000 print readers per quarter, 15,350 eTOC readers, and in 2018, 2 million page views of TPJ articles in PubMed from a broad international readership.

CME

The Kaiser Permanente National CME Program designates this journal-based CME activity for 4 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


ISSN 1552-5767 Copyright © 2019 thepermanentejournal.org.

All Rights Reserved.