A Teenager’s Ten Point Rating System for Doctors

My daughter was in her second week of a hospitalization for a life-threatening infection. She had been nearing the end of her freshman year at college and 2 years of a maintenance regimen for acute promylocytic leukemia when she began spiking very high fevers. She was medivaced to UCSF when her fever kept rising after 4 days of treatment at a small community hospital. The source of the infection was never confirmed, but the suspicion was a sinus infection.

During her visit, most medical personnel who came through the room whipped out their scope and took a look up her nose, and for good measure her eyes and ears and throat. The doctors talked to my husband or me about her sinuses and infection, the many antibiotics she was on and managing her high fevers. They rarely asked permission to look up her nose and few discussed her medical situation with her, but instead talked about her to us. We repeatedly looked at her and re-asked the doctor’s questions and waited for her to answer. Despite her clear and articulate answers, the next question was usually directed toward us.

We had experienced two years of medical care and this particular hospitalization had brought out an unusually large array of experts, rather than the more sensitive pediatric oncologists. Two year’s into her treatment, our daughter was an expert on doctors and their behavior. So, she developed a rating system to assess the top ten qualities of a good doctor.

That morning a series of doctors tromped through the room, each one asking the same questions as the one before.  I was sitting on a chair next to the bed where she was laying.  As each doctor examined her nose, she dropped her left hand over the edge of the bed and flashed a number of fingers, usually less than 5. Finally an infectious disease specialist paid her a visit.  He sat down on a chair next to her and asked her a series of questions about her overall well-being, about the tests she had that morning and he commented on her vitals which he had read in the chart.

After some conversation he asked if she minded if he looked up her nose. She replied, “why do you have to look in my nose when the last seven doctors have just done that.”  He smiled and asked about what they found. “Nothing,” she said. He persisted and suggested he could look briefly and he shared with her the reasons they were looking and what they were looking for.  She agreed to the exam.

While he used his scope she dropped her hand over the side of the bed, flashing 10 fingers. He finished his exam and explained that he too did not see anything alarming. He asked her a number of other questions and just before ending he said, “So, what was that signal you gave to your mother?”  She said “we have a rating system for doctors.”  He was immediately interested.  “What score did I get?” he asked. “A 10.”  “What score did the guy before me get?”  There was a hard moment of indecision before she replied “a 3.”  The doctor looked delighted. He asked about our criteria and nodded his head with appreciation as we described the qualities of a good doctor (minus the good looks criteria!)   

You can develop your own system, but here was ours.   

  1. The doctor looks at the patient when talking to her.
  2. The doctor talks to the patient (and not only to the parent).
  3. The doctor asks a general question about how the patient is feeling—and then listens to the answer.
  4. The doctor asks permission before touching the patient. (i.e. May I look up your nose?)
  5. The visit should not happen at an outrageously early time of the morning (teens like to sleep in).
  6. The doctor does not ask personal questions (about bowel movements and menstrual periods) in front of a whole team.
  7. Read the chart, so you don’t ask the same question as the doctor or nurse who was just in the room 5 minutes ago.
  8. The doctor is respectful.
  9. The doctor pulls up a chair and does not tower over you in the bed.
  10. The doctor is good looking.   

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