- In my years of training,
I've come across plenty of doctors who weren't so great.
Here are seven doctors, that if you come across,
you should probably look elsewhere.
- Hi, doctor. - Hey.
- [Patient] (coughs) Oh man, I just feel awful.
- Yeah, so do I. - I think I got the flu.
- Yup, you...
Wait, what symptoms are you having?
Do you have a fever?
- [Patient] Ah, yeah, I feel real hot.
- Chills?
- Ah yeah, some chills. - Back pain?
- A little back pain. - Do you have a rash?
- [Patient] I mean, maybe I have a rash somewhere?
- You have a rash somewhere?
We need to shut this down!
- What? - A category four quarantine.
- [Patient] Whoa, what?
- Contact your family, contact your family now!
- [Patient] Wait (chuckles), wait a minute.
Doc, hold on, I just got the flu here.
- You said fever, back pain,
rash- - Yeah, yeah.
- Smallpox.
Lock down this, lock down this ward.
And contact Billy Bob (sirens wailing)
in the Atlanta office, in the Atlanta office.
- Oh my God. - We're gonna have ourselves
an outbreak.
- Oh my God, I have smallpox! - We're gonna have
an outbreak! - I have smallpox, don't I!
- We're gonna have an outbreak!
- Oh my God! - Did you take the train here?
- [Patient] Yeah, I took the C-train.
- The C-train? - And then I transferred
to the seven-train.
Oh my God, there was a kid on the train
and he dropped his hat
and I picked it up and handed it to him.
Doc, did I give that kid smallpox?
- What color was the hat?
- [Patient] It was red.
- [Doctor] It's not in the textbook.
- We all love ourselves some "House, M.D."
But the reality is, when a patient comes in
and presents with some symptoms,
we can't just jump to the rarest diagnosis in the book.
It's gonna make life difficult for the patient.
and we're gonna miss a lot of
the most common-presenting diagnoses.
Here's how it should go.
- [Patient] Hey, Doc. I'm not feeling good.
I have a fever, I've got chills.
My roommate said he thinks I might have smallpox.
- It's more likely that you have the common cold
or perhaps the flu, but we'll obviously test you
for other viruses and bacterias
just to make sure we're not missing anything.
- Oh, Mr. Harbor, what seems to be the problem today?
- [Mr. Harbor] Ah, I'll tell you, Doc,
I've been feeling really tired, really fatigued lately.
- You need this.
This. - What? Uh.
- This is my life's work!
This is a vitamin juice-esque potion.
- [Mr. Harbor] What does it do exactly?
- It fixes it.
- [Mr. Harbor] It fixes it?
- Immunity, sleep, upsetness.
- It fixes upsetness? - It fixes upsetness.
- [Mr. Harbor] It looks like there's another label here.
Did you? - It's black label!
- [Mr. Harbor] Is it FDA approved?
- It's an FDA approved building
and there's a rental space next door.
I'm offering you a one-time, four-payments chance.
- [Mr. Harbor] What is it?
- It's a potion.
- A what? - It's a potion.
- A potion. - A potion.
- First, be skeptical if a doctor's trying
to sell you a product they made themselves,
especially one that has a proprietary blend.
Second, if a doctor starts treating your problem
before diagnosing it,
before finding out what the root of the problem is,
that should be a big warning sign.
Here's how it should go.
- [Patient] Hey Doc, I've been real fatigued lately.
Is there a vitamin I could take?
- Well, it's not really about a vitamin.
We need to figure out why you're fatigued
in the first place.
We need to get to the root of the problem
before we begin addressing it.
- Oh hi, Mr. Grant, how are you?
You know, let's talk about what seems
to be the problem today?
- [Mr. Grant] Well, I've been having
some swollen tonsils. - Swollen tonsils, okay.
What have you taken?
- [Mr. Grant] Just some ibuprofen, some water,
no prescription drugs. - Did you drink the water?
- [Mr. Grant] Oh yeah, I drank the water.
- Why?
- [Mr. Grant] Uh, for hydration, I assumed
that would help- - Did you think that helps?
And you've seen somebody for that?
- [Mr. Grant] No, you're the first person
I've come and seen. - Ah, I'm the first person.
You've never seen people in your life?
I just wanna clarify this for the record.
You said I'm the first person you've seen.
- [Mr. Grant] You're the first medical professional
I've seen for this condition.
- Any exposures?
- [Mr. Grant] To what exactly?
- To the exposures, how is your vision?
- [Mr. Grant] My vision has been fine.
It hasn't been a problem.
- The vision has been fine.
So swollen glands with excellent vision.
And that's your complaint today?
- [Mr. Grant] Could you look me in the eye?
- I'm looking at your chart.
And I see everything I need to know-
- Look at me in the eye, doc. - I see that you're
a noncompliant patient.
- Doctor, look me in the eye. - Who doesn't take
their medication. - Look at me, doctor.
- And I just don't wanna-
- Doctor, look at me. - Frankly,
I don't know why we're here but I'm
sending you a prescription - Look at me, doctor.
It was a pleasure meeting you.
- Being a good doctor, a diagnostician,
means connecting with your patients.
If you're just staring at the computer
and not looking at the patient,
you're gonna miss nonverbal cues and you're not gonna form
a healthy doctor-patient relationship,
thereby decreasing trust in you by the patient.
This is how it should go.
- [Patient] Hey doc, I've got some swollen tonsils,
real irritated, I think I might have tonsillitis?
- All right, well, I'm gonna ask you a few more questions
and then do a physical exam
and then we'll come up with a plan of action
to help you out.
- [Doctor] We met last year.
- [Patient] Yep.
- We said we were gonna start an exercise plan,
I have it documented. - We did say that.
- My nurse says still no exercise?
What, what's? - Well, you know,
exercise takes a lot of time
and I've been lucky enough
to have a pretty full schedule the last year.
- You lied to me.
So first let's mark poor patient compliance.
- [Patient] (laughs) I didn't lie to you.
- You said I'm going to start...
- Yeah, I did say, that was. - Lie, lie.
Do you think that's good for your overweight,
morbidly obese body?
- [Patient] I don't know if I'd go as far
to say I'm morbidly obese.
- Do you see what you look like?
- [Patient] Every day when I get up and look in the mirror.
- Yeah, you've had multiple, casual, sexual encounters,
one drink a week, do you need a drink a week?
You told me you had no time!
- [Patient] I had no. (patient sighs)
- Gen Z?
You want me to make a TikTok dance?
Facts.
Spinning facts.
- Gone are the days of the doctor barking orders at patients
in order to tell them what to do.
It's a teamwork-based approach.
The patient has to understand
why you're giving certain instructions,
why your recommendations are the way that they are.
And if you don't have that, you don't have anything.
This is how it should go.
Do you wanna begin an exercise regimen?
You seemed excited about it last time.
- [Patient] I mean, I would be interested in it.
It's just hard to find the time.
- Well, maybe we could talk about some options,
about scheduling your time in a slightly different way.
Maybe I can give you options of local gyms in the area.
We can discuss even workouts
that take as short as 10 minutes.
How do you feel about that?
- Mr. Bob, it looks like your appendix needs to come out.
We need to perform the surgery stat.
- Oh, no! - We say, stat.
- [Mr. Bob] Are you serious?
- Serious as a cucumber.
- [Mr. Bob] Is there another option here?
Is there a drug you can give me, a pill maybe?
- Should we run this back?
I came in, I said you need surgery.
- [Mr. Bob] I'm just really afraid of that.
- Are you afraid of no longer living?
- [Mr. Bob] Yeah, I'm really afraid.
- Yeah, so we need the surgery.
- [Mr. Bob] Is there like a physical therapy option
I could try?
- For your appendix?
- [Mr. Bob] How long is the recovery period?
- The recovery period is exactly as long as it needs to be.
- [Mr. Bob] Can I have half an hour to discuss?
- Half an hour?
You don't have five minutes!
- [Mr. Bob] Really? Am I gonna die?
- No, but we're rushing.
- If as a doctor you're gonna get mad at your patients
every time they ask a question,
they're just not gonna ask questions.
When you have an uninterested or an unengaged patient,
you're gonna have worse outcomes.
This is how it should go.
- [Patient] Oh my gosh, really?
I have to take it out?
- Yeah, we do have to take it out.
But look, I'm gonna talk you through that entire process.
We're gonna discuss the risks, the benefits,
and really what you should expect going into the surgery
and afterwards with the recovery.
You can ask me any question and I'll get right to it.
- Mr. Feltwood, how are you?
- [Mr. Feltwood] Um, I'm doing all right.
Except I have a little back pain.
- Lower back?
- [Mr. Feltwood] I mean, kind of,
it's in a few- - And it hurts a lot?
Sciatica. - If I lift up my shirt here,
you can kinda. - Why are you lifting
up your shirt?
- [Mr. Feltwood] Well, this is where my back
has been hurting.
- I know it's in the area of sciatica.
- [Mr. Feltwood] And there was something else
going on though, so you see my wrist?
My right wrist has been feeling a little numb
and strange lately.
- Do you have a keyboard?
- Ah, yeah. - Do you have a keyboard?
Carpal tunnel, Google it!
You have it!
- [Mr. Feltwood] Could you look at it though?
- I can, am I not looking at it?
I'm looking at you.
Is your wrist attached?
- [Mr. Feltwood] If you could just,
- I don't need to see it.
Put the carpals down!
- I have seen this one happen way too often
without a proper physical exam,
without visualizing and palpating the area.
You're not gonna make a correct diagnosis.
You're just flat out guessing and being lazy.
Here's how it should look.
- [Patient] I've got some back pain
and my wrist has been hurting.
I looked some stuff up,
I think I've got sciatica and carpal tunnel.
- Well, look, it's important
that we do a thorough history and physical exam
to make sure that we're not missing anything.
Those diagnoses have to be done
with a thorough physical exam,
so let me check both of those out for you.
- Blood pressure today is 128 over 82.
Looks like we gotta get the cardiologist involved.
- [Patient] Whoa, really? Is that high?
- Yeah, you know the heart, the pressure, the cardiologist.
- [Patient] Well, the reason I came in today
is because I've been having some headaches.
- Oh, headaches?
You know, for headaches we would get a neurologist on board.
- [Patient] Is a neurologist really necessary?
- Is your brain necessary?
- [Patient] Is there something maybe you can do?
- The way you're talking to me right now,
I feel like maybe there's a personality disorder happening.
- [Patient] Excuse me?
- So I think we should get a psychiatrist on board
and just work out whatever it is that's happening here.
- [Patient] Look, doc, I scratched my arm on my way in here.
Could you give me a band-aid?
- Dermatologist!
- Primary care doctors, like myself,
are trained to take care
of almost all of your medical problems.
Unless I'm uncomfortable performing a procedure,
don't have a necessary piece of equipment
or the complexity of the case becomes too high,
I don't need to refer my patients.
I can take care of them right then and there.
Here how it should go.
Your blood pressure seems to be running consistently high.
So let's talk about some lifestyle things we can do
to get that number in better control.
- [Patient] I also came in
'cause I've been having some headaches.
- All right, well, let me ask
some red-flag symptom questions
to see if it's anything serious or urgent.
And if not, we can discuss on the following visit
after trying some over-the-counter options.
So happy to take this off.
(groans)
These glasses are fired though.
Mm, Gucci, Gucci, Louis, friendly, friendly, Prada.
Do you think I was gifted with these abs?
- [Patient] You're in very good shape, Doctor.
Look at you.
Congratulations.
- The flu! - Little pox!
- [Patient] Normal flu.
- You don't know.
- F-L-U. - Do you know? Do you know?
- Do you know? - Do you know?
- Do you know? - I don't know.
- Do you know?
I feel. - Come now, come now!
Come now, it's smallpox.
(stutters) - Small pox, small pox!
- What do you want?
You want a second opinion?
You want a third opinion?
How many opinions do you need?
- Did anyone compliment you or comment on the pus?
- [Patient] Did anyone compliment my pus?
- What was the pus material like?
Was it very pus-y or limited pus-y?
- [Patient] I would say it was more pus-y than less pus-y.
- That makes sense, so. (laughs)
- [Man] Oh yeah!
- Yeah?
You can't even see my mouth.
- [Man] That's how big mustache works, baby.
- Oh, this is the worst one, look at this.
- [Man] Oh yeah!
Ooh!
- (groans) It doesn't get easier.
- [Man] And people think YouTube is easy.
- I clearly have a bizarre life as a doctor,
click here to check that out, and as always,
stay happy and healthy.
(upbeat music)