I went to the Podiatrist today for my plantar fasciitis...Not a good idea to make an appointment for April 15th, but my judgment maker has been defective lately. Lucy and I were late. I HATE to be late. This may surprise some people because it's not uncommon for me to be late (at least it feels that way to me).
Now, I have never been to a Podiatrist before. In fact, I don't remember a single visit to a specialist growing up. Well... There was the visit to the woman doctor when I was having especially painful cramps as a teenager, but never any other. This visit turned out to be an experience that stands alone among 31 years of doctor visits--but I don't think that seeing a 'specialist' was what did it.
This guy, Dr. Greg Gulso, answers his own phone so does his own scheduling. When I called to schedule, he answered by saying, I think, "Dr. Gulso's office," or something to that effect. Sure, just by having his phone answered by a man, he thumbs his nose at decades of tradition--but he answers it himself! I could hear two or more young kids fighting over something in the background and actually had difficulty hearing him.
I called another office before calling Dr. Gulso's; a woman answered the phone. I had no difficulty hearing her, and I was told that they had an appointment for me in 6 weeks. In 6 weeks, my foot would probably get better on it's own. Popular doctor.
Dr. Gulso, however, was scheduling a couple of days out.
So I made an appointment with the guy on the phone who was caring for the screaming children. I figured it had to be Dr. Gulso himself--thought he probably just keeps his Blackberry on him and forwards his calls when he's not in the office. The major tip-off there was that no one in his or her right mind would pay someone ELSE to do this very unprofessional scheduling. (Hey--a spade is a spade, is a spade.)
I have never been to a doctor's office with no receptionist, so I had difficulty imagining a situation where Dr. Gulso would do his own patient receiving, but when Lucy and I walked in, the office was empty except for a thirty-something guy wearing a tie with a nicely-ironed shirt, patiently waiting behind the little half-wall: the Receptionists domain.
Dr. Gulso apparently answers his own phone, schedules his own appointments, and does his own paperwork. He was the one who showed me the clipboard of new patient forms and waiver, and it was he who apologized for the faulty OfficeMax pen. He was very nice. He even responded (unbidden) to Lucy's requests to draw with her own clipboard and her own OfficeMax pen.
As nice as he was, I found the experience a little disorienting. While I filled out the forms and had these pleasant little exchanges with the man behind the counter, I still couldn't be sure that he was the doctor--because he didn't introduce himself. He just had me sign in. It was a little awkward when Lucy said something about going in to see the doctor. I think I half-ignored her, half-mumbled an acknowledgement that she had spoken about seeing the doctor. I should have just asked him if he was Dr. Gulso. I know.
I just felt that it would be weird and somehow disrespectful or rude to turn and ask him, "so...are you the doctor, then?" It would've been a little like pointing out that he was doing everything and I might've left the impression that I didn't approve. I knew we would find out soon enough, so I just did my best to give the impression that it was all very normal to me.
After returning my insurance card and checking my forms briefly--without a word of explanation as to his dual...er..multifaceted role in his practice--Dr. Gulso directed me to one of his exam rooms and became the doctor. (He pushed two spots on my foot that were exquisitely painful, gave me a shot of steroids in the problem foot, answered my questions, gave me his advice, and rescheduled me for May.) My foot is killing me. He told me that I would probably have some discomfort tonight that may last for 1 to 2 days.
Receptionist, Nurse, Doctor divided by three. Is this the future of medicine?
I really can't decide whether to be impressed with his hutzpah or put-off by his complete failure to acknowledge so many of the norms of the modern doctor's office. If he's just starting his practice, he probably has a good amount of downtime. I think that if I were in his shoes, I would probably question the need to hire a phone-answering paper-shuffler, too. (I have been employed as a phone-answering paper-shuffler, so no disrespect is meant here...my brother called me a phone monkey once and it hurt my feelings. I believe he meant well and I don't believe in holding a grudge, so I'm over it.)
I guess I am a little fascinated by the fact that a different (maybe better) model for a doctor's office was almost stunning to me. Lucy's only two-and-a-half, and she "knew" too, that you don't see the doctor before he opens the door to the exam room to take his rolling stool. That is, you don't unless you don't give a flying squirrel about people's expectations and the way it's done--unless you're Dr. Greg Gulso, apparently. On some level, you've got to respect that. I respect that.
The doctor I usually go to is Dr. Stephen A. Beck. It's his shared General Practitioners office that I've been going to since I was probably 5 years old. I realize now that there is at least one strange thing about his office, too. If I, as a patient, see a doctor in the hallway on the way to the exam room or to the powder room, we both seem to be expected to pretend that the other person isn't there. Weird. Why not just turn the head and give the patient a nod? Wary of engaging an unsuspectedly long-winded time sucker, I guess.
I always liked seeing Dr. Beck. To me, he is the quintessential family doctor: Somewhat short, somewhat round--with sparkly blue eyes and (now) white hair. He is the doctor I have seen (mainly) since I was...since I was still wetting my pants, probably. His partner is doctor...I don't even remember his name. A guy who is good whom I like, but is not lucky enough to have my loyalty. Aha. Dr. Peterson. Doctor Peterson is a remarkable typist. While you explain that you have been blowing your nose with unattractive results for two weeks and feeling slightly chilled at times, he will be looking at you intensely, nodding and squinting thoughtfully--typing at a tremendous pace on his computer. Who knows what he types as he listens? He does listen well. I've never had any complaints about his care. But what if he's an insanely good multitasker? Maybe his "notes" look like this:
her golden tresses. Phillip stroked her creamy neck and whispered
in reply that he too, could use something to quench his thirst. Hedda
had never known such a man. Phillip
VALERIE TAYLER: MUCOUS AND GREEN NASAL DISCHARGE 2 WEEKS. CHILLS
had come into her life when she had stopped believing in men who
cared, men who listened. Phillip, with his wisdom-filled eyes and
graceful ways. Phillip with his work-hardened arms and iron chest
When I was a teenager, Dr. Beck must've gotten too busy to deal with his patient load, because he hired a PA, David Badham. I always resented it when I called to get an appointment with Dr. Beck (whom I trusted implicitly), and I ended up having an exam from a guy who I didn't know from Adam. I admit that I put David on a hard road to acceptance, but I had gotten used to Dr. Beck's maturity...his quiet way of asking questions. This "David" guy was a lot younger and louder. He also liked to crack jokes then laugh at himself.
I understand that if a Physician or PA spent time between appointments chatting with all passing patients, they would be even more behind schedule than when all parties are invisible when not in an exam room. However, I have witnessed these same doctors (mostly David, in Dr. Beck's office) leaning on counters with charts tucked tight into armpits or dangling by fingertips on an extended arm, chatting it up with their staff.
Yeah, David has maybe gotten a bad rap from me. Still...he does pretend not to see me whenever I'm out of an exam room. It's very unnerving when he completely ignores me in the hall, then turns up the amplitude and charm once he's in the room with me feeling my glands. Who knows, maybe it's me. Still, I find it
weird
and--not ideal at all.
So which is better?
The rogue Dr. Gulso: Jack of all trades and (hopefully) master of Podiatry?
Or David Badham, Physician's Assistant: Nice guy and good care provider who, blind to patients like me in the hall, unveils his cordiality along with his general practice mastery only after he taps twice on the door of the exam room?
Lucy's fantastic pediatrician, Dr. Judd, does not ignore us in the hallway. Amazing. Yet, there are only women receptionists at Grow Up Great. (Ha.) There are also mostly women doctors in practice there. In fact, Dr. Judd is the anomaly. Announcer voice would be good here: The only man in an office of women.
We ended up with Dr. Judd because it was with him that we had the shortest appointment wait time when I called to schedule for just-born Lucy. He had barely started up; his schedule was wide open. I wouldn't be surprised to learn that Lucy is one of his "oldest" patients. (I don't know this. I just know that he started practicing in July of 2005. He saw Lucy for her first check-up and she was born in August, a month later.)
Lucy likes Dr. Judd a lot. Getting an appointment with him is a lot different now that he's established a following. Well-Checks aren't a problem, but sometimes it's hard to get in fast for a sick visit. It has gotten so if I can't get an appointment with Dr. Judd, we just go to InstaCare instead of seeing the other doctors at Grow Up Great. I've taken Lucy in to see a couple of different Grow Up Great doctors. One was unremarkable in a good way, if that can be said...the other was not.
I think I took Lucy in for what I thought might be an ear infection and--by my estimation, anyway--was not pleased when this other doctor failed to do a major part of her job. She noticed that Lucy's teeth are chipped and asked if she had broken them falling down. She then completely ignored the information I gave her about Lucy grinding her teeth and made comments about how her kids have broken teeth falling down, too.
Lucy has fallen down plenty. She's a normal kid. When Lucy appeared one day with a noticeably chipped tooth, Brian assumed that she had broken it in a fall, too. I wracked my brain trying to remember any falls and finally told him that she hadn't had any falls against anything hard recently. It was a mystery for a long time.
We were completely in the dark about Lucy's teeth chips until we went on a trip with a veteran dental technician, Kate, who took one look at Lucy's mouth and knew exactly what was going on. The teeth grinding explanation has also been confirmed by an endodontist who has been in practice for probably 30-40 years.
So yes, I just happen to believe that most, maybe all, of the damage done to Lucy's teeth is done at night when she grinds her teeth. I hear her. It's nerve-racking. I tried to explain this to the other Grow Up Great doctor, but she ignored me and made those brief but smug and very direct comments about kids falling and breaking teeth. It, frankly, offended me that she would think I would lie about something that small. The fact that that she didn't even appear to register the information I gave her made me never want to take Lucy to her again.
Good doctors, bad doctors...Is the Rogue Doctor Gulso a good one or bad one? Do his unconventional choices in how to run his practice offer any insight into his expertise as a doctor?
I think maybe Dr. Gulso is onto something. I don't fault him for tightening his belt and doing some of the dirty work himself. I just wish he would have said something in the beginning to relieve the uncertainty. Something like, "This is Dr. Gulso. I do my own scheduling. Would you like to make an appointment?" He may have to repeat himself a lot in the beginning, but then people wouldn't lie awake at night wondering if that was the doctor or his hard-luck cousin Eddie who needed a break. If only he knew that I am engaging my outstanding brain power on his behalf... He would be so relieved!
To be fair, when I call for an doctor's appointment now, I still ask for an appointment with Dr. Beck, but I also find myself frequently asking, after finding out when the open appointment is for Dr. Beck, if David has anything open sooner. That's a big deal. I don't mind him as a doctor now. But I would still prefer a nod to an invisibility cloak in the hallway.
I'm off to ice and elevate my foot per Dr. Gulso's instruction.
***
Update. The day after:
Dr. Gulso called this morning. He wanted to be sure my foot was doing well, I guess, because I called him yesterday to ask if it was normal for my foot to be in a LOT of pain. Happily, I was able to tell him that my foot feels great. Hooray!
