I know from personal experience that most doctors are difficult patients. Fortunately, I have not been sick too often but during my early years as a physician I felt great reluctance to seek medical advice unless things seem pretty bad. But this changed pretty soon for me.

Early in my medical career when I was in the second year of my surgical training in the United States, I needed to go through a surgical procedure to fix a problem with my sinuses. Things got to be pretty bad. Every time I got on a plane, it would feel as if my head was going to explode. The medicine and the physics is a trifle complicated but what it meant was that my sinuses tended to get stuffed up. What happened to me is similar to what happens to little children that makes them cry as the plane gets de-pressurised after takeoff and then re-pressurised before landing.

So, I went through this relatively ‘minor’ procedure under local anaesthesia. Everything went well but in the middle of the night after the procedure I started to bleed requiring an emergency trip back to the operating theatre and some activity on my nose but this time without any anaesthesia. Even though pain was not a major issue but what happened to me illustrated an important reason why doctors hate being treated for a medical problem. The saying among us is that if there is the chance of a complication, it will happen most often to a doctor being treated. So that perhaps is one reason why doctors make bad patients.

We are always worried about complications even of simple and presumably non-dangerous medical therapies. Of course we are much more aware of possible complications because of our medical training. At the same time we are also much more aware about the benefits as I became after my procedure.

The other reason why doctors get into trouble as patients is because of what is called the ‘VIP syndrome’. Doctors get treated too carefully. And overtreatment is often as bad if not worse than under treatment. Here again perhaps my experience with that one time I was hospitalised. The night before the operation a concerned nurse actually woke me up to ask me if I needed a sleeping pill to get to sleep. I don’t think that caused any problems for me from a medical point of view but it did prevent me from getting a good night’s sleep. Over the years I have seen that sort of solicitousness creating problems for VIP patients and for most doctors also. Often it is not just a sleeping pill but an extra antibiotic or an added medicine that might be really unneeded. And as we know, every extra treatment can have a complication including reactions to common medicines.

What then makes doctors particularly bad patients is that we are always worrying about complications. In the old days as a doctor I could order any medicine or treatment and be secure in the knowledge that my ‘orders’ would not be challenged except by a colleague or by a nurse if I had made a ‘clerical’ mistake while writing my medical orders down. This of course is in total contrast with what happens these days when almost every patient has fully researched the medical treatment on the internet.

Patients that have no idea of what is really wrong with them or what the intricacies of expected treatment could be start asking questions. That is inconvenient but not that much of a problem at least in Pakistan as yet. However, when a doctor gets into that mode wherever that might be, that can be quite difficult to handle. That then is one reason that makes doctors bad patients from a treating doctor’s point of view.

Another reason that makes doctors bad patients is that many, if not all doctors, treat themselves often until things get pretty bad. Treating problems beyond your particular area of expertise can be dangerous. Even though I went through a pretty diverse and relatively intense periods of training in different surgical subspecialties, I do not profess any ability to take care of problems in all those specialties. And even if I have a problem that I am presently trained to treat, I still prefer to have somebody else take care of it for me. Fortunately, I have enough colleagues, close relatives and good friends that are doctors and between them they cover most specialties so that I can almost always find somebody I trust and who can help me out and, if needed, take care of me.

Leaving my own experience aside, in my years as a physician I have seen too many doctors treat themselves even when they are out of their comfort zone or area of expertise.

A good illustration is what happened to me a couple of weeks ago. I got pretty sick. Any way, I had just returned from an extended trip abroad and on the way back I spent more than 15 hours in an airplane. As I have mentioned above, my sinuses and airplanes never did get along. A day after I got back to Lahore I developed a serious cough, a persistent fever and I also started to get pretty short of breath. I blamed much of this on my sinuses but consulted with a friend who happens to be a pretty good doctor. Why this incident is worth mentioning is that my doctor friend among the usual problems thought about one particular condition that I had not considered. And that can be a pretty dangerous problem to have.

Long plane journeys are sometimes associated with development of blood clots in the veins of the legs (thrombo-phlebitis) and these clots can travel to the lungs and produce serious problems. I always take reasonable precautions to prevent this from happening but still the timing of my breathing problems so soon after my plane journey worried my friend. On his advice, among other tests and X-Rays, I also got a particular blood test that can help identify blood clots that might have developed inside the body. Without consulting somebody else I would have never thought about getting this test. Fortunately, this test was fine and I did get better pretty soon. It was probably just my sinuses getting reacquainted with the dust of Lahore.

The reason for this entire discussion is the increasing use of the Internet that I have mentioned above. People without any medical training now tend to read up on every medical problem they might have. A pain in the chest becomes a heart attack; a persistently upset stomach can well be a stomach cancer and so on. Physicians easily get overwhelmed by such worries and are often forced to order expensive but unnecessary tests. This is a serious problem when considering the escalating cost of modern medicine. And like doctors every well informed patient now has the ability to become a problem patient.