"Credentials, Google, and Yakult: Three Things Difficult Patients Have Taught Me."

 "Credentials, Google, and Yakult: Three Things Difficult Patients Have Taught Me."

by:

Virgilio F. De leon Jr.MD

Over the years, dealing with difficult patients has taught me many things. Some of them are about medicine. Others are about human nature.

But if I had to narrow it down, there are three lessons that come up again and again.

1. They will try to intimidate you.

“By the way, I’m a manager…”

“Meron akong nurse na kamag-anak sa States.”

“Kilala ko si Doctor So-and-So…”

“Alam mo ba ginagawa mo, Doc?”

“Hindi naman ’yan ang sabi ng endocrinologist ko.”

The funny thing is that, in many of these situations, the intimidation comes after they have already been caught in a lie.

You point out the discrepancy. You show them the evidence. You explain what actually happened.

And then, almost immediately, comes the next attempt at establishing authority.

“By the way, I’m a manager.”

“I have a relative who’s a nurse in the States.”

“I know Doctor So-and-So.”

Apparently, when the facts stop working, credentials—real, exaggerated, or completely irrelevant—must take over.

Funny indeed.

2. They know absolutely nothing, yet demand to school you on something you have literally spent your life studying.

“Doc, sabi ni ChatGPT…”

“Ang galing nung doctor sa TikTok, sabi niya…”

“Cancer daw ito, sabi ni Google, Doc.”

“Alam mo, Doc, depressed ako.”

The internet has done many wonderful things for medicine.

It has also convinced a remarkable number of people that reading three search results is equivalent to medical training.

There is nothing wrong with patients asking questions. In fact, I encourage it. Patients should understand their conditions and participate in decisions about their own health.

But there is a difference between asking questions and insisting that a TikTok video, a Google search, or an AI chatbot has somehow invalidated years of medical education and clinical experience.

Most of the time, I simply let people wallow in their own ignorance.

It is funnier that way.

3. They suffer the consequences of their actions—and then complain about them.

This one is perhaps the most frustrating.

“Hindi ko tinapos yung gamot, Doc. Masakit ulit umihi. Bumalik ba yung UTI ko, Doc?”

“Okay naman na BP ko eh, kaya tinigil ko na.”

“Mahal yung gamot, Doc. Tumira na lang ako ng Yakult.”

You explain why they need to finish the treatment.

You explain why maintenance medication is called maintenance.

You explain that feeling better does not necessarily mean that the underlying problem has disappeared.

And then they stop the medication anyway.

When the problem returns, they come back and ask why.

Medicine is sometimes like that. There are consequences to decisions, and unfortunately, the human body does not always care whether those decisions were made because someone was stubborn, misinformed, or simply trying to save money.

What makes it particularly difficult for doctors is that we are often expected to fix the consequences while simultaneously being blamed for them.

And that brings me to the uncomfortable part.

These interactions are not the reason doctors become doctors. We enter the profession because we want to help people.

But after years of dealing with intimidation, misinformation, self-diagnosis, noncompliance, and patients demanding that you undo the consequences of decisions they knowingly made, the frustration accumulates.

One difficult patient is manageable.

Another one is manageable.

And another.

But eventually, you begin to wonder why you are fighting so hard to help people who seem determined to fight you every step of the way.

And this is why more and more doctors are becoming tired of the profession.

Not because we stopped caring about patients.

Sometimes, it is because caring for patients has become the easiest part of the job.