Things Bad Doctors Say

Mikhail Varshavski, DO, who goes by “Doctor Mike” on social media, is a board-certified family medicine physician at the Atlantic Health System’s Overlook Medical Center in Summit, New Jersey.

While the vast majority of doctors are kind, intelligent, and have a strong moral compass, Dr. Mike has identified seven types who are more like snakes hiding in the weeds. These doctors can be selfish, greedy, ignorant, or just downright mean. Whether they’re trying to sell you their own miracle cure, refusing to perform a physical exam, or judging your lifestyle, these doctors should be sent back to medical school for some extra education.

Following is a rough transcript (Note that errors are possible):

Varshavski: 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.

DOCTOR 1

Patient: Hi, doctor.

Doctor 1: Hey.

Patient: Oh man, I just feel awful.

Doctor 1: Yeah, so do I.

Patient: I think I got the flu.

Doctor 1: Yep. What symptoms are you having? Do you have a fever?

Patient: Yeah, I feel real hot.

Doctor 1: Chills?

Patient: Yeah, some chills.

Doctor 1: Back pain?

Patient: A little back pain.

Doctor 1: Do you have a rash?

Patient: I mean, maybe I have a rash somewhere.

Doctor 1: You have a rash somewhere? We need to shut this down. A Category 4 quarantine. Contact your family. Contact your family now.

Patient: Wait a minute. Doc, hold on, I just got the flu here.

Doctor 1: You said fever, back pain, rash?

Patient: Yeah. Yeah.

Doctor 1: Smallpox. Lock down this ward and contact Billy Bob in the Atlanta office.

Patient: Oh my God.

Doctor 1: We’re going to have ourselves an outbreak.

Patient: Oh my God, I have smallpox

Doctor 1: We’re going to have an outbreak.

Patient: I have smallpox, don’t I?

Doctor 1: We’re going to have an outbreak.

Patient: Oh my God.

Doctor 1: Did you take the train here?

Patient: Yeah, I took the C train.

Doctor 1: The C train?

Patient: Then I transferred to the 7 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. Doctor, I gave that kid smallpox.

Doctor 1: What color was the hat?

Patient: It was red. It’s not in the textbook.

Varshavski: 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 going to make life difficult for the patient and we’re going to miss a lot of the most common-presenting diagnoses. Here is 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.

Varshavski: It’s more likely that you have the common cold or perhaps the flu, but we’ll obviously test you for other viruses and bacteria just to make sure we’re not missing anything.

DOCTOR 2

Doctor 2: Oh, Mr. Harbor, what seems to be the problem today?

Mr. Harbor: Ah, I’ll tell you doc. I’ve been feeling really tired, like really fatigued lately.

Doctor 2: You need this. This…

Mr. Harbor: What…?

Doctor 2: This is my life’s work. This is a vitamin juice-esque potion.

Mr. Harbor: What does it do exactly?

Doctor 2: It fixes it.

Mr. Harbor: It fixes it?

Doctor 2: Immunity, sleep, upsetness …

Mr. Harbor: It fixes upsetness?

Doctor 2: It fixes upsetness.

Mr. Harbor: It looks like there is another label here.

Doctor 2: It’s black label.

Mr. Harbor: Is it FDA approved?

Doctor 2: It’s an FDA-approved building and there is a rental space next door. I’m offering you a one-time, four-payments chance.

Mr. Harbor: What is it?

Doctor 2: It’s a potion.

Mr. Harbor: A what?

Doctor 2: It’s a potion.

Mr. Harbor: A potion.

Doctor 2: A potion.

Varshavski: First, be skeptical if a doctor is 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 is how it should go:

Patient: Hey, Doc. I have been real fatigued lately. Is there a vitamin I could take?

Varshavski: 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.

DOCTOR 3

Doctor 3: Hi, Mr. Grant, how are you? Let’s talk about what seems to be the problem today?

Mr. Grant: Well, I’ve been having some swollen tonsils.

Doctor 3: Swollen tonsils. Okay. What have you taken?

Mr. Grant: Just some ibuprofen, some water, no prescription drugs.

Doctor 3: Did you drink the water?

Mr. Grant: Oh, yeah. I drank the water.

Doctor 3: Why?

Mr. Grant: For hydration, I assumed.

Doctor 3: Yeah? Did you think that helps? You’ve seen somebody for that?

Mr. Grant: No, you’re the first person I have come and seen.

Doctor 3: I’m the first person. You’ve never seen people in your life? I just want to clarify this for the record. You said I’m the first person you’ve seen.

Mr. Grant: You’re the first medical professional I have seen for this condition.

Doctor 3: Any exposures?

Mr. Grant: To what exactly?

Doctor 3: To the exposures. How is your vision?

Mr. Grant: My vision has been fine. It hasn’t been a problem.

Doctor 3: The vision has been fine. Swollen glands with excellent vision, and that’s your complaint today?

Mr. Grant: Could you look me in the eye?

Doctor 3: I’m looking at your chart and I see everything I need to know.

Mr. Grant: Look at me in the eye, Doc.

Doctor 3: I see that you’re a noncompliant patient …

Mr. Grant: Doctor, look me in the eye.

Doctor 3: … who doesn’t take their medication …

Mr. Grant: Look at me, Doctor.

Doctor 3: … and I just don’t want to …

Mr. Grant: Doctor, look at me.

Doctor 3: Frankly, I don’t know why we’re here, but I’m sending you a prescription. It was a pleasure meeting you.

Varshavski: 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 going to miss nonverbal cues and you’re not going to form a healthy doctor-patient relationship, thereby decreasing trust in you by the patient. This is how it should go:

Patient: Hey, Doc. I have got some swollen tonsils, real irritated. I think I might have tonsillitis?

Varshavski: I’m going to 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 4

Doctor 4: We met last year.

Patient: Yep.

Doctor 4: We said we were gonna start an exercise plan. I have it documented.

Patient: We did say that.

Doctor 4: My nurse says still no exercise. What …?

Patient: Well, exercise takes a lot of time and I have been lucky enough to have a pretty full schedule the last year.

Doctor 4: You lied to me. First let’s mark poor patient compliance.

Patient: I didn’t lie to you.

Doctor 4: You said I’m going to start …

Patient: Yeah. I did say that was.

Doctor 4: 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.

Doctor 4: Do you see what you look like?

Patient: Every day when I get up and look in the mirror.

Doctor 4: 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 …

Doctor 4: Gen Z, you want me to make a TikTok dance? Facts. Spinning facts.

Varshavski: 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 and why your recommendations are the way that they are. If you don’t have that, you don’t have anything. This is how it should go:

Varshavski: Do you want to 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.

Varshavski: 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?

DOCTOR 5

Doctor 5: Mr. Bob, it looks like your appendix needs to come out. We need to perform the surgery stat.

Mr. Bob: Oh, no.

Doctor 5: We say stat.

Mr. Bob: Are you serious?

Doctor 5: Serious as a cucumber.

Mr. Bob: Is there another option here? Is there a drug you can give me? A pill maybe?

Doctor 5: Should we run this back? I came in and I said you need surgery.

Mr. Bob: I’m just really afraid of that.

Doctor 5: Are you afraid of no longer living?

Mr. Bob: Yeah, I’m really afraid.

Doctor 5: Yeah, so we need the surgery.

Mr. Bob: Is there like a physical therapy option I could try?

Doctor 5: For your appendix?

Mr. Bob: How long is the recovery period?

Doctor 5: The recovery period is exactly as long as it needs to be.

Mr. Bob: Can I have half an hour to discuss …?

Doctor 5: Half an hour? You don’t have 5 minutes

Mr. Bob: Really? Am I going to die?

Doctor 5: No, but we’re rushing.

Varshavski: If as a doctor you’re going to get mad at your patients every time they ask a question, they’re just not going to ask questions. When you have an uninterested or an unengaged patient, you’re going to have worse outcomes. This is how it should go:

Patient: Oh my gosh. Really? We have to take it out?

Varshavski: Yeah. We do have to take it out. But, look, I’m going to talk you through that entire process. We’re going to 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.

DOCTOR 6

Doctor 6: Mr. Feltwood, how are you?

Mr. Feltwood: I’m doing all right. Except I have a little back pain.

Doctor 6: Lower back?

Mr. Feltwood: I mean, kind of, it’s in a few …

Doctor 6: And it hurts a lot? Sciatica.

Mr. Feltwood: If I lift up my shirt here, you can kind of …

Doctor 6: Why are you lifting up your shirt?

Mr. Feltwood: Well, this is where my back has been hurting.

Doctor 6: I know it’s in the area of sciatica.

Mr. Feltwood: There was something else going on though. So you see my wrist? My right wrist has been feeling a little numb and strange lately.

Doctor 6: Do you have a keyboard?

Mr. Feltwood: Ah, yeah.

Doctor 6: Do you have a keyboard? Carpal tunnel. Google it. You have it.

Mr. Feltwood: Could you look at it, though?

Doctor 6: Am I not looking at it? I’m looking at you. Is your wrist attached?

Mr. Feltwood: If you could just …

Doctor 6: I don’t need to see it. Put the carpals down.

Varshavski: I have seen this one happen way too often. Without a proper physical exam, without visualizing and palpating the area, you’re not going to make a correct diagnosis. You’re just flat out guessing and being lazy. Here is how it should look:

Patient: I have got some back pain and my wrist has been hurting. I looked some stuff up, I think I’ve got sciatica and carpal tunnel.

Varshavski: 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.

DOCTOR 7

Doctor 7: Blood pressure today is 128 over 82. Looks like we got to get the cardiologist involved.

Patient: Whoa, really? Is that high?

Doctor 7: Yeah. You know the heart, the pressure, the cardiologist.

Patient: Well, the reason I came in today is because I have been having some headaches.

Doctor 7: Oh, headaches? For headaches we would get a neurologist on board.

Patient: Is a neurologist really necessary?

Doctor 7: Is your brain necessary?

Patient: Is there something maybe you can do?

Doctor 7: The way you’re talking to me right now, I feel like maybe there is a personality disorder happening.

Patient: Excuse me?

Doctor 7: 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?

Doctor 7: Dermatologist.

Varshavski: Primary care doctors, like myself, are trained to take care of almost all of your medical problems. Unless I’m uncomfortable performing a procedure, I 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. 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.

Varshavski: All right, well, let me ask some red-flag symptom questions to see if it’s anything serious or urgent. If not, we can discuss on the following visit after trying some over-the-counter options.

Mike Varshavski, DO, is a board-certified family physician and social media influencer with more than 17 million subscribers.