Posted by: notdeaddinosaur | June 2, 2015

When Turnabout is Effective as Well as Fair

I’ve written before about transforming my own preventive care needs (and failings) into an opportunity to help my patients get things done even when their first instinct is avoidance. It happened again the other day.

I’m not good about going to the dentist. Even though they want me there every six months, they’re lucky when it’s once a year. Every now and then, it stretches out even farther. Now is one of those times.

I’m sure many others share my feelings about the dentist. I also know those feelings extend to other preventive services…like pap tests. I’ve had women in the midst of a pelvic exam tell me they’d rather be at the dentist. Can’t say I blame them.

So when I was seeing a lady for a physical the other day, I noticed it had been a long time since her last pap. More than five years, which is the outer limit of the most liberal of the new guidelines for women over 30 with no history of abnormal paps or evidence of HPV on testing. However I tried to slice it, she was due. But she really didn’t want it. Not today.

As it happens, she’s my dentist’s receptionist. So I came up with the following deal:

I told her that when I called her back with her blood test results, I would go ahead and schedule my dental checkup if she would agree to then schedule her pap. She agreed enthusiastically.

I called with her perfect labs. Then at the same time, I scheduled my checkup. And then she scheduled hers.

I guess I’m not the only one not above using the personal in pursuit of the professional.



  1. Great negotiating doc. You took care of yourself by caring for your patient. Whatever works!


  2. Unrelated question for you.

    What are your feelings about when a patient breaks up with you? I love love love my doc, but she’s no longer willing to be an active participant in my care, deeming me too medically complex for even the simplest of complaints. I’m sad about this–we’ve been down a long arduous road together. But seriously, I’m not going to the urologist (or the ED!) for a simple, once a year, UTI that is unrelated to my medically complex needs. I’d also like to be able to take more concerns than my normal EKG tracing to my physical each year. I’ve found a PCP group calling themselves extensivists, basically interested in folks on multiple meds with complex diagnoses and managing their care within a medical home type structure and focused on keeping people out of the ED and out of the hospital that seems to a better choice for me.

    So do I send a note? Thanking her for her help and kindness for the last 12 years? A small handmade gift? I always told her I’d knit her some socks if she’d figure out how to fix me. Most of all, I want her to know I’m appreciative for all of her help. She’ll still be seeing my husband for his once a year BP med renewal/physical.

  3. JAB: Dedicated a whole new post to this…for you.

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