Podcast transcript

INTRO
Welcome to Docs in a Pod, presented by WellMed. Over the next half hour, Docs in a Pod will educate you about the health and wellness of adults everywhere. Co-hosts Dr. Rajay Seudath and award winning veteran broadcaster Ron Aaron will share information to improve your health and well-being. And now here are Ron Aaron and Dr. Rajay Seudath.


RON AARON
Thank you so much for joining us today on the award winning Docs in a Pod. Our podcast is available wherever you get your podcast, and we're also on the radio in several markets in Texas and Florida as well. Dr. Rajay Seudath, our co-host, is with us today. He's board certified in family medicine. He's a Tampa native and current lead physician for Optum. He's at the university location in Tampa. Dr. Seudath earned his medical degree from the University of South Florida Morasani College of Medicine. We're delighted to have you with us again, Dr. Seudath. Nice to see you, sir.


DR. RAJAY SEUDATH
Thank you so much for having me.


RON AARON
Have you ever been a patient as a doctor?


DR. RAJAY SEUDATH
Yes, of course. In fact, my preceptor at USF became my primary care physician.


RON AARON
We're going to talk about doctors as patients beyond the chart. Stories of connections that happen outside the exam room when doctors become patients. Our special guest is Dr. Melanie Simpson. Dr. Simpson, who is with us today, earned her medical degree from Ross University School of Medicine and Dominican West Indies. Her residency was at Greenville Hospital in South Carolina. She works at the WellMed Florida Network clinic, Premier Medical Associates in Clermont, Florida. She is dedicated and compassionate about primary care. She's also an author. When one book is not enough, I think she's working on three at the same time. Dr. Simpson, great to have you with us.


DR. MELANIE SIMPSON
Thank you so much. My pleasure.


RON AARON
What is it about beyond the chart when doctors become patients that attracted your interest?


DR. MELANIE SIMPSON
A brief story of mine. Years ago when I considered getting pregnant, my husband and I, of course, you get married, and it's kind of like that storyline where you want to have children and expand your family, all of those things. So, I recall a physician coming in who was new, actually, to the area, and he was expanding into the Clermont area. He came in and introduced himself, and we had a conversation and he said, please feel free to refer your patient. So, jokingly I said to him, well, maybe I'll see you sometime as a patient, but I wasn't thinking anything along the lines of the OB portion of it. Long story short, he became my ObGyn.


RON AARON
And did you get pregnant?


DR. MELANIE SIMPSON
I did get pregnant. And I remember when I showed up in his office, he actually looked at me a little surprised because I think initially he was thinking, and of course, Dr. Seudath is smiling, but I think initially he thought I was coming in for a Gyn consult. So, I did not say anything initially. I just went in and I said, well, yeah, you know, I've kind of missed my cycle and I'm just curious if everything's okay. And he looked at me and he said, "You did promise you would come in and see me if you ever got pregnant.” And I said, “Well, here I am.”


RON AARON
That's pretty cool. What are the challenges for the doctor who becomes a patient?


DR. MELANIE SIMPSON
I think some of the challenges are that you think about your own self and from a primary care perspective, you think of the things that you would be expecting to be the questions, the answer, the atmosphere that’s set for it to be comfortable for you as a patient. But sometimes it's a little nerve-wracking, believe it or not. It's not as easy as it sounds.


RON AARON
Nerve-wracking because?


DR. MELANIE SIMPSON
I guess maybe you have preconceived ideas in your head, so you start thinking, okay, I hope they go along this line in terms of the questioning so that I don't necessarily have to kind of force the information out. They make it easy for me. Sometimes you kind of have to steer the doctor in the direction that you really need to get.


RON AARON
So, do you end up second guessing?


DR. MELANIE SIMPSON
Sometimes you do. I think less than you probably would expect to, but sometimes you do.


RON AARON
Dr. Seudath, what's been your experience as a doctor?


DR. RAJAY SEUDATH
Again, my preceptor was my primary care provider, so he kind of just said, okay, kid, present me the patient. So, I presented myself to him. This is a 32 year old male who has a history of familial diabetes coming in with tiredness and increased urination who has not been able to check his sugars. Previously on metformin, has been off his medication for six months. I think he has prediabetes. Needs to get A1C and probably needs to restart his metformin.


RON AARON
And you were asking for a friend.


DR. RAJAY SEUDATH
So, I presented myself and he said, that's pretty good. I would add a few things to that. He went on to say the other things that he might be thinking of. So, that was that experience. It's true that you want to make sure everything in your head comes out in a respectful manner. that you're not challenging them. But as a physician, as a doctor, as a provider, you know when you're dealing with a health care provider, there are the worst patients ever. So, you already know they have something in their brain. So, I often give them the out. I give them the option to tell me what's going on first.


RON AARON
I love this.


DR. RAJAY SEUDATH
I can hear where you're coming from. And then they tell me what they think it is. It's like two lawyers. We both quote prices and we meet in the middle. Well, yeah, we both call diagnosis and we meet in the middle.


RON AARON
Stay with me for just a minute. I want to let folks know who may have just joined us, you're listening to the award-winning Docs in a Pod. Our podcast is available wherever you get your podcasts. We're also on the radio in several markets in Texas and Florida. Our co-host is Dr. Rajay Seudath and our special guest, Dr. Melanie Simpson. By the way, if you are listening to our podcast and you like it, post a review on Yelp and Google and elsewhere. That way you let other folks know that they can tune into Docs in a Pod, and we will appreciate that. We're talking about when doctors become patients. I’m curious, Dr. Simpson, maybe I'm wrong about this, but I would think that as a doctor who becomes a patient, you get a good sense of patient care, of doctors who are more responsive and who are listening. Does that make you a better doctor?


DR. MELANIE SIMPSON
I think it does, but I'll give you another quick story. I had a colleague of mine who asked me to become his PCP, and I said, oh, sure, no problem. We're in the same office, etc. The interesting part of it is I pulled up his chart and he pretty much had given a list of things that he would like ordered and he would like done prior to the consultation. So, I started laughing and I said, well, you can't tell my MA what it is that you need to have ordered and you need to have done because we haven't had a conversation. And he said, oh yeah, but don't worry about it. I kind of know that I need this checked and I need that done and etc. So, you do run into cases like that where the doctor actually wants the doctor himself.


RON AARON
And it's like a lawyer. The worst client you can have is a lawyer who's his own client, and I would guess doctors are caring for themselves is not a good idea.


DR. MELANIE SIMPSON
No. Definitely not.


DR. RAJAY SEUDATH
Very much so.


RON AARON
Now, do they cover that, Dr. Seudath, in med school? Do they explain to you that once you become a doctor, it doesn't mean you can doctor yourself?


DR. RAJAY SEUDATH
There are ethics. We do go over ethics. We go over ethics in a multitude of ways. Typically, the idea is friends and family can be okay in certain circumstances. You have a family member who's visiting, they got bronchitis, you give them a Z pack. That's fine. You have a family member who is on blood pressure medicines, and now you're changing their heart medicines. You're giving them a 90 day supply. That's fringing on the lines of ethics. Same thing for you. You're out of your diabetes medicine, you put in for a 30 day supply until you see your PCP. But if you're writing your own 90 day supplies, that's not appropriate.


RON AARON
Legally you can write a prescription for yourself?


DR. RAJAY SEUDATH
Yes. That is legal. But again, we're getting on the grounds of ethics. That could be something that the board can look at. If something else is happening and they see, oh, this guy, there's an issue of ethics for this particular patient, and now he's writing for himself that kind of built to what is this person's character is? How are they using their license? Are they within the norms of ethics?


RON AARON
So, writing a 180 day supply of opioids for yourself is not a good idea.


DR. RAJAY SEUDATH
Not a good idea. Definitely not.


RON AARON
For doctors, Dr. Simpson, who do become patients, you mentioned that there are some stories of what happens outside the exam room.


DR. MELANIE SIMPSON
I think one of the most important things as a primary care practitioner, and Dr. Seudath probably can allude to this, it's interesting that you are able sometimes to form friendships with your patients. Obviously they are boundaries that you have to protect, but I think it's important to recognize that, yes, even though you may work with a colleague or have someone that you're familiar with in the community that's a practitioner, and you become a patient of theirs, it doesn't take away from the professionalism that needs to be maintained in the doctor patient relationship. But you can expand on that relationship in some instances into an actual friendship. So, sometimes there are moments when you can bounce things off of each other in terms of your practice styles and things of that nature. But when it comes to your own health, taking that into consideration and separating the two, sometimes there's a fine line where you have to tread lightly in that area. Sometimes they'll say, oh, it doesn't matter. Don't worry about it, etc. and it could be to your own detriment. So, that becomes crucial.


DR. RAJAY SEUDATH
Just building on that, it could be to your own detriment. But again, the physician as a patient or the physician caring for another provider, it can also be to that patient's detriment. To that other provider’s detriment.


DR. MELANIE SIMPSON
Yes.


Because if you just take what they say at face value and you don't do a proper investigation, you could be missing something that could harm them.


RON AARON
That's a really good point because the doctor who's the patient may present it to you as his PCP, here's the issue. I know what they are. And you take and run with it.


DR. MELANIE SIMPSON
Yes. And that's exactly what I was making mention of. At the end of the day, you're still obligated to do no harm. Doing no harm goes beyond the friendship circle, if you will. You really have to think about protecting not just your license, but protecting the health of that patient as well. So, that's important.


RON AARON
In fact, that's part of the oath you take. To do no harm.


DR. MELANIE SIMPSON
Yes.


DR. RAJAY SEUDATH
I'll give you a quick piece of advice that I got from one of my other preceptors. He said, Rog, anybody who's got your cell phone number should not be your patient. That was a pretty quick, easy rule of thumb. If they can text you and they can't go through the proper channels, yeah, those channels are there not only to protect them, but also to protect you. I haven't been able to keep to that rule of thumb, because there are some colleagues who became my patients before I knew better, but now, none of them. The other ones are the friends and family. When you're treating friends and family, you've got to give them the friends and family rate, which is to charge them double.


[Laughter]


DR. MELANIE SIMPSON
I agree with you. I would just expand on that really quickly with regards to the cell phone. Recently, because I've had cases where patients are unable to reach you in the office. This is not necessarily talking about just provider to provider. But patients are unable to reach the office. So, you'll say, oh, you're 90 something years old. It's okay, here's my number. You can contact me if you need to. Let me tell you, I had to hit block, block, block, block, block all the way down. I let all of them know. I said, as of this moment, you no longer have access to me in this way. So, I think that's important, too.


RON AARON
Why?


DR. MELANIE SIMPSON
I think one of the things is that it sometimes becomes abused. Even though you desire to be of help and be accessible to the patient, sometimes it could be to your own risk doing so because they'll call after hours. I'm trying to put my daughter to bed. I'm getting texts, and it's not a crisis. It's things that they could have reached me through the office. So, I think that's kind of the thing you have to think about, too, sometimes.


RON AARON
You mentioned phones. Phones can be a problem. If you can't get through to your PCP or to your office, or if you've been sitting on hold for five, ten, 15 minutes with no response, it's very tempting to just go direct if you've got that texting number.


DR. RAJAY SEUDATH
Yep. It's true. I've made it a policy to let patients know I can't give up my number. I inherited my practice. So, when I got out of residency, I joined Optum/WellMed, but the provider whose office I joined, he was retiring that year, so it was a full patient panel. They had known this guy for 30 years, many of them were specialists in the community. So, many of them were like, okay, so when do I get your number? When are you going to give me your cell phone number? I was like, I'm going to lose my job if I do that. I really can't. Part of the job of taking this is I told them I would not take anybody's number. Now, some of them were specialists, and I had to give them my number because I'm texting them for information about our patients. But those patients were already in my panel. I didn’t say, oh, why don't you join my practice? They were already in practice. So, those are the ones I kind of got roped into in that sense. But again, I've seen them as patients as well. Going there, I typically don't tell them I'm Dr. Seudath. Because I want to see what my patients experience when they go to this guy. When I get in the room, they’re like, Rog, what are you doing here? They’re kind of surprised that Mr. Seudath is actually Dr. Seudath.


RON AARON
Are you treated differently?


DR. RAJAY SEUDATH
Yes.


DR. MELANIE SIMPSON
Definitely.


RON AARON
My dad taught me a long time ago when I was making reservations for dinner at a restaurant to use Dr. Aaron, which my dad always did. The reason you do it is, man, you get much better service and you get a table.


DR. RAJAY SEUDATH
Yes. That is true. I'll tell you, I don't like wearing scrubs. I hated wearing scrubs when I was in residency in med school. I like wearing regular clothes, but whenever I go to visit family in the hospital, I always wear scrubs. Always. My grandmother, who was there not too long ago, I went to visit her and she was like, oh, son, are you working here today? Are you working in the hospital? No, nanny. When you go to war, you've got to wear your armor and I'm going to war for you. That's just one of the things. It's true. You do get preferential treatment if they know you're on that side, or if they know you have a higher level of health literacy. I don't often say, hey, I'm a doctor, lay it on me. But you walk in with your scrubs or you drop some of those buzzwords, you know, that Latin, and they go, oh, I see. I see you speaking my language.


RON AARON
We're having too much fun chit chatting, and we need to stop for just a moment. I'm Ron Aaron, and you're listening to the award winning Docs in a Pod.


AD
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RON AARON
We're so pleased you're sticking with us right here on the award winning Docs in a Pod. Our podcast is available wherever you get your podcasts. If you can take the time to write a review about us, we'd love that on Yelp or Google or wherever. Let them know you love Docs in a Pod because that will get other people to listen, and that would be wonderful. We're talking with a couple of really interesting folks, our guest, Dr. Melanie Simpson, and we're talking about beyond the chart when doctors become patients. Dr. Simpson is in the WellMed Florida Network at Premier Medical Associates in Clermont, Florida. We're talking with our co-host, Dr. Rajay Seudath, who's in Tampa with the Optum clinic there. Dr. Simpson, we were talking off the air about how if you look like you know where you're going, you can go anywhere. When a doctor is a patient, they get special privileges if they're in the hospital or if they’re walking into the hospital. Does that affect your ability to provide care for them?


DR. MELANIE SIMPSON
I'll tell you this interesting part. Of course, I started out with talking about getting pregnant and seeing my ObGyn, so it gets better. The day I go to deliver, there are no other patients on that floor who were actually actively in labor. So, I'm on the floor and being treated really nicely by the nurses, but nobody knew I was a practitioner. I get to the point where my water breaks, the doc comes in, I deliver, all of that. The funny part, he goes, congratulations, Dr. Simpson. The nurse turns around and everybody in the room is kind of like, what? It was the funniest part. So, I get on the floor and I'm in recovery and flowers come and all of these things come. I mean, there was such special treatment and it was so funny. The nurse goes, no one told us you were a doctor. And I said it because in this condition it really didn't matter.


RON AARON
Now what's interesting, you got to see firsthand the difference in the response of folks when they discover you're a physician.


DR. MELANIE SIMPSON
Yes. Definitely different. It's a good feeling, obviously, but it is kind of unfortunate because really and truly, we're all patients in our own right who deserve respect, who deserve to be treated with dignity, all of those things. But there's just something about the title that just kind of bumps you up, if you will and puts you in a different category. Almost like a different realm, to be honest, in the way that you're viewed and the way that you're dealt with. I think sometimes people are afraid of doing something that just seems outside of the norm. You'll have nurses who wash their hands a little bit more. I mean, just all kinds of things. Are you okay? Every five seconds, they keep coming into the room and to check on you. I mean, it's just very different. I don't know if Dr. Seudath wants to speak to that, but that's been my experience.


DR. RAJAY SEUDATH
What I would say is, as a person who's cared for other providers, as a person who's been under the care of other providers, you kind of feel that there's a little more scrutiny to my actions. Am I doing it right? Am I doing good enough? I'm sure they feel the same way when they're taking care of me. Am I doing this right? Is this guy looking at my physical exam? Am I getting graded immediately right now? I think everybody has that feeling in the back of their mind. One of the things I wanted to touch on, though, as a provider and caring for providers, is the reluctance to have care.


DR. MELANIE SIMPSON
Yes.


DR. RAJAY SEUDATH
Which is oftentimes quite not what we would expect. The story I'll bring up is it was a nurse practitioner who was in our practice, and she would not have a colonoscopy. She's well past 50. Her father had a colonoscopy at age 97. He had a complication because he was that old, under anesthesia and died during the colonoscopy, and she would not have it. I had seen her for about a year, and then she started to have rectal bleeding. And I said, you have to get the colonoscopy. We are not doing the standard of care. One, we’re not doing the standard of care with your screenings and two, you’re symptomatic. We absolutely have to do this. It was rectal cancer. We caught it early. It had not spread. She had surgery, chemo, and radiation. Every day she comes in, she says, I can't believe it. I still look at myself in the mirror and I say, I could be dead if there wasn't someone who was able to convince me, pull me off of my pedestal and shake me and say, just because you're a health care provider doesn't mean you know what's right.


RON AARON
I had a very good friend who died of colon cancer because he would never get a colonoscopy. And when he finally got it, it was too late. It had already penetrated through his intestines and there was nothing at that point they could do. He was very well-educated. He was a retired police chief working at a high level in the private sector, and he died.


DR. RAJAY SEUDATH
That's part of the issue in caring for other people, caring for people who have their preconceptions and the things that they want. As a provider, I always tell my patients, I'm going to do the best I can within your parameters of your values. It's your values and your goals, and whatever that goal is, we're going to try and meet that goal within the boundaries of your values. And if we can't get to that goal, we're going to get as close as possible.


RON AARON
Now, do you find Dr. Simpson, when you are caring for another physician that you may tend to over-order tests and over-prescribe because you know what they're thinking and what they might want done.


DR. MELANIE SIMPSON
I wish I could tell you yes, but that's a no for me. I think about health care costs, so for me, that would be a no. But one of the things I would say really quickly is, I had an experience where I wanted to get an EKG on someone and the individual said, I don't need an EKG. I don't have chest pain or shortness of breath. I don't have any issues with physical activities. And I said, let's just do the EKG. It’s part of your wellness, whatever. And they hesitated, said, fine, let's do the EKG. So, we did the EKG. Of course they came in several months later and they were complaining of feeling fatigued. So, I said, well, let's do an EKG again, get some labs and try to figure some things out. Here you go with that EKG again. I said, come on. We have been down this road. Let's just go ahead and get the EKG. So, we did. And believe it or not, they had a left bundle branch block. They were actively having chest pain after a portion of time. So, EMS was contacted. The person got airlifted and had bypass surgery.


RON AARON
Wow.


DR. MELANIE SIMPSON
So, every time I would see this individual, they kept saying, you saved my life. You saved my life. I said, no, I listened to your complaint.


RON AARON
That's a great place to end this segment. We are flat out of time, but that's a wonderful story. Thank you, Dr. Melanie Simpson and our co-host Dr. Rajay Seudath. I'm Ron Aaron, thanks for joining us on the award winning Docs in a Pod.


OUTRO
Executive producer for Docs in a Pod is Dan Calderon. The producer is Cherese Pendleton. Thank you for listening to Docs in a Pod presented by WellMed. Be sure and listen next week to Docs in a Pod presented by WellMed.


DISCLAIMER
This transcript is generated using a podcast editing tool; there may be small differences between this transcript and the recorded audio content.

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