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The question

My doctor, whom I have had for three years, does not remember me. Every time I show up for an appointment, she asks me questions that make it obvious that she has no idea about me or my medical file. One time, when I came in for an appointment, she actually asked if I was a new patient. I see her at least six times a year, if not more. This makes me wonder about the quality of care I am receiving. How can I deal with this issue?

The answer

The telltale sign of a poor doctor visit is if a patient leaves the office with significant questions left unanswered. I think your case is far worse: Your physician seems to have no clue who you are and doesn't seem to recall that this has happened more than once.

If her failure to recall you was occasional, I would forgive her; she may be running late or you may have come for a last-minute appointment and she didn't have time to adequately prepare. But if your physician must be repeatedly reminded of your existence and details of your file, it makes me wonder what else she is forgetting.

"We're all run off our feet, we're all busy but there's a problem here," said Garey Mazowita, chief of family medicine at Providence Health Care in Vancouver. "And it's entirely understandable why the patient is not just perplexed but troubled by this."

What Dr. Mazowita finds puzzling is why a doctor wouldn't remember a patient who has a half dozen visits a year, noting "that's a lot of visits. …

"It really raises for me the possibility that there is something going on here," he said in a telephone interview.

What else could be going on? If your physician is elderly, perhaps she has early signs of dementia, but doctor regulatory bodies are usually quick to pounce on that issue before it becomes apparent to patients. Another scenario are work-flow problems due to poor office practices.

At the start of each day, doctors in larger medical practices often have a huddle with their staff about what patients are coming in and for what reason. Given that a very busy day for one doctor involves seeing 40 patients a day, you can imagine how difficult it would be to keep all that information straight without such a meeting.

I agree, you are right to be concerned about the quality of care you are receiving. Doctors require patients to divulge information that can be so embarrassing that many wouldn't even confide it to their spouses. How can you do that with an absent-minded doctor?

You need to get to the bottom of this, and Dr. Mazowita suggests talking to the physician and getting the information "straight from the horse's mouth." If that is too intimidating, talk to the medical office assistant, perhaps with this opening: "The doctor never seems to remember me."

I think you have to put it on the table and see what happens. Closely observe your doctor's response; it will tell you a lot about her ability to deal with tough situations.



The Patient Navigator is a column that answers reader questions on how to navigate our health-care system. Send your questions to patient@globeandmail.com .

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