Skill should trump personality when choosing your doctor

Dr Christine O’Malley says the most important factor in choosing a consultant is how good they are at their job, even if their personality might rub patients up the wrong way

“Please choose a consultant for me.”

My ophthalmologist said I needed to see a retinal surgeon about my complex eye problems. She named specialists across the country, and asked who I wanted to see.

I had no idea how to decide. This time I was the patient, not the doctor, and I didn’t want to choose. So she referred me, and I was very happy with her choice.

Many years ago, my sister decided to have sight-correcting surgery. A friend highly recommended his eye specialist. He had worn bottle-end glasses all his life, and the outcome of his surgery was impressive. But a male engineer (without children) probably has different expectations of a doctor.

Accompanied by her small daughter, my sister sat nervously in the waiting-room. On the door of the great man’s consultation room was a sign: ‘Unruly children will be sold into slavery.’ My sister was not amused. Then the patient before her (a woman) emerged, saying “that is the rudest man I’ve ever met!”

The unfortunate receptionist was most apologetic and tried to ease the situation by talking about his great skill as a surgeon.

Then it was my sister’s turn. Usually very mild-mannered, she gave out to the consultant about his waiting-room sign. They had a row. Then he examined her eyes, and said she did not need corrective surgery. She needed surgery for undiagnosed cataracts.

It can be quite difficult to believe a consultant after you’ve had a fight. They nearly had a row in the operating theatre, too. But he is a very able surgeon and did a good job.

I remember when my mother had a life-threatening cancer of her thigh and I accompanied her to see the surgeon and radiotherapist. A GP friend surmised that my mother would like the radiotherapist, known to be very friendly, but would find the surgeon arrogant and ‘godlike’. I knew both men since student days, and probably would have guessed the same.

We were wrong. My mother found the friendly man patronising.

She really liked the surgeon. I was there when, after much deliberation, he outlined his conclusions. He did not have to recommend a horrific amputation. He could completely remove the tumour, perform curative surgery, and she would still be able to walk. But, he added, she might need to use a stick.

I was overwhelmed with relief. Up to this, amputation had seemed the only possibility.

My mother said nothing. He looked at her: “I can see you don’t like the idea of a stick. I’m hoping you won’t need it, but I have to warn you, just in case.”

I’m a geriatrician. My mother was 75. I was shocked and confused by her reaction, but her surgeon wasn’t.

The operation went well and she didn’t need a stick. The following years were good: Among other fun times, my mother navigated a boat (for the first time) through all the locks on the Shannon-Erne river system. She nearly got to the Grand Prix in Barcelona, but her cancer returned.

It was her final illness. Her surgeon said to me: “Maybe I was wrong. Maybe I should have amputated after all.” “No”, I said. “She had three great years. You were right.”

Even the ‘gods’ have moments of self-doubt.

At a party, a friend was talking about his daughter’s experience as a graduate medical student. She was giving out about consultants, especially some of the more arrogant, ‘godlike’ surgeons.

Like the receptionist, usually I would be somewhat apologetic, but talk about their abilities. Not this time. I told him some truths.

It takes all types; different patients like different doctors. We’re not always the best at deciding for ourselves which doctor suits us.

A surgeon’s primary role is to make decisions and to operate. Or to make the equally difficult decision not to operate.

Skill as a doctor does not always travel with the most amenable personality. It’s nice to like your consultant, but personality is secondary.

And who knows what the right personality is?