Everyone wants a “nice” doctor. That is pretty reasonable. If we had a freer market in healthcare, doctors who were not nice would have a poor business even if they were objectively pretty skilled. But we don’t have a free market. Patients can’t freely choose their doctors, doctors absolutely have no choice in their patients, and hospitals have a hard time firing doctors. It would seem everyone is stuck with each other.
Doctors, like everyone else, strategize about how they can have a good day at work. For some, that is reducing liability to the max. For others, it is saying yes to every patient demand to avoid complaints. For some others, it is following dull quality algorithms to the letter so they can reassure themselves that they were adequate that day.
We have manufactured shortages of doctors. Admission rates to American medical schools are in the single digits so that even some of our brightest students fail to gain admission to medical school. Meanwhile, we import hordes of doctors from other countries whose cultures are vastly different and whose education systems are vastly different. Some of them are good, others awful.
There are a few doctors who most would consider normal and reasonable. But virtually every patient would consider himself normal and reasonable. Doctors are under many absurd pressures to do unreasonable things in the name of sham quality measures, ersatz patient satisfaction measures, unrealistic productivity measures. Meanwhile insurance companies drive patient volumes independent of all of those variables, hospitals buy up practices, and patients abandon personal responsibility to the nanny state.
So expecting to show up with a sore throat and receiving a loving interchange with an avuncular and charismatic doctor seems optimistic.
Enter the smiling nurse practitioner.