It’s been a rough week.
Before I get into the bad, let me start with the good (always a good practice, right?) What I love about my (medical practice) job is the medicine itself, and the fulfillment from helping people get better. I love that they share their stories with me, and feel heard, and that more often than not I can do something to alleviate their suffering.
What I HATE about my practice is dealing with patients who feel entitled to stuff they’re not paying for, and who think I should be at their beck and call. Don’t get me wrong—if I know someone means well and isn’t trying to take advantage of me, I will go above and beyond for them, and enjoy every minute of it (especially when they’re grateful)! But this week especially, there’s been an inordinate number of phone calls that went something like this:
“I don’t understand why it’s my responsibility to pay for my labs. I pay for my visits, I pay for my supplements — if the doctor wants to pick up the bill then that’s up to her!” (No joke. I have actually gotten stuck with a couple of bills totaling over $1000 because of the way government insurance companies work, but this was the first time a patient literally EXPECTED me to do it… and cited the fact that she had paid for services received as a reason why she deserved to have me foot her medical bills.)
(To my office manager, or OM from here on out): “You can just go ahead and put the doctor on the phone right now.” OM: “I’m sorry, the doctor isn’t available right now, can I help you with something?” Patient: “Well, just have her call me as soon as she is available.” OM: “I’m afraid she isn’t available between patients—” Patient: “You know what? I am a current patient, and you will have the doctor call me as soon as she is available!” (In case you are wondering if mine is a concierge practice in which patients do, in fact, pay for this privilege — it is not. Nor will it EVER be, for exactly this reason.)
Patient who missed her appointment: “I need the doctor to increase the dose of my prescriptions.” OM: “That was what the appointment was supposed to address, and I’m afraid we can’t change prescriptions without discussing it with the doctor—” Patient: “That is unacceptable! I have only four days left and I need my prescriptions refilled. Period!” (I told my office manager to let her know we would refill her current prescriptions, but would not increase her dose without an appointment. Period. Then we sent her a missed appointment fee.) 🙂
My office manager walked into my office after all of this today and told me she was on the verge of an anxiety attack. So we had a little meditation break, and just made people wait for us to finish. I told her the fact that we even have this problem is my own fault: I was the one who had trained my patients to think this kind of behavior was acceptable, and what you put up with is what you end up with.
But seriously, what is with this, “I want it and I deserve it and you should give it to me now” mentality?
Entitlement and Narcissists
According to Google, entitlement is “the belief that one is inherently deserving of privileges or special treatment,” while narcissism is “extreme selfishness.”
Kind of sounds like a two-year-old, doesn’t it?
Most of the psychology research I’ve found on this topic suggests that the culprit for this has been a chronic lack of boundaries. Kids are inordinately praised, not for good work, but for the fact of their existence. The government hasn’t helped either — more and more government programs have led people to believe that it’s someone else’s job to take care of our needs, rather than our own. Someone else is always to blame for our problems — if I don’t do well in school, it’s the teacher’s fault. If I don’t have enough money, it’s society’s fault. If someone tells me no, they’re mean and bad. If they tell me yes and give me what I want, then they’re good! (This of course leads to reinforcement of the behavior in question: I vote for the politician who promises me free stuff for nothing. I punish my parents for denying me what I want, and praise them for granting me instant gratification. And the cycle continues.)
Dr Jean Twenge of San Diego State University apparently had over 16,400 students take the Narcissistic Personality Inventory between 1982 and 2006. In 1982, 1/3 of them ranked in in the narcissistic category (which is still pretty scary). In 2006 that number was over 65%! (What is it today I wonder?)