Spark [Robert_Klitzman]_When_Doctors_Become_Patients(Boo | Page 59

48 Becoming a Patient Because of such self-doctoring efforts, lay patients may be more straightforward to treat than doctor-patients. Herb added: It was easier for nondoctors to see my role as I saw it, and under- stand: ‘‘Come into the office. Let me treat you like a patient.’’ Docs would say, ‘‘I’m busy; I can’t do it this week.’’ Other patients would say, too: ‘‘I’m busy at work.’’ But I can pull rank on them. With the docs, it was hard to put my foot down. Some talked back. Herb did not feel strong enough in his beliefs about appropriate stan- dards to argue. Practicing ‘‘Research-Level Medicine’’: Aggressive Treatment Many ill physicians not only self-doctored, but approached treatment decisions more aggressively than they standardly would for their patients. Some practiced ‘‘research-level medicine’’—using less proven, experimen- tal treatments that were ‘‘off-protocol,’’ not yet approved for the partic- ular use in question. These behaviors offered insights for lay patients as to what else patients might do if they had the knowledge and professional connections of physicians. For centuries, doctors have self-experimented. But here, this tendency appeared as part of a larger trend: of physicians approaching risks and benefits differently for themselves than for their patients, accepting dif- ferent