Dear Primary Care Physician

Dear Primary Care Physician,

I’ve been meaning to write you for a while. I first had the urge to reach out in November of 2014 when I arrived home from the hospital after giving birth to a baby that wasn’t even mine, as I had been a gestational surrogate for a friend. After checking the mail, I found a letter from you that stated your concerns for my last weight check at my last doctor’s appointment and a suggestion that I reach out to your Nutritionist. Although, most women love to have their weight pointed out to them, after 10 months of steadily gaining weight in order to nourish the human growth inside me, I felt annoyed. The letter did not mention that I had actually been pregnant,it just said that my weight was up. Now-I get it-you probably have some automatic ticker that spits out letters of concern when patients at your practice meet certain…..milestones…..but, like, you didn’t even know that I was pregnant? And carrying someone else’s baby? Don’t you get the notes from my other doctor’s?

Speaking of notes from my other doctors….Remember that time that YOU referred me to see the “breast guru” in order to have those pesky little nodules on my breast looked at? Remember that? Even though I actually saw the Nurse Practitioner, she consulted with you because she just wasn’t sure-remember? Remember that? You both weren’t quite sure. I think you probably remember, but maybe not. Let me elaborate.

It turns out that those nodules were actually cancer. Cancer? Can you believe it? I know. I was shocked. I started having all of my doctor’s notes sent to you as well. Because they ask you at your appointments who you want your notes sent to. And you, my Primary Care Physician, you were one of those people I thought should have those notes. Because, in theory, you help manage my health. And did you know, that when you have Stage IV Breast Cancer you are supposed to take all of your illnesses pretty seriously. Like, for instance, if you feel sick, you need to go see a doctor because, of course, you want to make sure the cancer isn’t progressing or anything. You ARE a doctor so you probably DO know that, but I just wasn’t sure because you see, I haven’t heard from you. Like, at all.

I know you know because when my husband went to the same practice because he was sick and ultimately had pneumonia, the Nurse Practitioner mentioned to him that she heard I had breast cancer, so I know that somewhere in your computer system it’s mentioned. But still nothing. I’m wondering if maybe you should develop some sort of automatic ticker for when your patients get diagnosed with a terminal illness, kind of like the weight one mentioned above. I mean, it didn’t seem to take all that much effort to tell me you were concerned that I was getting fat, maybe something similar that says, “Hey sorry you got cancer”. Something simple.

Since you are actually a human being, I’m sure you can sense my frustration and can understand why your behavior is offensive. I found these Emily McDowell Cards for moments like these. They are literally the best cards ever and may offer an explanation for why you haven’t called or written. Except, as an actual Doctor of Medicine, I do hope that part of your education is centered around what to say in moments like these. But you’re old, maybe you forgot. See, I’m willing to give you the benefit of the doubt. A little.


Now that it’s been over 5 months since my diagnosis, I’m worried that the moment has passed. So to save you from any further embarrassment and awkwardness, I’m going to go ahead and find a new primary care physician. You see, I am planning to be alive for quite some time, but I need someone who gets me. Who knows when to say something and when not to. Who sees me as a person and can talk to me about my diagnosis and my needs. So consider this my goodbye. I’m sure you are a great doctor for some people, but not for me.


Maggie Van Duyn


16 thoughts on “Dear Primary Care Physician

  1. I hope you send this Maggie. It seems justified. I am thinking of you and sending strong healing energy your way!!


  2. Way to advocate for yourself Maggie! I’m sure this whole process has been a string of self-advocating moments, but brava for switching to a new primary care doc. When you are investing much of your hard-earned cash in your health, you deserve to have good customer service. I switched to a new OB/GYN practice after I had Sam because when I went in for my 6 week follow-up the doctor (the very same doctor that actually delivered him…and Charley 3.5 years earlier), asked me, “so, how does it feel to be a first-time mom?” I was like, for real? I have been your patient for more than 10 years, lady. Moving ON! It was such an incredible hassle to change practices too – the original practice at first refused to send my file to the new doc, because it was “too big” (that’s 10 years of lady parts appts, plus 2 babies for you…). Then they sent it to a medical file clearing house, which took – I am not kidding – 6 months to transfer to file to the new doc, whose office is literally 2 miles away from the old doc. Hope your transfer process is smooth and simple – you do not need that kind of BS these days!


  3. It sounds like an, “It’s My Turn” op-ed to me . . . something that needs more light than that of an envelope . . . sadly, it happens in multiple ways to many . . . love you, Suz


  4. I’ve been waiting for this read. Can’t help feeling tremendous gratitude for Marlo Thomas and “Free To Be “. One of the best gifts I ever gave to my daughters. So proud you know you have a voice and that you have such talent in presenting what you feel and believe.


  5. Hi Maggie…you also don’t know me; I am a friend of your Mom. I am also a nurse, nearing retirement and, as Gail (who posted above) does, work at UVMMC. All week long I have had similar conversations with some co-workers; it is so disconcerting that at a time when so much is written about what is being done to improve the provision ‘optimal care’, (to put it simply) something so very basic got missed….treating the patient as a respected, important human being. With your permission, I would also love to share your post…on facebook. I totally understand if you’re not comfortable with that.
    I think of you pretty much daily and send positive waves your way….I marvel at your bravery, strength, raw honesty and pure grace…but then, you come from good woman-stock. (o: YOU GO! (as they say)


    1. You don’t know me, nor do I know you mom. (Hope you giggle. ) I don’t know the specifics about your doctor but I am a doctor and a patient whose life got flipped upside down in a similar way. First, I am sorry that you are having to deal with the crap sandwich of cancer. Prayers for you and your family. Second, I too have left doctors that didn’t seem to be able to read the chart before entering the room or were condescending asshats. Third, I wanted to say as a PCP, the system is broken. In the age of Dr Google. People wanting an office visit to be like Burger King and administrators wanting Family docs to rush people through like a fast food joint…well…it’s hard. I so desperately desire a meaningful relationship with my patients because that is where truly good care happens. But it’s being squished, literally between bean counters and dwindling reimbursement…especially in the land of Primary Care. So I am glad you stuck up for yourself, I just wanted to give you the other side. When you have 3-5k patients on your panel, it is hard to keep up. I seriously just assume I need to update my FP every time I see her because I am complex. I know she is slammed and can’t remember everything. Often when I mention stuff, it will spark the memory of her review and I see her every 2-3 months. Regarding, contacting you when finding out you had a cancer diagnosis, often I NEVER get stuff from other offices and drives me batty because the patient doesn’t think I care or know what’s going on. And, honestly, I think you have a good point about being uncomfortable making contact. Some people (I think) just can’t say ‘I don’t know ‘ and are scared a patient will ask them prognosis questions. It’s a shame. I respect doctors who can say, ‘I don’t know but we will figure this out’, then those that try to BS their way through (hence why my neurologist got kicked to the curb!) My point is, have reasonable expectations and I really hope you find a great FP/IM doctor to quarterback your team…that you connect with and trust. Don’t give up, we are out there. Good luck and thank you for your time.


      1. Thank you so much for that perspective! I wish that the patient-doctor relationship was valued more in our society. I know many doctors who wish that they could spend more time with their patients. Maybe something to strive for in the future?


  6. Thank you, so so so much for articulating the last 6 months of frustration that has lingered in my life. I have a rare progressive congenital heart disease that my PCP has ignored and has even DENIED me referrals for a second opinion and a gastroenterologist for a related esophagus issue. Not going to get into it, but basically, yeah, all of this is spot fucking on with my situation. Thank you so much!


  7. I am so sorry that you are going through a tough time but I have a question. Why not just make a appointment with your doctor? Why not advocate for yourself and make a follow up appointment after your diagnosis?


    1. The short answer is I have a million doctor’s appointments to attend and schedule already. In particular, right after my diagnosis I was pretty overwhelmed and trying to cope with the diagnosis, how to talk to my children, starting chemo and learning a new medical language. I guess I want a doctor who is compassionate enough to understand and reach out. I don’t necessarily need an appointment-just a phone call saying “this sucks, how can I help.” Recognition is what I’m looking for. Thank you for reading!


  8. I completely feel your pain and frustration with this. I had my thyroid out due to ‘possible cancer’. My levels went crazy and so did I. I saw my primary and my fiance went with me because I was such and emotional mess due to hormones off the charts. She said my headaches were because I ‘probably had brain cancer.’ My periods were off because I ‘probably had a miscarriage.’ I was emotional because my fiance ‘was abusive’ (least abusive person in my life). She said I needed to see a therapist, have a brain scan, and get scraped. None of this was accurate but I had it all ruled out to be safe. She only drew my vitamin D levels and never checked my thyroid. Saying this to emotional train wreck did not go well. Saw another doctor, they increased my thyroid meds and I was fine, all problems solved. They never checked on me or tried to do a follow up.
    There is nothing my aggravating then being ignored or misdiagnosed. You should send that letter.Hopefully good can come of it and it wont happen to another. I have written mine in my head a dozen times. I find this post empowering and it angers me at the same time.


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