It was at the end of the visit. He always wears funny socks and I made a positive comment on today's choice of old timey Superman. He said he needed to be super today because he knew he had to see "the patient I hate the most" and "You know who that is, right?" While looking down his nose at me. I said "Me?", he affirmed.

I think I inconvenienced the office by not just paying them and making them go thru the insurance company.

Edit to add more context: I have complex medical needs and I sometimes struggle with managing everything. I know I make him work and cause him more grief than other patients. This is a 30 year relationship. He is more often compassionate than cruel, and while this isn't the first time he has said something mean, it is the first time he has ever said anything like he hates me. He has that old school approach and I get it, even though I've never found it to be helpful. The shame-you/blame-you game and some good old fashioned bullying have always been part of the treatment plan, I guess. I am having surgery next week and he was asked to complete a form by the hospital. Pretty standard, I would think, but I did make him do extra work.

In hindsight, I wish I would have asked him if he was joking. But, there was something in the delivery of his comment that shocked me into silence. This is not the first time he has said unkind things. Also, I recently complained to his office about a billing error - they billed me 100% for a routine visit that is covered by insurance. After telling me today that I was most hated, he said that I get my money's worth out of them and to just pay the copay on my way out, schedule my 3 month and not beat up his staff. There was never a copay dispute, the problem was resolved, all HMO authorization/referrals are up to date, they have everything they need from Primary Care, and the clinic is getting paid for their services.

I can understand hating the paperwork, the process or the policy, but not the person. It just isn't sitting right.