From the physician’s point of view
by DZ Stone, Special to CreakyJoints
In Part 1 of our “How to Leave Your Doctor” series, we focused on the patient’s perspective. The bottom line: a good rheumatologist is hard to find but if you decide you absolutely must leave, know that you don’t have to tell or confront your doctor. If the idea of confronting elicits fear and high anxiety, be aware that you don’t have to say a word. After you find a new doctor, simply request that your old doctor’s office forward your medical records to the new one. That’s all you have to do.
Here in Part 2, we take on more of the physician’s point of view, encouraging you to consider telling your doctor that you are unhappy before you bolt. No one—including physicians—like to be left without a reason. Given the particular intensity of the patient/rheumatologist relationship because chronic diseases such as Rheumatoid Arthritis require long-term care, you may discover that airing your concerns is just what was needed to get you and your doctor on track.
However, if the idea of confronting your doctor makes you nervous because your rheumatologist intimidates you, perhaps this is a good time to remind yourself that in the patient/doctor relationship it is you—not the doctor—who is in charge.
“Medicine is all about you, the patient. You deserve the best care, period,” said Dr. Stephen Paget, MD, Physician-in-Chief Emeritus at the Hospital for Special Surgery in New York City. “Does the power differential seem large, it is—you are the powerful one,” Dr. Paget added.
According to Dr. Paget, you deserve a smart, well-trained and up-to-date doctor who cares for you and about you. Your doctor should also be someone who can understand the feelings experienced by you; is responsive to your needs; educates you about your illnesses and medications; appreciates medical costs and minimizes them; runs an effective and efficient office; works well with the staff and is respected by them; keeps your waiting to a minimum and returns your calls promptly.
“You should be treated just as a doctor would treat her or his own family,” said Dr. Paget.
If you’re thinking, wow this is a tall order for the doctor, keep in mind that the patient/doctor relationship is a collaboration that also requires the patient to take on a partnership role. Your physician cannot do this tango alone.
You need to help your doctor to be your advocate: know your medications, doses, reasons for taking them and side effects; communicate with your doctor about medical costs, report symptoms accurately and in a timely manner; give feedback about your care; be accurate and assertive with messages; let the doctor know who you are personally; be able to get a feel for the doctor’s style and approach; arrive on time and expect the same from your doctor.
“Doctors are not mind readers. Neither are you. If you are unhappy with your care, say so,” Dr. Paget advised.
Say so? Really?
Okay, what if you tried to be the best patient ever but you still can’t overcome the fear and anxiety of confronting your doctor about your care?
Dr. Paget suggests that you consider bringing a family member or friend along as an ally. You should also consider writing out your concerns beforehand and practicing your approach.
Yes, why not get in front of the bathroom mirror and practice just as if you were delivering a speech or presentation. Stand there and say: You don’t take me seriously when I say I am in pain. You never answer my questions when I bring up medications I’ve read about. Your staff is rude. You never answer my calls...
What if you confront your rheumatologist and it ends up one of those speaking-to-a-brick-wall moments?
“Since it is all about you, remember if she or he does not improve, you can change doctors,” Dr. Paget advises.