In medicine, as in love, the longer and deeper a relationship, the more difficult it is to sever ties.
With today’s physician shortages and narrowed health insurance networks, breaking up with your physician is certainly hard to do, as it involves transferring your medical records and leaving behind someone who knows some of your most personal information.
Hard to do, but sometimes necessary.
“The pediatrician’s practice we went to had been seeing my son since before he was born,” says Sabrina Williams of Accokeek, Maryland. When Williams took her 5-year-old in due to a range of symptoms uncharacteristic of the normally healthy boy, she felt her concerns were dismissed, and she was told to “let it run its course,” she says.
“I pressed [the doctor] to do more blood tests … I told her if our insurance didn’t cover the cost, we’d pay cash, upfront.” Williams’ requests were brushed off, she says, then flat-out denied.
The doctor-patient relationship is one that depends on trust. The patient is putting his or her health in the physician’s hands, and the doctor, in turn, is tasked with making momentous and potentially life-changing recommendations.
In the past, “doctor knows best” meant these instructions were followed blindly. Now, patients are more active and discerning in their care, with the average American patient seeing more than 18 doctors in his or her lifetime, according to one 2010 survey from GfK Roper.
Communication as a Cornerstone
Communication and decision-making anchor the relationship between a doctor and patient, according to a paper published by the American Journal of Managed Care. “Physician communication style and the tone of patient interactions” and “inclusiveness of the patient in decision-making” are key considerations when choosing a physician, according to the paper.
Having someone who truly hears your concerns is important when it comes to any relationship, but certainly one where your well-being is central. Without good communication between patient and doctor, your health stands to suffer.
“If you don’t feel heard or understood by your doctor, share your concerns with them directly,” says Dr. Jay Harness, a breast oncologist with St. Joseph Hospital in Orange, California, and one of many experts who suggest first voicing your issues directly with your physician. “If he or she doesn’t seem engaged following your discussion, perhaps it’s time to find another doctor.”
Errors, Delayed Treatment and Health Concerns
Still concerned after her interaction with her son’s pediatrician, Williams took her son, who had a pre-existing heart condition, to a cardiologist, who suggested Lyme disease could be behind the boy’s symptoms. Williams returned to the pediatrician and requested additional lab work based on that possibility, but, she says, the request was denied.
Two weeks after his initial appointment, the 5-year-old received a diagnosis, not from his doctor but from an urgent care center — he did, in fact, have Lyme disease.
Errors and delayed diagnoses can be hazardous and even deadly. With Lyme disease, early detection and treatment can reduce the risk of long-term complications such as joint pain, heart problems and neurological effects. Had Williams and her husband trusted the advice of her son’s pediatrician, they may have missed the diagnosis in that first crucial stage of the disease.
“Medical errors could indicate you are with the wrong doctor,” says Dr. Helen Riess, chief scientific officer and director of the Empathy and Relational Science Program at Massachusetts General Hospital. “If your medical tests are not reported to you in a timely fashion, if you are given a serious diagnosis and your provider does not call you or meet with you to discuss it, if recommendations aren’t explained clearly enough so you understand what to do and if there is no follow-up after an important procedure or surgery, you’ll need to find someone who provides more patient-centered and collaborative care.”
Matching Values and Personality
Doctors also may differ in therapeutic approach. A patient may value conservative modern medical interventions and wouldn’t be best matched with a doctor who is aggressive in treatment recommendations. In these cases, finding a doctor who is a personality and value match, or at least one who respects your approach to health management, is also important.
“There is a misconception in American health care that all physicians should take care of all patients. That’s simply not true,” says Dr. Sachin Jain, one of the authors of the AJMC paper and chief medical officer of CareMore, a company offering Medicare coverage. “Patients and physicians vary in their personal style. Oftentimes, there is no good or bad — just different.”
The differences that can send a patient packing could even be cultural or societal, according to the AJMC paper — patients from certain ethnic backgrounds may feel more comfortable and therefore find more successful treatment from a doctor sharing the same background, language of origin or even religion.
When to Stick it Out
The fact remains that finding a new doctor isn’t always easy, and jumping from physician to physician could create gaps and result in less than productive medical treatment.
Reiss, whose Empathy and Relational Science Program at Massachusetts General Hospital helps doctors learn to better communicate with their patients, suggests patients speak up for themselves and communicate their concerns before throwing in the towel.
“Many patients choose to end a relationship because of fear of bringing up an issue to a person whom they view as an authority figure, especially when they are angry,” she says. Verbalizing your dissatisfaction could open up a productive dialogue between you and your doctor; failing to have these talks certainly won’t. These difficult discussions could save you from having to look elsewhere for health care.
If you feel you must move on, communicating your reasons for leaving could put the doctor in a position to better treat current and future patients. So don’t leave without saying your piece — if not to the doctor, then to the office manager, and if not in person, then in a letter or email.
For the Williams family, a compromise made sense. They stayed with the clinic, but chose not to see that particular pediatrician again. No records had to be transferred, and their son and older daughter could continue to see the other doctors to whom they had grown accustomed.
“I made sure that the front staff knew when we made appointments, and I made sure the other doctors knew my frustration,” Williams says. “I hoped it would help them identify Lyme disease in other children and urge them to be more diligent in their diagnosis of it.”
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It’s Not Me, It’s You: When It’s Time to Break Up With Your Doctor originally appeared on usnews.com
