Monday, February 23, 2009

Why don't patients ask their Doctors questions ?

I recently saw a patient who was very unhappy with the IVF clinic where he had failed his second treatment cycle. Unfortunately, he did not have any medical records of the IVF treatment, because " the doctor keeps all the records, and does not give them". This smacked to me of poor quality medicine, and I told him so. I then had to drill down and extract basic information, including what meds were used for supervulation ; what the doses were; how many eggs were retrieved ; how many embryos were transferred ; and what their quality was.

He looked progressively blank, and did not have a clue as to what the answers were. I was even more dumb-founded than he was, Imagine going through an expensive and time consuming treatment like IVF - twice ! - and not knowing the answers to such basic questions. He became defensive and challenged me , saying - I am sure my doctor knows all this stuff - why should I know any of it ?

I think he did finally realise that his earlier doctor had not been frank and forthcoming, so I did not pursue the matter any further, but it still amazes me that patients will insist on an invoice and a receipt when buying a TV set - but will not ask for a copy of their medical records !

I think it boils down to the fact that doctors can be intimidating and that patients think twice before asking them questions. They are scared of their doctor and do not want to offend him. Their concern is that if they ask too many questions, the doctor will get angry or irritated; and may take offense, because asking questions may suggest that the patient does not trust the doctor.

I think it's important that patients should trust their doctors - but this trust needs to be earned - it cannot just be given away ! In the attempt to not rock the boat, not asking questions can actually end up creating lots of problems, when medical problems occur - as they invariably will, a certain proportion of the time. A patient who has asked questions and received satisfactory answers will be in a much better position to cope with these complications, if they do occur. Good doctors understand this, and encourage questions. Clever doctors have developed a wide range of techniques to raise questions and answer them, without spending a lot of their own time in doing so. These techniques include: providing patient educational materials with FAQs on the web or in the form of brochures; and hiring nurses and assistants, whose primary job is to clarify the patient's doubts.


  1. Anonymous11:32 PM

    Yes, I agree completely. Today I went to visit a doctor, but not my regular doctor, since she wasn't in. I made a last minute appointment because I was having some vague problems, which I was afraid could be related to my kidneys, because I had a proteinuria diagnosis a few weeks prior and middle back pain all day yesterday.
    I proceeded to tell this doctor my symptoms and she asked me some questions. Then she told me she didn't think it was anything serious and wasn't going to do to much about it. Because I had done a little research on the web, I asked some more specific questions related to my pain and she basically made me feel like I was imposing on her time and that I should just trust her final judgement. She didn't seem to want to take the time to explain anything or even listen to my questions. She had just decided that I was one of those hypochondriac patients who was wasting her time; at least, that's how she made me feel.
    Sad really. It made me feel like I should think twice about getting any symptoms checked out, lest I be condescended to and dismissed again.
    Even if it really turns out to be nothing, at least listen to the patient's concerns and answer her questions!

  2. Anonymous9:40 PM

    I asked two questions, both straightforward, but they went through the office personnel, so I do not know how they were presented to the physician.

    I had also asked that the physician call me. (There is no nurse). He did not.

    I was then discharged from the practice.

    Even I find it very hard to believe that I did not "do" something to cause the discharge; but such is the case.

    Sadly, the discharge has affected me very negatively and I became ill from the stress of this 'dishonorable discharge'.

    It is a fallacy that physicians want any questions whatsoever, even the most simple, unless the question demonstrates one's profound admiration for the physician, is not a female, (always seen as trouble waiting to happen - do they all hate their mothers or something?), and is directly related to 100% compliance - keeping as silent as possible is the only way to avoid repercussions, searching the internet to find any place where one can get solace in this humiliation. That, however, does not fix this ongoing, very real problem.

  3. I am sorry you've had a bad experience. Most doctors are empathetic and understand that patients are confused and worried when they are ill. Most good doctors are happy to give their patients a shoulder to cry on , and to answer their queries.

    If your doctor does not do so, this is a red flag - maybe you should consider firing him !


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