Thursday, August 08, 2013

Why are patients scared to question their doctor ?

While talking to one of my patients , I wanted more information about her earlier IVF cycle.”  Did you ask your Doctor why he selected that particular dose of HMG injection for your super ovulation? “She seemed puzzled . “ How can I question my doctor ? Isn’t that rude ? Won’t he get offended if I ask him questions ? I don’t want to upset him by challenging his authority ! And in any case, what do I understand about any of these medical terms. Even if he did answer my question , most of it would go over my head so there would be very little point in cross-examining him . And he’s the expert, so I am sure he must know what he‘s doing !”

I think this is a hangover from the good old days when the family doctor knew everything there was to know about the family , and could be trusted to make the right decisions for the patient. In that age , all the medical knowledge was locked up in medical books and journals , which only doctors had access to. There was little patients could do if they wanted to do their own  research .  

When doctors were seen as being a trusted friend , philosopher and guide , it made a lot of sense for a patient to blindly accept what their doctor told them. Patients felt no need to ask their doctor any questions. However, we cannot continue with this archaic attitude , because times have changed. For one, most of us don't even have our own family physician. We are forced to go to a particular specialist, . depending on which particular part of the body is troubling us ! The trouble with specialists is that they have tunnel vision , and since they are very focused on doing what they are good at doing ( just like a man with a hammer will only see nails), their major interest is in doing procedures which are related to the particular organ system in which they have a special interest . They lose sight of the fact that the patient has problems which could originate from another organ system – and they do not understand much about the patient’s personal preferences , since their interaction is episodic and disjointed.

Even more importantly, it  is now possible for patients to do their own homework on the internet , so they can find the information they need in order to be able to have an intelligent discussion with their doctor. Not only is this good for the patient , it's good for the doctor as well . Such patients keep doctors on their toes – and these are the kind of patients who command more respect from the doctor , because they're well informed.

However, some patients still believe that questioning your doctor is rude and inappropriate. In fact , there are still many doctors who take offense when patients ask them questions . They are very good at putting these patients in their place by saying things like – I have spent 10 years of my life studying this problem, so I know everything there is to know about this. How can I explain it to you in 10 minutes ? Others will treat all websites as being full of garbage, because they believe online information is unreliable. Some will become offensive, and will say, “ If you want to ask questions , I suggest you find another doctor ! If you don't trust me , what's the point of coming to me ? “

Doctors who get defensive when they are questioned are not good doctors in my opinion. There is no reason for a doctor to feel threatened when the patient asks questions. Everyone knows that when you are sick , you are likely to have lots of questions , and that it's part of the doctor’s job description to answer those questions and allay your doubts and fears. Any doctor who doesn't do this is not doing a good job .

It’s important that you ask your doctor questions , but it’s equally important that you learn to ask the right questions . There is very little point in having a laundry list of generic questions , because these will just end up just wasting a lot of your precious time with your doctor; and may end up irritating him as well ! After all, if you can find the answers to these questions online , why do you want to waste the doctor’s time in getting him to answer them ? It would be far more efficient and effective to ask specific, pointed questions, which are specifically related to your particular problem.

 A good doctor will encourage questions ; and will also help you to ask intelligent questions , so that you can form an effective partnership which keeps both of you happy with the quality of medical care which you receive. As a patient, it is your responsibility to learn to ask intelligent questions - and it's the doctors responsibility to help you to find answers to your questions !

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