The Millstone Times January 2022

Monroe Township News | As We Age What to Do When You Don’t Agree with Your Doctor By Robert Pedowitz, DO

Medicine is part art, part science. While some conditions are relatively easy to diagnose, others are more complex. At times, physicians and their patients may have differing opinions about a diagnosis or treatment plan. So, what’s the best way to express your concerns to your doctor? It’s completely acceptable to disagree with your healthcare provider. Long gone are the days that “the physician is al- ways right.” Now, we want you to be a participant in your care. We value patients’ opinions. While we’re still the clinical experts, it’s important for us to hear—and address—any concerns that you may have.

Establish Trust . In an ideal scenario, you have a physician who you trust; someone who you see regularly and knows your medical history and health goals. Whether you have a long-time, trusted physician or are seeing a provider for the first time, think about your goals and expectations for the visit, and be honest about things like lifestyle habits (smoking, drinking, diet) or your religious beliefs, which can impact your treatment options. Think of it like dating: the conversa- tion shouldn’t be one-sided, with your doctor monopolizing the conversation. Be open and honest about your health and if you’d don’t feel comfortable with your doctor, you should consider switching medical practices. Once trust is established, ask yourself: Do I like this doctor? Do I trust and respect her opinion? Am I comfortable with this treatment? Have all of my options been fully explained to me? Ask Questions . If you don’t understand your diagnosis or treatment options, ask questions. This goes for a complex cancerous tumor or a simple upper respiratory infection. In either case, our job to make sure that you fully understand your condition and our plan for treating it. For example, you have a sore throat and think it warrants antibiotics, but your doctor won’t give you a prescription and says just to rest and drink fluids. Because your sore throat is caused by a virus, antibiotics won’t help, but if your doctor doesn’t explain that to you, you think that he didn’t treat it correctly. Feel free to ask why you didn’t receive the care you had anticipated. I would avoid telling your doctor that he or she is wrong. If you don’t agree with your doctor’s opinion, ask things like, “Why did you prescribe this medi- cation,” “Why do you think this treatment won’t work,” “Why don’t you think that I have XYZ condition,” or “Why did you come to this decision?” There is likely a good explanation for the difference in opinion. If you have concerns, write them down and take some time to think about your top 2 or 3 issues. Your doctor will be put off if you pull out a laundry list of complaints that include everything from the lack of parking near the office to medication side effects that you’re experiencing. Focus on the most important issues first. Be Honest . Tell your doctor if you haven’t followed through with his past advice or treatment, even if you’re embarrassed about it. When a patient says they aren’t taking a medication that I’ve prescribed or haven’t gotten a test I suggested, I ask why. Sometimes the answer is that they can’t afford the medication or had a side effect from it. This is important information for your doctor to know. Another reason for noncompliance can be that the doctor didn’t explain why he or she was advising that treatment or test. Again, we need to know if you don’t understand something. Don’t Rely on Information on the Internet. At your appointment, avoid saying things like, “I already know what’s wrong with me” or “My friend says I have XYZ.” While it’s tempting to try to diagnose yourself, there is a lot of inaccurate medical advice on the Internet. I tell my patients to be discerning about the websites they visit; sometimes sites are funded by a pharmaceutical company that’s trying to push a particular medication or they’re the work of a well-meaning but ill-informed support group manager. Be cautious of the information that you read online. For example, if you’re trying to figure out what’s making you more tired than usual, you could wrongly diagnose yourself with everything from Lyme disease to sleep apnea to cancer. Physicians and other providers have dedicated their lives to medical education. Leave your diagnosis to the experts. If you want to read up on a condition, I recommend the Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), Mayo Clinic, Cleveland Clinic, the Journal of the American Medical Association (JAMA), and the New England Journal of Medicine. When to Get a Second Opinion . I encourage my patients to get second and sometimes even third opinions when they’re dealing with life-threatening cancer or elective surgery. Treatment options can vary widely in these areas, so I provide referrals to specialists, so my patients feel as informed as possible about their options. Be sure to bring your records or have them sent to the new office before your appointment so the doctor has the information necessary to form an opinion. During the first appointment, explain what your doctor had recommended and ask their opinion about her advice: Do I really need surgery? What approach would you take? What’s your opinion about my options? When to Find a New Doctor . If you and your doctor continually don’t see eye to eye, it may be time to find another doctor. Red flags can include: • Pushing a certain treatment or product more than another • Touting his personal views or own products • Not making enough time for your questions or rushing through the appointment • Not being open to all treatment options • Not explaining things thoroughly • Being resistant to hearing other opinions • Being rude or curt As a doctor, it’s my job to provide advice for my patients and guide them toward better health. While I base my clinical decisions on evidence-based med- icine, I don’t know everything. Your path to wellness requires shared decision making between you and your healthcare providers. If you’re not getting that now, get a second opinion—or a new doctor.

32 The Millstone Times

January 2022

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