We need to talk. We need to talk about your doctors.
We need to talk about getting those doctors off a pedestal, realizing there are other doctors in the sea, and seeking second opinions and better doctors. We need to talk about respect, and facts, and truth, and, yes, jerkfaces.
Let’s call this Part I: Signs You Need A New Doctor.
Our next installment will be Yes, You Can Get A New Doctor.
Signs You Need A New Doctor.
Your Doctor is Condescending, Rude, or Inattentive
This goes without saying, right? I don’t need to elaborate. But yet I know SO MANY PEOPLE who stick with rude, condescending doctors who don’t listen at all. If you walk out of a doctor’s appointment and can honestly say that you would NEVER stand for being treated that way by a store clerk, your spouse, or your child’s teacher, why on earth are you ok with it just because this is a doctor?
Your Doctor Isn’t Capable of Considering Your Opinion or Ideas
Does your doctor brush aside your thoughts or opinions? Ignore your ideas?
“Hey, doctor, I found this interesting research study that suggests that switching to ferric citrate from ferrous sulfate results in much fewer side effects and greatly enhanced absorption. Also, the National Kidney Foundation’s CE class on managing anemia in renal patients had several portions that were highly favorable of this medication switch. What do you think?” “Hm, I think we’ll just stick with the ferrous sulfate for now. Moving on…”
Yes, as a responsible patient, you should push for further conversation. (See our handy list of questions to help you self-advocate.) If the doctor provides it, that’s great. But you shouldn’t have to push for further conversation every single time. Get a new doctor if this one doesn’t learn that you deserve consideration.
If your doctor doesn’t consider your opinions or ideas even when pushed, though, get a new doctor right now.
Your Doctor Isn’t Capable of Reasonable Conversation
Your doctor recommends something or makes a diagnosis and you’re uncertain. “You know, I was reading up on that diagnosis, but it doesn’t seem to fit. Symptoms include x, y, and z that I don’t have, but don’t include a, b, and c that I do have. Why do you think this is the right diagnosis?”
A doctor worth your time will have that conversation. They’ll answer your questions, they won’t be offended or defensive. They’ll be able to reasonably discuss their thought process.
A doctor who needs to be replaced will get irritated or defensive. Or they’ll pull some variation on “oh, where did you get your medical degree?” Or they’ll disparage the idea of patients self-educating. They won’t be willing to have a reasonable conversation in which they explain themselves and their thought process to you.
If your doctor doesn’t respect you, you need to get a new doctor.
Your Doctor Does Not or Cannot Back Up Their Position With Facts and Research
Let’s pause on this one. Sometimes there just isn’t research. But if that’s the case, a doctor should be able to explain that, and tell you where their recommendations or opinions come from. Often in our own case, Teddy’s doctors can’t pull out a study that says, “kids with this, this, and that have been successfully treated by this other thing,” because there’s literally not one. We have to go by “well, I called a bunch of other doctors and they suggested we try this” or “I don’t know, but logically, this seems like it would be a good option to try.”
But often there IS research. And if a doctor states something as fact, they should be able to back that up. “You said that our options are x and y, but you prefer option x because it’s less risky. How are you quantifying that risk?” “You said that my child needs x, but when I looked at CDC recommendations, they state instead that we should do y. What is the basis for your recommendation?” If they can’t or if they won’t back up their statements, you need a new doctor.
I have most often seen this with women seeking a VBAC (vaginal birth after cesearean). The anti VBAC OB for some reason starts making things up to convince the woman that she can’t have a VBAC, or sometimes they state things like “your chances of x happening are DOUBLE!” which is technically true, but the risk goes from like .03 to .06. Yeah, that’s double, but it’s still REALLY unlikely.
Your doctor threatens to call CPS.
If you have a provider who threatens to call CPS (Child Protective Services) on you and – this is important – you’re not actually putting your child in danger, you need a new doctor. This should go without saying, but first make every effort – including getting a second opinion, and not just from the internet – to make sure that you’re NOT endangering your child. And then get a new doctor.
Let’s back up a bit. You need to be nice. If your doctor suggests a course of treatment with which you disagree, you need to be nice and attempt a conversation. Why do you disagree with that treatment, what alternatives are there that you’d like, why does the doctor recommend this course over the alternatives? It should be a conversation, not an argument, at least on your end, at least to start. If you’re being nice, considering the doctor’s position, attempting a conversation, and are STILL threatened with CPS? You need a new doctor.
(An example that I hear most often with this. Child gets feeding tube. Doctor says child needs formula. Child doesn’t have a medical diagnosis precluding food. Parent says, “thanks but I think we’ll do a blended whole foods diet.” Parent doesn’t back down from this VERY REASONABLE position and doctor can’t back up his position with facts or studies. Doctor falls back on misconceptions like “you’ll introduce bacteria!!” and when that doesn’t work, they use that as a justification to call CPS. They’ve made up a “danger” and then use that as the basis for CPS involvement.)
And the problem here isn’t really that any doctor who would contact CPS with concerns automatically needs to be thrown out. The problem here is with doctors who use CPS as a way to manipulate and bully their patients. You don’t need to be treated so disrespectfully. Make sure you’re in the right, then get yourself a new doctor.
You’ve exceeded your doctor’s expertise
This is another that should go without saying, but yet it does need to be said. Have you just exceeded your current doctor’s expertise? Many doctors in smaller hospitals (even smaller University hospitals – I’m looking at you, UIowa) just haven’t seen a lot of the rarer issues. We’re happy with most of Teddy’s Iowa City doctors, but several of them have only ever seen one kid with one or another of Teddy’s diagnoses – HIM. This is why we’ve sought second opinions or even transferred care for some specialties to larger hospitals. They’ve just simply seen more kids, and seen more kids with his things. It’s not anything against the local guys – but when you work at a smaller hospital, you see fewer rare things – that’s just statistics. If your doctor hasn’t ever seen someone with your issues, go somewhere else if you can, even if you don’t intend to transfer care.
How do you know? Ask. “How many other patients have you treated with this diagnosis? And what is your success rate with those patients?” If it’s less than a handful… really, truly, honestly do yourself a favor and at least seek a second opinion from someone who’s seen a LOT of that diagnosis. Someone who’s conversant with the issues without first hitting up a reference book.
Another way you know? Other patients with similar diagnosis (or parents whose kids have similar diagnoses) will tell you, especially if you ask. Find a group for the diagnosis. Ask. If your doctor or hospital doesn’t have a great reputation for your diagnosis, you’ll find out.
(stay tuned for the next exciting installment in our series – Yes, You Can Get A New Doctor. We’ll be overcoming most of your excuses for sticking with a bad doctor.)
How did you know it was time to replace your doctor? I’ll give some examples from our own lives, and you can leave yours in the comments.
A GI doctor who needed to replace Teddy’s Gtube button, and said Teddy uses a Mini One (brand) button. I said, nope, he uses a Mic-Key, always has. The man looked me straight in the face and said no, Teddy is using a Mini. I pointed out that the button he had and the button the doctor brought in look nothing alike, and I offered to Google what Mic-key buttons look like for his reference. He INSISTED he was right. He was wrong. I let that one go, but in his clinic notes, he put that Teddy doesn’t even use the G-tube for food any more. This topic literally never came up during our appointment. And it resulted in about 6 months of hard work on my end when the insurance company got ahold of the clinic notes and decided to stop paying for his tube feeding supplies (which he was using for 100% of his caloric intake). Yeah, we fired them.
A GI doctor who never had answers for ongoing problems, but wanted to see us every 3 months anyway. Every three months so they could shrug and suggest we try decreasing fiber, or increasing fiber. Fired.
A specialist who first refused to contact Teddy’s nephrologist and cardiologist to make sure their recommended course of treatment was safe for his kidney and heart, and then finally relented and said he would contact them. At the next appointment, he said that they’d never called back. This made me concerned, so I contacted them myself. They reported that they’d never heard from this doctor. Fired.
A specialist who consistently didn’t answer my questions, even when I pressed. Fired.