How To Break Up With Your Doctor

Discussion in 'Fibromyalgia Main Forum' started by JLH, Jan 29, 2010.

  1. JLH

    JLH New Member

    Breaking Up With Your Doctor

    Is your doctor-patient relationship on the rocks? Find out if it's time to move on.

    Brenda Della Casa had been seeing her primary care physician for two years and had brushed off her concerns about getting rushed care - until she had a health scare she couldn’t ignore. She told her doctor she was experiencing terrible back pain and stomachaches. Her doctor checked her, said she was fine, and sent her on her way.

    Five days later, Della Casa, an author and dating coach in Chicago, was traveling and had pains so severe she could barely move. When she received a voicemail from her doctor saying she had “misread her results” and needed to be treated immediately for a kidney infection, she was furious. “I decided then and there I would never see her again,” Della Casa tells WebMD.

    Breaking up with your doctor is not a choice most people take lightly, but there may come a time when it's the single best decision for you and your health. Some patients have had complaints that have been mounting over the years. Others decide to fire their doctor after one heated episode - perhaps because of a missed diagnosis like Della Casa, a disagreeable interaction, or a health concern that was dismissed.

    "Patients don’t want to break up with their doctor," says Gregory Makoul, PhD, Chief Academic Officer at Saint Francis Hospital and Medical Center in Hartford, Conn. "They will often put up with a relationship that isn’t going great for them."

    But that may be a mistake.

    "It’s critical to remember it’s a relationship," Makoul tells WebMD. "People often think it’s a one-way relationship, but the doctor is invested, too. If you think it’s a business transaction, you’re missing an important part of the picture."

    Wait, Can You Hear Me Now?

    Ann Middleman, a marketing research consultant in Westbury, N.Y., had been seeing the same ob-gyn for more than eight years. During a routine check-up, she was surprised to learn she had gained 10 pounds. When she asked if her thyroid should be checked, her question was dismissed. Instead, the doctor responded, "You eat too much!"

    After the appointment, Middleman wrote a letter to the office explaining that the doctor had been rude and insensitive so she would no longer need her services. "I don’t consider myself too demanding," she says. "I expect somebody to treat me with respect, honesty, and politeness -- someone who talks to me like I'm a human being."

    The most common complaint, when these conflicts arise, is that people feel like they’re not being heard or understood, says George Blackall, PsyD, author of Breaking the Cycle: How to Turn Conflict Into Collaboration When You and Your Patients Disagree and professor of pediatrics and humanities at Penn State University College of Medicine in Hershey, Pa.

    Keep in mind that this is a partnership, Blackall says, where both parties bring expertise to the table. The physician brings medical expertise and the patients bring the expertise of knowing their body and preferences for treatment and care.

    "The core assumption is that both parties are trying really hard to help the person get better," Blackall says. "There are times in a doctor-patient relationship where there are going to be outright disagreements. It's actually quite common."

    So when is it time to fire your doctor? "If you feel in your heart that you’ve given your best effort to build a partnership with your physician and it hasn't happened, then it's time to move on," Blackall says. "If a person decides that it’s time to move on, it should be a conscious choice, not one made out of haste or anger."

    When Your Styles Don’t Mesh

    When Crystal Brown-Tatum, a public relations firm owner in Shreveport, La., was diagnosed with breast cancer in 2007, she sought out a female oncologist. She says she initially found her doctor “pleasant and caring." But as her treatment progressed, Brown-Tatum found her doctor to be too clinical, less compassionate, and desensitized to her needs.

    "I began to dread going to see her," Brown-Tatum tells WebMD by email. So she decided to find another oncologist. The final straw was a scheduling mistake. Brown-Tatum used that as the reason for switching practices, because she didn’t want to hurt the doctor’s feelings.

    “I have no anger toward the doctor,” Brown-Tatum writes. “Her treatment style became more of a personality conflict. At the end of the day, the patient must feel 100% comfortable and confident with her doctor.”

    Cancer survivor and seven-time Tour de France winner Lance Armstrong switched oncologists because he wasn't comfortable with the language the first doctor used to describe his treatment ("I'm going to hit you with chemo... kill you and then bring you back to life."), Gary M. Reisfield, MD, and George R. Wilson III, MD, of the University of Florida Health Science Center wrote in the Journal of Clinical Oncology in 2004. Armstrong found another oncologist whose approach better suited him.

    "There are times when it's just not a good chemistry between people," Blackall says. "You don't hit it off. That's not because they're a bad doctor or you're a difficult patient. It's because your styles are so different you're just not compatible."

    Partnering With Your Doctor

    Medical training and accreditation programs have added communication skills training courses, so the emphasis on communicating with patients today has come a long way from the traditional "doctor knows best" model.

    "We’re not talking about an 'either-or,'" Makoul says. "A patient wouldn't want a great communicator over somebody who is excellent technically and clinically. The point is to be excellent across the board; patients are looking for the whole package."

    Blackall points out that there is emerging research showing that patients with a chronic disease like diabetes who work collaboratively with their physicians may actually do better medically.

    "Let's face it, the stakes are high," Blackall says. "People come in and they're sick and they're suffering. It's very emotional stuff. When patients become upset with their doctor, a common reason is that they're frightened. They're scared they're getting worse and the doctor's not going to be able to help them."

    "Know yourself," Blackall says. "Everyone has different styles when it comes to coping with illness. Be clear with your doctors about what you need from them."

    Signs of a Bad Doctor-Patient Relationship

    If you've been routinely unhappy with your interactions with your doctor, it's time to re-evaluate the relationship. Here are four signs that you may need to move on:

    * You can't get an appointment when you need to see your doctor.

    * You can't trust or be honest with your doctor.

    * Your doctor ignores your questions or dismisses your complaints.

    * Your doctor fails to explain your condition, treatment, or options for care.

    If you do decide to leave your doctor, it's important to make sure your personal medical records, including physician notes, test results, and other relevant medical information are transferred to your new doctor.

    Most doctors’ offices have a release form you can use to request your records. Once you fill out all the proper paperwork, you can usually have the records sent directly to your new doctor, but there may be a fee involved.

    By Jennifer Soong
    WebMD Feature
    Reviewed by Louise Chang, MD