You and your doctor. Does being assertive ever come across as being combative?

Dr Gary
By Dr GaryCA Latest Reply 2015-03-17 22:39:02 -0500
Started 2015-01-09 12:58:09 -0600

Recently, one of my clients had a bad experience at her doctor’s office. She waited well over an hour. She felt the doctor was dismissive when she brought up a symptom she was experiencing. And when she reviewed the charges to the insurance company, she questioned one of her doctor’s charges.

She decided to let him know exactly how she felt about the way things had gone.

And guess what happened? He fired her as a patient.

I think that few people would disagree with the current thinking that patients benefit from taking responsibility for their own healthcare. Even doctors agree. Among other things, taking more responsibility means making the best use of the time you have with your doctor. Doing your own research on your condition and its treatment so you can ask your doctor questions. Keeping all of your doctors in the loop on medications. Making sure you stay on top of test results.

Communication with your doctor is an important part of getting the best possible care.

A question: Are there are times when the best approach is the direct approach? And are there times when it’s best to let something go?

Here’s a link to an article I posted awhile back:

http://www.diabeticconnect.com/diabetes-infor...

Is it ever advisable to take a step back and consider your perspective before you act? In other words, is your frustration or anger at your doctor based on an ideal world and the real world in the current healthcare environment?

Do you feel like you have to “manage” the relationship with your doctor? What you say but also how you say it?

Or do you feel like you can speak freely and openly at all times?

I’m really interested to know your thoughts and experiences on this topic!


92 replies

gatp
gatp 2015-03-15 21:45:17 -0500 Report

I wrote some things down for my doctor because I can't remember them when I am under pressure. He took my note and without looking at it, dumped it in the wastebasket. Not sure I feel as if he really cares.

Dr Gary
Dr GaryCA 2015-03-17 22:39:02 -0500 Report

Hey gatp, WOW, that was really pretty nasty, it seems to me. Did your doctor tell you why he was doing that? Just amazing. I am sorry this happened to you.

TsalagiLenape
TsalagiLenape 2015-01-14 00:36:28 -0600 Report

Well with the majority of my new doctors ( I moved to Missouri ), I can be open and speak freely. None of them treats me as the village idiot like the one doctor who has some kind of inferiority complex with himself and everyone else around him. He thinks he is GOD. Well guess what buddy boy let me tell you what LOL The methadone prescribed by you isn't good for me. I have over 3 to 4 side effects like disorientation confusion suicidal thoughts. LOL Actually that is true. So now we are back at square one. Where I cant sleep right now due to pain and tomorrow I have a fasting glucose blood drawl. I know my A1C's aren't going to be better. But I am getting out that nonsense of despondency. I am now getting back on track with positivity thoughts and etc. Most of the time I "manage" my diabetes. If I fail to do what I say I will do before my meds are changed, then I have to suck it up. LOL But I will keep my promise. Mind you with $80 co-pays and paying for all my meds $230, I would say so eh? LOL Have a great day!:) Keep calm and carry on!

Dr Gary
Dr GaryCA 2015-01-14 15:54:00 -0600 Report

Hi TsalagiLenape! Always great to hear from you. I appreciate your empowered attitude. Your post is another example of how patients really need to let their doctors know how they are feeling, to really stand up for themselves. Side effects can be not only uncomfortable but dangerous, as you said. Glad you are staying optimistic! That's excellent. Wow, those copays are really high, so sorry to hear that. All the more reason to make sure you are getting the best care possible. Thanks for checking in, my friend!

Gavia
Gavia 2015-01-12 18:25:33 -0600 Report

I had a similiar situation with my old PCP. Turns out I wasn't the only over 40, overweight, educated woman he had trouble dealing with. I live in a small town and found out several of my female friends also felt he was belittling and dismissive in attitude. So we all made complaints to the parent medical system patient advocate. Given the number of complaints, he was let go and now we have a great PCP in town. Ask your friends and co-workers about their experiences with their doctors and use their info as a starting point to find a new dr.

Dr Gary
Dr GaryCA 2015-01-14 15:44:31 -0600 Report

Hi Gavia! This is a really interesting story. Thanks. Sometimes, doctors just have a bias against certain types of patients. It is there problem, and not yours. Nevertheless, the patient bears the brunt of it. Glad to hear you and the others made your report and got someone new in the job. Great idea to make it a group effort.

Dr Gary
Dr GaryCA 2015-01-14 15:42:02 -0600 Report

Hi Gavia! This is a really interesting story. Thanks. Sometimes, doctors just have a bias against certain types of patients. It is there problem, and not yours. Nevertheless, the patient bears the brunt of it. Glad to hear you and the others made your report and got someone new in the job. Great idea to make it a group effort.

DiabetesSuperGrl
DiabetesSuperGrl 2015-01-12 16:16:52 -0600 Report

I'm actually kind of surprised that the doctor fired the patient…don't doctors work for US? Do we (or our insurance companies) pay them to work for us? It doesn't always click with the first doctor you get. I have 9 docs that I see regularly, due to a lot of complications of T1. Some I didn't like right away, some I've replaced, some we just came to a mutual understanding from the beginning. I feel like it has to be a relationship of mutual respect, at the very least. We have to feel comfortable with communicating what we need to, in order to help our doctors treat us accordingly. I had a situation with my PCP where a blood pressure med that she had prescribed was sending my blood sugars off the charts. She and I argued back and forth, through a nurse, for 3 days…she was convinced that I was wrong about it being the cause because SHE had never heard of such a thing. I finally had to get mad about it and made her actually talk to me, not through a nurse. She finally took me off of the drug, my sugars returned to normal and as a result, we actually have a much better relationship. She listens to me much more than she used to and we communicate with each other directly. Its a team effort and if you have doctors that do not see it that way, its time to kick them off of the team.

Dr Gary
Dr GaryCA 2015-01-12 17:03:39 -0600 Report

Hey DiabetelsSuperGrl, nice to see you! Thanks for checking in with us. As you said so well, it can take time to build a good medical team, with some ripples along the way. That is quite an amazing story about the PCP, unfortunately one that I have head before. I had a similar experience myself. Doctors often have a fallback position of assuming they have all the answers. And sometimes patents have to remind them that we know our own body and know when something isn't working right. I hope your doctor took that lesson to heart. Sounds like the two of you got through a rough patch and have a better relationship as a result. Great! I hope you will stay in touch with us!

MaryYouBetcha
MaryYouBetcha 2015-01-12 12:37:14 -0600 Report

Hi! I had to "wade" through a couple of endocrinologists before I found one that recognized I might know about what was causing my own symptoms. This happened when I was having problems with hyperparathyroidism and was feeling terrible because of it. Two endos completely dismissed me and said that I wouldn't feel any different if I had hyperparathyroidism and they would only consider surgery if I had bone density problems. I finally went back to a great endo I had when I was first diagnosed with T2 diabetes years ago. He scheduled me for scans and then surgery and I experienced a great relief in fatigue and other symptoms. (Surgeon still insists that this was all a placebo and that I can't possibly feel any different - sheesh!)

I kept this endo for my non-controlled Type II D after this experience. Unfortunately, he and I are having to work through an extreme reaction I had to metformin (see a post I made under Oral Medications) and so I'm struggling with very high A1C's right now but he still listens to me and has many creative solutions to some of my previous diabetes problems (for instance, high BG's in the morning after fasting - the same as I've read here but no other doctor told me).

So, point of all this is that being up front with your doctor is very important but even more important, I believe, is finding a doctor with whom you can be up front. After the first two endo's I saw, I went home and cried. I also made sure I made comments to the clinic manager and doctor/patience liaison about how I was treated. I am part of an "HMO" (they call them managed care systems now) and there is usually a way to give feedback on both good and bad treatment.

I don't believe in doctor swapping (in order to get the answer I want) but I do believe in trying new doctors until I find one with whom I can communicate. That's how I found both my endocrinologist and my CNP (my primary care "doctor").

Dr Gary
Dr GaryCA 2015-01-12 15:58:09 -0600 Report

Hey Mary, really nice to meet you. I really appreciate your honest response, and your wisdom here. Sounds like you have had some physicians that weren't very patient-centric, Glad to hear you weren't afraid to advocate for yourself and to get connected with doctors that you can communicate with, who will talk to you and listen to what you have to say, and take you seriously. There is a lot to be said for a doctor who will admit that something isn't working and work with you to get to a better solution. Thanks for jumping into the conversation. And stay in touch!

Stuart1966
Stuart1966 2015-01-11 19:27:49 -0600 Report

They are solely a business and nothing more.

Yet they hold both the ability and the capacity to do irreparable harm to us, if we do not obey, literally.

In five decades "White Coats" acting in MY best interests I scoff with bitter laughter, choking on the concept,

I have never met a single one, not one. I have been taught bitterness by their interactions. "Manage", you better believe it… no I have no need to see you clown, there is nothing, zero to be gained on my end, but you refuse to issue the script(s) for the insulin, syringes that keeps me alive, unless I do so?

I am your prisoner, we are never equals.

Disagree, have an informed difference of opinion… we get threatened for them. Seething contempt born of scars "white coats" inflict.

An ideal world, not remotely. There is no relationship except a financial one. A entirely one way relationship, to which we are all soldered-chained unwillingly.

No thank you, gladly prefer to swim in a pool with a great white shark, in a hamburger swim suit. I know what to expect with a great white shark.

Dr Gary
Dr GaryCA 2015-01-12 15:24:40 -0600 Report

Hey Stuart,

I remember that you have not had the best experiences with doctors, to say the least. The power balance between doctors and patients is certainly there, narrowing only very gradually over time. Thanks for jumping in here with your own experiences.

Stuart1966
Stuart1966 2015-01-15 13:25:55 -0600 Report

I genuinely wish I had rainbows and kittens to share re: my experiences. In total candor I would give anything to erase the night terrors, I endure.

Ever been outright blackmailed by doctors? I have openly, and very bluntly. Not an endo, not an expert in things diabetes it did not inhibit or prevent her on any level. I can list chapter and verse, a dozen experience exactly like it in nearly fifty years, people with "supposed" medical degrees, entirely dead wrong.

When we stand up, and quietly point out their potentially lethal mistakes, it never ends well.

We are enslaved, and very much at their mercy. As people, I liked several of them. But the relationship were & are financial which I have endure.

Dr Gary
Dr GaryCA 2015-01-15 21:08:39 -0600 Report

I understand. Really sorry to hear this. Another reason why patients really have to advocate for themselves, to do their own research and to not hesitate to question.

Stuart1966
Stuart1966 2015-01-15 13:25:54 -0600 Report

I genuinely wish I had rainbows and kittens to share re: my experiences. In total candor I would give anything to erase the night terrors, I endure.

Ever been outright blackmailed by doctors? I have openly, and very bluntly. Not an endo, not an expert in things diabetes it did not inhibit or prevent her on any level. I can list chapter and verse, a dozen experience exactly like it in nearly fifty years, people with "supposed" medical degrees, entirely dead wrong.

When we stand up, and quietly point out their potentially lethal mistakes, it never ends well.

We are enslaved, and very much at their mercy. As people, I liked several of them. But the relationship were & are financial which I have endure.

Stuart1966
Stuart1966 2015-01-15 13:25:36 -0600 Report

I genuinely wish I had rainbows and kittens to share re: my experiences. In total candor I would give anything to erase the night terrors, I endure.

Ever been outright blackmailed by doctors? I have openly, and very bluntly. Not an endo, not an expert in things diabetes it did not inhibit or prevent her on any level. I can list chapter and verse, a dozen experience exactly like it in nearly fifty years, people with "supposed" medical degrees, entirely dead wrong.

When we stand up, and quietly point out their potentially lethal mistakes, it never ends well.

We are enslaved, and very much at their mercy. As people, I liked several of them. But the relationship were & are financial which I have endure.

Stuart1966
Stuart1966 2015-01-15 13:25:27 -0600 Report

I genuinely wish I had rainbows and kittens to share re: my experiences. In total candor I would give anything to erase the night terrors, I endure.

Ever been outright blackmailed by doctors? I have openly, and very bluntly. Not an endo, not an expert in things diabetes it did not inhibit or prevent her on any level. I can list chapter and verse, a dozen experience exactly like it in nearly fifty years, people with "supposed" medical degrees, entirely dead wrong.

When we stand up, and quietly point out their potentially lethal mistakes, it never ends well.

We are enslaved, and very much at their mercy. As people, I liked several of them. But the relationship were & are financial which I have endure.

Stuart1966
Stuart1966 2015-01-15 13:23:08 -0600 Report

I genuinely wish I had rainbows and kittens to share re: my experiences. In total candor I would give anything to erase the night terrors, I endure.

Ever been outright blackmailed by doctors? I have openly, and very bluntly. Not an endo, not an expert in things diabetes it did not inhibit or prevent her on any level. I can list chapter and verse, a dozen experience exactly like it in nearly fifty years, people with "supposed" medical degrees, entirely dead wrong.

When we stand up, and quietly point out their potentially lethal mistakes, it never ends well.

We are enslaved, and very much at their mercy. As people, I liked several of them. But the relationship were & are financial which I have endure.

Stuart1966
Stuart1966 2015-01-15 13:23:07 -0600 Report

I genuinely wish I had rainbows and kittens to share re: my experiences. In total candor I would give anything to erase the night terrors, I endure.

Ever been outright blackmailed by doctors? I have openly, and very bluntly. Not an endo, not an expert in things diabetes it did not inhibit or prevent her on any level. I can list chapter and verse, a dozen experience exactly like it in nearly fifty years, people with "supposed" medical degrees, entirely dead wrong.

When we stand up, and quietly point out their potentially lethal mistakes, it never ends well.

We are enslaved, and very much at their mercy. As people, I liked several of them. But the relationship were & are financial which I have endure.

Stuart1966
Stuart1966 2015-01-15 13:22:58 -0600 Report

I genuinely wish I had rainbows and kittens to share re: my experiences. In total candor I would give anything to erase the night terrors, I endure.

Ever been outright blackmailed by doctors? I have openly, and very bluntly. Not an endo, not an expert in things diabetes it did not inhibit or prevent her on any level. I can list chapter and verse, a dozen experience exactly like it in nearly fifty years, people with "supposed" medical degrees, entirely dead wrong.

When we stand up, and quietly point out their potentially lethal mistakes, it never ends well.

We are enslaved, and very much at their mercy. As people, I liked several of them. But the relationship were & are financial which I have endure.

Stuart1966
Stuart1966 2015-01-15 13:22:32 -0600 Report

I genuinely wish I had rainbows and kittens to share re: my experiences. In total candor I would give anything to erase the night terrors, I endure.

Ever been outright blackmailed by doctors? I have openly, and very bluntly. Not an endo, not an expert in things diabetes it did not inhibit or prevent her on any level. I can list chapter and verse, a dozen experience exactly like it in nearly fifty years, people with "supposed" medical degrees, entirely dead wrong.

When we stand up, and quietly point out their potentially lethal mistakes, it never ends well.

We are enslaved, and very much at their mercy. As people, I liked several of them. But the relationship were & are financial which I have endure.

Stuart1966
Stuart1966 2015-01-15 13:22:22 -0600 Report

I genuinely wish I had rainbows and kittens to share re: my experiences. In total candor I would give anything to erase the night terrors, I endure.

Ever been outright blackmailed by doctors? I have openly, and very bluntly. Not an endo, not an expert in things diabetes it did not inhibit or prevent her on any level. I can list chapter and verse, a dozen experience exactly like it in nearly fifty years, people with "supposed" medical degrees, entirely dead wrong.

When we stand up, and quietly point out their potentially lethal mistakes, it never ends well.

We are enslaved, and very much at their mercy. As people, I liked several of them. But the relationship were & are financial which I have endure.

Stuart1966
Stuart1966 2015-01-15 13:22:04 -0600 Report

I genuinely wish I had rainbows and kittens to share re: my experiences. In total candor I would give anything to erase the night terrors, I endure.

Ever been outright blackmailed by doctors? I have openly, and very bluntly. Not an endo, not an expert in things diabetes it did not inhibit or prevent her on any level. I can list chapter and verse, a dozen experience exactly like it in nearly fifty years, people with "supposed" medical degrees, entirely dead wrong.

When we stand up, and quietly point out their potentially lethal mistakes, it never ends well.

We are enslaved, and very much at their mercy. As people, I liked several of them. But the relationship were & are financial which I have endure.

Stuart1966
Stuart1966 2015-01-15 13:22:01 -0600 Report

I genuinely wish I had rainbows and kittens to share re: my experiences. In total candor I would give anything to erase the night terrors, I endure.

Ever been outright blackmailed by doctors? I have openly, and very bluntly. Not an endo, not an expert in things diabetes it did not inhibit or prevent her on any level. I can list chapter and verse, a dozen experience exactly like it in nearly fifty years, people with "supposed" medical degrees, entirely dead wrong.

When we stand up, and quietly point out their potentially lethal mistakes, it never ends well.

We are enslaved, and very much at their mercy. As people, I liked several of them. But the relationship were & are financial which I have endure.

Stuart1966
Stuart1966 2015-01-15 13:19:06 -0600 Report

I genuinely wish I had rainbows and kittens to share re: my experiences. In total candor I would give anything to erase the night terrors, I endure.

Ever been outright blackmailed by doctors? I have openly, and very bluntly. Not an endo, not an expert in things diabetes it did not inhibit or prevent her on any level. I can list chapter and verse, a dozen experience exactly like it in nearly fifty years, people with "supposed" medical degrees, entirely dead wrong.

When we stand up, and quietly point out their potentially lethal mistakes, it never ends well.

We are enslaved, and very much at their mercy.

Edie
Edie 2015-01-11 05:04:20 -0600 Report

I have said this before. Back in December 2010 on the 3rd I had ruin out of my Lantus and Humalog and decided to quite both till I could lose some weight that I much needed to get rid of. My Dr at the time said I needed the Insulin to keep my sugar under control but I knew that if I did not get rid of some of my weight I would die in the not to distant future I just felt it. So I told him give me a chance to lose some of the weight and if by my 50th Birthday I didn't lose atleast 10 pounds I would go back on the insulin and not Bitch. Well on Valentines Day he again pushed for me to go back on the Insulin and when I asked him what did he not understand about the weight loss I was trying to do, no insulin till July 31st if I didn't lose any weight. Well another Drs. apt was coming up so I started looking for a different Dr. when I went into the new Drs office I was interviewing him first. With my attitude as it is I didn't care what they thought of me at the time and still don't I have a right to get to the bottom of this disease and I am not going to stop being me. My Dr told me he likes me taking the lead in my care as it keeps me being honest with myself. It is hard some times to keep going but we all need to no matter what. I am now under 200 pounds and have been for 2 months now. My highest Weight was 268 on Dec. 03,2010 and now I am 199 so that is 69 pounds lighter. I just went back on Insulin on July 31,2014 I am still on the Victoza so the Weightloss is still moving down the scale for me it is going slower now that the cold weather is here but it is still moving down. I was thinking of starting my Discussion on Weight loss again for us to talk about what we are doing or not doing to get where we want to be like I did last year and the year before.

Dr Gary
Dr GaryCA 2015-01-12 13:15:33 -0600 Report

Hey Edie, great to see you again, my friend. And thanks a lot for sharing this with us. I really admire your empowered attitude, the way you took charge of your self-care and accomplished that amazing weight loss, as well as the way you communicated so directly with your doctor. I am glad to hear the second doctor was able to really hear you out and recognized that patient empowerment can benefit both the doctor and the patient. Glad that you are doing what you need to do to take the best possible care of yourself, including both the insulin and the continued attention on weight loss. I know it's not so easy during the winter months. I think starting a discussion on weight loss is a great idea. It's a topic that is always important. Thanks again. And I hope you will stay in touch with us!

Edie
Edie 2015-01-18 19:29:05 -0600 Report

I was going out to bring in Chloe last night and with all the ice in the yard I fell then tonight when I was trying to bring in her tie out with all the ice I couldn't get it to let go for me so tomorrow when it is daylight I will try to move the ice to get to the tie out to move it up to the porch until the weather clears later.

camerashy
camerashy 2015-01-10 10:18:17 -0600 Report

Fortunately, I have 2 doctors who respect me and listen to me, and are really helpful in respect to my problems. One of which, right now, is having trouble controlling my glucose level. I didn't know that stress could be so wicked!

Dr Gary
Dr GaryCA 2015-01-12 16:59:02 -0600 Report

Hi camerashy, good to know you have a team in place to help you with this. I hope you are able to get the glucose under control soon. Yes, stress can really toss you around. Take care of yourself!

Kats49
Kats49 2015-01-10 10:10:06 -0600 Report

I have that issue with my PCP. I see three specialists so normally do not have to deal with the office anymore than needed. I was recently hospitalized my PCP came into the ICU and said I don't think you are a patient with us anymore we haven't seen you in 18 months. I said no worries I am sure another PCP can be found. He backed off and said while you're here might as well treat you. He has a good personality, but he is mistaken on so many issues. He has strong affiliations with the hospital I was at. However, since I have medicare and health insurance through my employer…i do not have to use his office to see the specialists. So, do I manage the relationship? Yes. Not sure if after 30 years it is worth the hassle of moving all my records…The best thing was that the nurse who was in the room with me was not happy at all with his attitude. She validated my shock. Here I am struggling to breathe and his bedside manner really sucked. ALL of my specialists are the best I have ever had in my life. My endocrinologist has helped me in the last five years manage my diabetes ten times better. I have access to her even over the weekends if I need help. I simply call in my numbers and voila by the end of the day if not sooner the solution is at hand. She also has been in practice for over 35 years, however she focuses on one thing only. Me the patient. She has standing rules,,,shoes off before she comes into the room. I like her organization. The LAST thing I need when ill is to have a doctor who screws me up worse than before I came in. I have to be actively involved with my healthcare. Proactive preferably. I want to be around to watch my grandchildren grow and learn and those four great grandchildren as well. Life is too beautiful to give up. Sharing my wisdom with the younger generation is what helps keep me alive.

Dr Gary
Dr GaryCA 2015-01-12 16:57:38 -0600 Report

Hey Kats! Wow, that was some attitude you got directed your way! A good example of how patients have to speak up for themselves. It sounds like you have over time got connected with doctors that you do like and that you can communicate with. Your endo really sounds like a gem. It takes time to build relationships, and being empowered. Excellent!

Skatinlayton
Skatinlayton 2015-01-10 08:16:12 -0600 Report

Doc I havent had the problem yet with my primary doctor yet. But I do think if you have a problem you had better speak your mind. Recently I was at the VA doctors office for my yearly exam. I told her how my glucose readings were way down since changing my eating habbits. And the fact that I was getting many many lows. She said I was doing good and to keep regulating my insulin. To make a long story shorter, when it came time to re-order test strips I was told that I have controlled blood sugar and thats all I need. Here lies the problem. I test glucose 4 plus times a day, Because of low readings and trying to keep on top of the insulin I take. Well I called her personaly and she said she remembered me because of the great strides I have made. But she insisted that I need not test more than twice a day. I pleaded my case(no F bomb Steve)lol and she won… I am puchasing the extra out of my own pocket. But it is always good to speak your mind if it is not going to hurt someone.
Dave

Dr Gary
Dr GaryCA 2015-01-10 23:15:31 -0600 Report

Hey Dave, this is a really good example of doing every thing you can to treat the thin line between getting really frustrated and blowing up and trying to keep you cool to avoid having your relationship with your doctor go off the rails. It is not easy, as you said so well. I am not a physician, but I suspect that one of the reasons you are doing so well is that you have been checking your blood sugar frequently, so that you can really stay on top of the fluctuations. Right? So this must be totally frustrating. Amazing to me how the healthcare establishment thinks, and how doctors and insurance payers don't always get what it takes to be proactive. Well, you certainly did what you could to advocate for yourself. I hope you will keep taking such good care of yourself! Thanks for sharing this.

haoleboy
haoleboy 2015-01-10 11:27:07 -0600 Report

the reluctance to provide a proper amount of strips drives me nuts … up until last month Medi-Cal was only providing 100 every 90 days for non-insulin dependent T2's… now I am getting 50 a month (still less than I think is appropriate).
Might try slipping in the F bomb next time Dave, worked well for me ;)

Steve

Type1Lou
Type1Lou 2015-01-10 08:19:46 -0600 Report

This is where insurance is "penny-wise and pound-foolish" If frequent testing yields tighter BG control and lower risk of future costly and devastating complications, it should be a "no-brainer" to authorize those test-strips. (But who accused insurers of ever having "brains"?)

Skatinlayton
Skatinlayton 2015-01-11 07:16:00 -0600 Report

This is what I told the VA. It may be controled one moment but the next it could bottom out and who knows what winding road that may lead down. Steve maybe the F bomber may have helped.
Dave

robertoj
robertoj 2015-01-10 01:04:56 -0600 Report

I've had doctors that refused to be questioned and I was combative. I've also had doctors that would discus my options. Sometimes we disagree but I'll assert myself if I'm reasonably sure but even then I prepare a backup plan just in case. I trust their medical opinions but they don't always take other problems as serious as I do.

Dr Gary
Dr GaryCA 2015-01-10 23:00:41 -0600 Report

Hey Roberto! Great to see you. Good point, Very good point about a backup plan. If things fall apart with you doctor, and you can't communicate the way you need to, it's always good to have a Plan B. You both need to be on the same page as much as possible.

Lakeland
Lakeland 2015-01-09 20:08:32 -0600 Report

Talking to doctors is hard. I got aggravated yesterday with my mom's doctor, I held my tongue, but I've been boiling. my mom had a triple by pass, then during recovery got bronchitis & she's not feeling well, but her surgery went well & he did an ablation & came out and said "he fixed it"

at todays follow up the physician assistant starts saying mom's in the 10percentile of having a stroke. ect. he rattled off a bunch of stuff, that the surgeon said was"fixed". then he said he'll stop a medicine,but didn't change it on the paper. I asked if he will call the home nurse & let her know but it's 2 health systems & they don't talke to each other— so much for electronic records. So I'm aggravated & I' was boiling, I don't want to see this guy again, I'm thinking it was a waste of time, but now when I see her surgeon I have a ton of questions & I might be a little intense when I ask these questions. all I want are true answers but I feel like someone is lying to me

Dr Gary
Dr GaryCA 2015-01-09 21:27:43 -0600 Report

Lakeland, so sorry to hear this. How frustrating. I understand that concern about wanting to discuss something but also not wanting to boil over and not have the discussion go well. I encourage you to make a list of the questions you have, and to firmly insist that you get the answers you need. Sounds like the surgeon and the physician assistant need to communicate better themselves. You have a right to boil over, I would say. I hope you will keep us posted on how you do with this.

haoleboy
haoleboy 2015-01-09 19:08:59 -0600 Report

being assertive almost got me thrown out of her office … or perhaps it was the "F" bomb I dropped (sometimes my language belies my kind and gentle nature) … she ended up apologizing to me and we have had a much better relationship ever since.

Steve

Dr Gary
Dr GaryCA 2015-01-09 21:14:06 -0600 Report

Hey haoleboy! Very funny. Yes, that assertiveness can lead you into some risky situations with doctors. Sounds like the two of you worked through this one.

Gabby
GabbyPA 2015-01-09 18:30:42 -0600 Report

I bugged my doctor for several visits to check my feet. I would be there with my shoes off and ready to go. He would not do it. I told him that I felt I had neuropathy but he didn't really care because it was not a required thing for him to do. (the joys of a clinic)

So I finally went to my podiatrist and asked him to check. He did and he diagnosed me with the beginning stages of neuropathy. When I told my doctor that I had gotten this diagnosis, he was miffed. Ever since then we really have had our relationship go in a downward spiral. I was not rude or anything. I was just sharing with him what I had found out so it would be in his records. (well, okay, maybe I wanted a little "told you so", but I was not mean about it)

I understand both sides of the story. My line of work, I have to be able to assess people from the first meeting. Same goes with doctors and patients. It is a two way street. They are not "gods" and we are not "stupid". We need to stop treating each other as if we are.

Dr Gary
Dr GaryCA 2015-01-09 21:22:42 -0600 Report

Gabby, wow, what an experience. It's so disappointing when doctors do only what they are required to do, and don't really listen to patients and take their needs into account. And then to get annoyed when you give him an update. A shame. A good point about assessing people. That's emotional intelligence, reading the other person and responding to them in a way that they can hear. And I agree, let's talk to each other as people in a professional relationship.

Docjjb
Docjjb 2015-01-09 17:46:42 -0600 Report

In my experience dealing with doctors and any disagreement about medication or doing something I'm not comfortable about, I don't argue or get disrespectful but I do remind them that since I am paying him to provide a service for me that the one who takes the money is the employee, thus he works for me. Done with tact I've found that this simple yet unarguable fact changes their "bossy" attitude to one of mutual respect. All the best to you and yours.

Dr Gary
Dr GaryCA 2015-01-09 21:19:47 -0600 Report

Hey Docjjb, Good point, there is a way to do this without being combative while still making it clear that you are the patient and you have certain expectations about service. It is about mutual respect.

Type1Lou
Type1Lou 2015-01-09 16:11:22 -0600 Report

I think it all depends on the doctor and on how you approach the issue(s). I've had both supportive doctors and others. One ophthalmologist yelled at me because I was unable to keep my eye open and stop blinking while he was doing a fluoroscein (sp?) angiogram even though much blinking is reflexive and not totally controllable…I WAS trying to comply. I had had my Type 1 diabetes for 15 years at that time and at the end of my appointment he advised me that I should not be seeing an ophthalmologist, (?) and make my annual appointment with an optometrist. Needless to say, we parted ways and I found a new ophthalmo. In 2010, my prior PCP considered me non-compliant because I questioned his approach to increase my daily Lantus while decreasing/eliminating my bolus Novolog insulin. I self-referred to an endo who actually reduced my Lantus dose by 20% and reeducated me about carb counting and bolus insulin. In 2011, my endocrinologist had increased my dosage of Simvastatin to 40 mg/day. At the followup appointment, he commented how well I was doing and that my triglycerides had dropped nearly 100 points. Since my triglycerides have never been over 60, I asked him what his records showed as my previous reading. Somehow, instead of inputting 56 into their computerized records, it got posted as 156. I showed him the lab report (I always keep copies) so they would correct their medical records. He graciously apologized for the error. My HDL/LDL did see some needed improvement. We do benefit by being proactive and knowledgeable about our conditions and not be afraid to speak up but we should try and approach our concerns politely and reasonably…not always easy…I'll admit.

Dr Gary
Dr GaryCA 2015-01-09 21:17:34 -0600 Report

He Type1Lou! Thanks a lot for sharing this. I totally agree. There is a way to advocate for yourself while still being polite and respectful. It's admittedly hard sometimes. But when we approach physicians in a way that they can open up and hear us, and not make them feel like we are zeroing in to attack or to question their abilities as doctors, then we are more likely to get what we need. And even have a better relationship. Admittedly, this doesn't always work. But it's a good starting point.

Jan8
Jan8 2015-01-09 14:35:25 -0600 Report

If I can't speak freely or a doc is dismissive I simply get another doc.

RebDee
RebDee 2015-01-09 14:29:53 -0600 Report

Your friend is lucky that he fired her as a patient. Now she can get a physician more in tuned to her feelings, symptoms, problems.
I always write my primary care physician a list of symptoms that I wish to talk about. She gets the list before I arrive through e-mail. She is then ready for me and can answer all my questions.

Dr Gary
Dr GaryCA 2015-01-09 21:12:14 -0600 Report

RebDee, that is a great idea to get that list in ahead of time. Then everybody is on the same page, so to speak!

Just Joyce
Just Joyce 2015-01-09 19:25:39 -0600 Report

Why wait for the doctor to fire the patient. The patient can fire the doctor. I have done that several times. You are paying the doctor thus he is your employee. If that employee is not taking proper care of your health or is not willing to listen or discuss medical problems then fire them.

jigsaw
jigsaw 2015-01-09 15:25:13 -0600 Report

I agree completely ! When there are a few things to talk about, I make up a list also, and hand it to the Doc. It's an effective, efficient way to not overlook, and get all your concerns addressed.

Jibber Jabber
Jibber Jabber 2015-01-09 14:09:20 -0600 Report

MOST doctors have a God complex…they do not like to be questioned and they certainly do not like it when you balk at something they say…I just keep on trucking…doesn't change the questions I ask one bit and it doesn't stop me from calling him out when he needs to be..Frankly I don't give a flying fig newton if my doctor likes me or not…

Dr Gary
Dr GaryCA 2015-01-09 21:11:17 -0600 Report

Hi Jibber Jabber, we do run into doctors who don't want to respond to questions. It does seem to me that doctors are recognizing the importance of communication, and medical schools are taking time to teach them how to be better listeners. Hopefully, patients will see the positive effects over time.

Jibber Jabber
Jibber Jabber 2015-01-10 10:29:44 -0600 Report

I am very upset with you right now…not because of anything you said..but because you are in NYC…I miss it there so much…(sad face)…

glennb61
glennb61 2015-01-09 14:07:22 -0600 Report

While I know you have to use tact when dealing with your doctor, your doctor also has to realize that you are a paying patient.
I had a doctor previously when I was living in Virginia and had just retired from the US Navy, he was a civilian doctor working at the Navy Base Clinic.
The doctor never seemed very interested in anything I had to say and at one point when I complained about my toe, he just ordered a medicine for toe fungus without ever looking at my toe.
I did complain to the base clinic patient care reps and they seemed at first to care but then I got some weird calls asking what my problem with the doctor was, I told them I want to be seen by another doctor or I would choose an off base provider. They assured me that I would be assigned to another doctor. But at my next appointment the same civilian doctor that I told them I never wanted to be seen by walked in. I immediately walked out and demanded to see someone in charge.
The situation was resolved because I was forced to choose another provider who was very respectful of my opinions. Now I am living in California and my doctor is outstanding, he listens to me and we openly talk about my care.

Dr Gary
Dr GaryCA 2015-01-09 21:07:11 -0600 Report

Hey glenn. We do run into those doctors that just seem to have no interest in communicating with their patients. I wonder why they are even in the business and not off doing research somewhere or go into administration. And it sounds like the clinic reps weren't really listening to you. Glad to hear you stood up for yourself.

denipink57
denipink57 2015-01-09 13:53:43 -0600 Report

i am truly blessed to have the doctor i have. he is a real gem. i can be completely open with him at all times. he is forever asking me if he can help me more or if i have any questions for him. i do my own research and will fax this in to him to so he will have time to review my research and my questions. he will show me on his computer when he feels i need to understand something in particular. he always prays with me and reads me scripture to encourage me. i could not ask for a better doctor.

Dr Gary
Dr GaryCA 2015-01-09 21:01:30 -0600 Report

Hey denipink! This doctor is a real gem indeed. He takes his work seriously, and clearly values his relationships with his patients. I would call him a doctor with a true body, mind, spirit approach!

BreC
BreC 2015-01-09 13:51:50 -0600 Report

I had a bad experience with an ENT. My first visit, this doctor came into the room, reached out and shook hands with myself and my son who was with me. His first words to me were "you sure are a pretty lady". He proceded to speak about my symptoms, while facing my son, and without an examination he diagnosed me with TMD which is similar to TMJ. I asked who he was talking to, me or my son. He put his hand on my knee and said "I am talking to you". Yeah right!! My son and I both felt very uncomfortable. I went later to my family doctor and told him what happened. He wanted me to report the incident to the medical board but I told him I didn't want to ruin someone, I just didn't want to go back to him. My doctor set me up with a new ENT and told his nurses to take the one off their referral list. Afterward, I heard that he was "just that way". Sorry, he will never be "that way" with me again.

Dr Gary
Dr GaryCA 2015-01-09 21:00:11 -0600 Report

BreC, that is quite an experience you had. And that doctor needs a lesson in how to talk to patients and how to conduct himself in an appropriate manner. It reminds me that there is still a lot of sexism out there, and women are not always treated respectfully by male doctors. Glad to hear you moved on to someone else.

ConnieMarie
ConnieMarie 2015-01-09 13:44:21 -0600 Report

My Doctor was caught off guard on my last visit - I came in with 2 pages of questions. She tried to answer them & she went to consult specialists to get the answers then CALL me with them. I advise others to be their own advocates and fire Doctors that dismiss their concerns. I do this because I didnt question and had a Doctor cause 4 strokes. I've fired 10 Neuros to find a really good one.

Dr Gary
Dr GaryCA 2015-01-09 20:57:51 -0600 Report

Hey ConnieMarie. Wow, you were well prepared. And your doctor was patient and thorough, it sounds like. You have apparently learned the hard way how important it is to be an empowered patient. That's great.

Gabby
GabbyPA 2015-01-09 18:35:09 -0600 Report

I used to do this with mine. I would come in all written down with spaces so I could write down his answers. I would come with my log book and food journal to show him how things were working out. He was okay with it at first, but I think he eventually found it irritating and after he started to dismiss a lot of my sharing, I just stopped sharing.

ConnieMarie
ConnieMarie 2015-01-09 19:47:02 -0600 Report

The list of questions caught her off guard. I usually go with the flow. The logbook she wants to see and the fact I scribble what I ate & when delighted her - she could see where my spikes are. I did a 30 day challenge that ended up being a 90 day challenge with 6 diabuddies. My Doctor was floored at the numbers and the fact that I kept everything in a tight controlled range once I figured out a carb count that worked me during the day. The challenge was to be under 200 for every check. I am T2 and my friends T1…who do you think had the easier time? I poked myself 4 times a day I learned I needed more water than I was drinking. I could eat certain fruits and be ok if I had them in the morning. Very valueable learning experience for me.

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