Ask the Doc- Why isn’t my doc willing to hear out my ideas?

A reader wrote in about a concern she had with her dermatologist. Her concern is that her current treatment is causing more harm than good. She has tried to show him research studies that she has found about the issue, but he won’t read them. She has also tried to show the study to her PCP, but hasn’t had any success.

In the doctor-patient relationship, I believe it is very important that there is trust between both parties. Patients need to trust their physician’s judgement and believe that their doctor is looking out for their best interest. But this does not mean they cannot seek further explanation or information.Patients have a right and responsibility to be involved in their care and treatment, and advocate for themselves.

As a physician, I believe in addressing my patient’s concerns, even if they may seem trivial. I may not always agree with what my patients are saying, but I believe it is worth considering, even if it is to simply show my patients that I respect and care about their feelings. Doctors have extensive medical knowledge and training which guides their decisions, but that doesn’t give us permission to completely dismiss our patient’s opinions.

Although we may be open to our patient’s ideas, sometimes our hands are tied. We have to be careful about going off- protocol, as does anyone in any other profession. There are standards of care in medicine, and treatment plans constructed around evidence-based medicine. Deterring from these standards can cause major issues for a physician.If there were to be a negative outcome due to a physician going off label, or denying the recommended treatment, the physician can be held liable as well as feel the guilt of going against consistently proven methods and causing damage.

I think the real issue here is that the reader does not feel that the dermatologist is being receptive of her concerns. I would encourage anyone in this situation to make their doctor aware that they feel their concerns are being ignored. We sometimes get so focused on the plan we have in our head, that we don’t realized we’ve stopped listening. If the physician is still not willing to listen, then I think it’s not a bad idea to get a second opinion. At the end of the day, the doctor and patient should work together as team with one goal- providing the best care for the patient.

6 thoughts on “Ask the Doc- Why isn’t my doc willing to hear out my ideas?

  1. I need to start with a caveat…I adore my PCP, but it took me a good 30 years to find one I liked…so, there’s that.

    That said, Doctor, you said something very telling and insightful:

    Although we may be open to our patient’s ideas, sometimes our hands are tied. We have to be careful about going off- protocol, as does anyone in any other profession. There are standards of care in medicine, and treatment plans constructed around evidence-based medicine. Deterring from these standards can cause major issues for a physician.

    This is information I’m betting 99% of patients don’t know, as most believe their doctor is giving care based solely on that one patient and his/her known histories. If a doctor would take a few moments to explain this to his/her patients, a lot of frustration on both sides may be avoided.

    It’s also important to know that with the Internet the patient is bombarded with anecdotal information presented as scientific ‘fact’, and it is extremely difficult to discern one from the other. A ‘study’ may be, in fact, science-based, but it could also be based on ‘testimonies’ from people with the same, or similar, issues.

    At the very least, a good doctor will listen to anything the patient says about his/her condition and then carefully explain the whys and wherefores of protocol.

    Health care is a two-way relationship, and a good doctor knows this.

    1. I completely agree that physicians need to take the extra minute to explain these things. Also I planned to do another post in the future addressing the information on the internet, and explain what a clinical study really entails.

  2. Yes!

    Dear Doctors,

    we are not all “That Patient”

    We are trying to communicate respectfully and want a team relationship with you…

    We are your mothers, your sisters, your sons, your daughters…. we are human.

    Please don’t make us feel like we are bothering you.

    At the very least, invite us back for an appointment to discuss our concerns and that way you can listen attentively. Make some good points.. Open our minds!

    Challenge the status quo that you are only teaming with big Pharma.

    Step out and really embrace the human condition!

    One change can lead to a new and exhilarating kind of life!

    P.S Patient doctor, I know you already subscribe to this idea…These comments are for the ones who didn’t get the memo yet 🙂

  3. This hits pretty close to home. I recently found an article written for the NIH on their website that discusses the lasting damage of chemotherapy on various organs. I would love for a few of my doctors to consider it, but I have been told that taking articles to them is pretty useless. These doctors are not oncologists and do not know what the powerful drugs that I took are capable of doing. One of them told me the chemo that I did was safe. Believe me when I tell you there is nothing safe about mustard gas. I guess this is my answer. I wish there was a way to get them to see it.

    1. Thanks for the comments.There are a lot of things I’d like to say about this. I plan on writing another few post to follow up on these comments because they’ve brought up a lot of other related issues that are important and interesting to discuss.

  4. My large team of docs are, in my opinion, the best in their businesses! The key to a great doc is one that does “with” their patient not “to” their patients!

    It’s a shame that this reader isn’t able to tell this provider that if he/she isn’t willing to work w/ them, they’d find someone who will!

    I’m not saying that a doc has to say yes to everything a patient wants to be great but they must be able to listen, discuss & problem solve as a team!

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