Firing Your Doctor

[David Baxter PhD]

Firing Your Doctor
by Ashley, Nourishing the Soul
October 10, 2012

Is your doctor acting like a child?

I had a less-than-stellar experience with one of my physicians recently. I?ll spare you the muddy details, but it was borne out of a combination of unreasonable waiting times, irritable support staff, inability to get in for an appointment, and inappropriate comments made by the doc herself. Looking at this situation from any other seat, it seems reasonable to pull out the Blackberry and search for another provider on my way down the elevator. And yet something told me to go back for my next appointment and see what I thought.

So I dutifully went, listening to that compliant, wouldn?t-want-to-make-a-fuss little girl inside of me. And it was slightly better, actually. The wait was only moderately unreasonably long, my next appointment slightly easier to make, and my doc seemingly less stressed. But then they made a billing error. And took over five weeks to resolve it.

And you know what? That pesky little voice inside of me told me that I should still just ignore it. It was a little better the next time after all, right? And wouldn?t it be a pain to transfer all of my records? And this office is so convenient from work! And is it really worth it to call around? What if the next office is just as bad?

Oh, mind, the places you?ll go?

A better question to ask myself was why I was making so many excuses for not getting the heck out of that practice and into a place that would support my health. A little bit of self-reflection allowed me to come up with some pretty understandable reasons ? ones that I knew I could work on to get to a place where I could advocate for myself. And when I started talking to other people about all this, I realized that there are lots of us out there who are settling for less than amazing health care. And I knew that this wasn?t okay.

So many of us allow things to slide when it comes to those who manage our health. From using inappropriate or offensive language to not looking up from an iPad to dismissing our concerns about a health issue, medical professionals screw up sometimes. Some screw up lots of times.

And in case you?re an MD and thinking I?m laying this all on you, I?m not. Psychologists, naturopaths, dentists, accupuncturists ? heck, even your vet ? can all be guilty.

The people that we entrust with out health are some of the most important people in our lives. And they not only have a responsibility to ensure that our physical health is sound, but they have a responsibility to ensure that our whole health is sound. That means treating us with respect and dignity, staying attuned to our emotional and mental state, and even being cognizant of our cultural and spiritual health as well. I realize this is a lot to ask of those who treat us, but as a provider myself, I?m willing to make that commitment. And I expect others to do the same.

There are of course situations in which it?s worth talking to your doc before giving him or her the boot. Then there are the non-negotiables (like, say, mixing you up with another patient and giving you the wrong treatment, or even using offensive or derogatory language). You?ll have to decide if it?s worth having a conversation about your concerns. If the issue relates to something administrative, take it up with the office manager rather than cutting into your time with your provider.

If you?re unsure what to do, share the situation with a few trusted friends and gauge their take. If it?s clear that moving on is the right thing to do, and you?re still finding yourself stuck, it?s worth exploring a little deeper. Remember ? you deserve the best care possible, and there are tons of caring professionals out there to do it. Don?t sell yourself ? or your well-being ? short.

 

[wheelchairdemon]

Good article. It's true, we don't need to continue putting up with inappropriate, demeaning or disrespectful behaviour.

With a doctor shortage, moving on to a new doctor is not as easy as you think though.

It's also policy, in some clinics, not to take on patients who have chosen to leave another doctor from a clinic that the doctor declares they support.

According to Health Care Connect (http://www.health.gov.on.ca/en/ms/healthcareconnect/public/faq.aspx), and based on personal experience, a person must first discontinue service with their doctor and register the change with OHIP. Calling the toll-free number listed on their site led to me being given instructions to tell the doctor he must sever the file. The situation was not one I could manage alone, so I went to my MPP's office for help.

Once the severance has been made, then there is a long waiting list to get a new doctor. It's not an easy process. Thankfully the long wait paid off and I got a decent new doctor.

Based on my experience, I would just like to caution that people do their homework first, and then consider it. If one is on the Ontario Disability Support Program (ODSP), require equipment through the ADP (Assistive Devices Program), etc. the person may find, as I did, that if they don't have a family doctor, they will no longer be able to get medical forms filled out when their in between doctors because After-Hours Clinics and Emergency Rooms have adopted a policy to not fill these forms out. (The image showing this policy won't upload). Please ask if you want to see it.

 

[Max10]

I have wanted to fire my primary doctor for quite some time. But... I can't find another doctor willing to take me on. They often say 'your case is too complex' or they are to far away and require me to take several buses to get there. (I don't own a car) My current doc makes me choose 2 or 3 of the issues on my list and lets her ego get in the way because I'm well informed on what I'm dealing with. She'd rather I was dumb and said yes to every medication she prescribes. I read the pros and cons of all medications before I say yes.
I've kinda given up on finding a new doctor and am just trying to figure out what works for communicating with the one I have.

 

[Retired]

I read the pros and cons of all medications before I say yes.

While I am a strong believer in being well informed, I also believe in working in partnership with the doctor.

With regards to medication strategies, your doctor likely has protocols she has developed from her own clinical experience, her continuing education, and consultations with her peers.

Most doctors work in collaboration with their peers to learn new strategies based on rational clinical experience.

Reading product monographs or internet reviews as a lay person rarely paints a true picture of the reality of the art of medicine, which comes from training and clinical experience, and that comes from being a professional in the mainstream of day to day medicine.

 

[David Baxter PhD]

While I am a strong believer in being well informed, I also believe in working in partnership with the doctor.

With regards to medication strategies, your doctor likely has protocols she has developed from her own clinical experience, her continuing education, and consultations with her peers.

Most doctors work in collaboration with their peers to learn new strategies based on rational clinical experience.

Reading product monographs or internet reviews as a lay person rarely paints a true picture of the reality of the art of medicine, which comes from training and clinical experience, and that comes from being a professional in the mainstream of day to day medicine.

And specifically where you read all those pros and cons makes a huge difference. Most of what you will find on the internet is incredibly misinformed and often just outright wrong.

 

[Max10]

My doctor had me on a blood thinner(Lovenox) for 7 months that's only approved for 17 days ! Only after I had the drug company rep phone her did she agree to put me on name brand Coumadin. I had been on generic Coumadin but it had caused severe headaches so she switched me to the Lovenox. I looked it up on the drug manufacturers website to see what the long term effects were and then called them because no studies had been done with regard to long term usage. I am very good about researching my health conditions and know what sites to trust. My father taught me to research medicines as well as to not be afraid to inform my doctors regarding my health and medications that are prescribed.
The only reason I am currently seeing this primary doctor is because my former one who I saw for 17 years retired and all of her patients were referred to this one.

 

[Retired]

I looked it up on the drug manufacturers website

The point I tried to make earlier about reading a product monograph, the document you likely consulted on the manufacturer's website, contains the information made in the submission to the regulatory agency (FDA) for approval. The monograph may be updated periodically with new indications, but generally the basic research information remains the same.

On the other hand, clinical experience and later studies performed by practitioners, that have been published in peer reviewed journals combined with studies that show off label usage of medications do not appear on manufacturers' websites.

What is being suggested is that, as informed lay consumers of health care, we need to be careful not to do ourselves a disservice by second guessing our doctors, who, through training and continuing education, have access to much more information that does the average lay consumer.

Just because a particular treatment plan is not identical to what is contained in a product monograph, does not mean your doctor is not following an accepted medical rationale for providing it.

 

[Max10]

I called because the monograph contained no long term usage facts and that was a red flag for me. The company called my Dr and informed her that it should never be used for more than 17 days and my future health was at risk as a result. Besides Lovenox costs my insurance $3000 a month and namebrand Coumadin is $35 to 40 a month.
The Lovenox had caused large hematomas all over my belly as it's injected subcutaneous in the gut.
This is but one example of my dealings with my doc. I have started looking for a doc that I can have a comfortable and workable relationship with as this is important for me.

Thanks for your input....

 

[Retired]

I have started looking for a doc that I can have a comfortable and workable relationship with as this is important for me.

Absolutely the prudent course of action. If you feel there is evidence of incompetence with your doctor, and sadly not everyone graduates at the head of the class, then it is best to look at other options.

Many doctors will have a "meet and greet" meeting with a new prospective patient so both parties can make up their mind if they can work together. It might be an idea to be vague and diplomatic about expressing your concerns about the competence of the doctor you are leaving, and talk about not feeling comfortable in that doctor's care.

Depending on your local medical community, there may be professional or even personal relationships between physicians, where your criticism may obstruct your opportunity to be accepted in a different practice.

In the meantime, do some research to ask around about other doctors. Sometimes helpful resources can be your pharmacist who has frequent contact with local doctors, or nurses who work at your local hospital or in local clinics. Nurses are usually pretty good judges of the doctors in a community.

There are some online doctor rating sites, but I find those have to be taken with a grain of salt. They have to be read like any other online review....the best reviews and the worst reviews are often suspect....look at the ones in the middle.