When it comes to your medical care, you want the “A-team”. You should feel 100% confident in the recommendations your doctor’s giving you. This might mean seeking out top experts elsewhere, getting additional testing or researching treatment options. There’s nothing wrong with taking these steps or questioning your doctor (and we'll show you how). On the other hand...
Fear of Disagreeing with Your Doctor Hurts You
Researchers found that as many as 88% of those who sought a second opinion for a complex medical condition at the Mayo Clinic had a new or refined diagnosis that changed their treatment plan, with 21% of the diagnoses being completely changed by the second opinion. Only 12% received confirmation that their diagnosis was correct and complete!
Despite this, a Harvard health article points to a poll showing about 70% of Americans don’t feel compelled to get a second opinion or do additional research. In some cases, this may be due to limited resources (concerns about paying for consultations, traveling and time off work) or being unsure how to research options. In many cases, it is due to the perception that doctors are authority figures not to be questioned. The Atlantic’s “Questioning the Doctor: Challenging a God” cited patients fear of losing their doctor’s goodwill and lack of time to discuss concerns during visits. We naturally feel vulnerable in these situations. And, of course, we may be in a state of shock, emotionally and physically drained.
There’s a fear of being labeled a “difficult patient” as portrayed so humorously in Seinfeld years ago:
Getting a Second Opinion/More Info: Standard Operating Procedure
On the flip side, getting another opinion should be standard procedure for major health issues. Doctors themselves do it all the time and generally welcome input from other experts. Also, if you aren’t sure about a doctor’s recommended treatment or diagnosis, you should be able to clarify, seek further information and even disagree and pursue alternatives.
We’ll share how to approach the process, tips for general communication with doctors, what to do when you disagree, and ways to improve your care (and results).
Setting Up Good Communication with Your Doctors
Knowing that time with the doctor is limited, it’s important to come prepared for appointments. Make notes about symptoms and a list of questions. You can review our checklist for before, during and after your doctor’s appointments here.
You can also take advantage of electronic communications tools, if your doctor offers these. Many offices offer access to notes online and opportunities to contact the doctor/staff. Whether it be via those tools or other methods, never hesitate to clarify information. Also, be conscious of the fact that your doctor can only work on the information given. It is your responsibility to provide accurate and thorough information. (This is why we recommend taking notes as you experience symptoms and listing questions.)
Make sure you make your goals and priorities known as well. In one study, investigators asked a group of patients and providers to rate concerns and goals around treatment for early-stage breast cancer. The ratings differed significantly in several areas. For example, patients were more likely to focus on possible side effects. Your doctor may only casually touch on certain considerations for a treatment, while these may be significant to you.
This leads to the next key tip. Trying to clearly communicate all we mentioned above may be tough when you’re unwell. Not only are you possibly feeling bad, you’re in an emotional situation. You may feel quite vulnerable.
So while you might be a strong advocate, now’s the time to consider leaning on others. Bring a loved one or friend. But, also, be aware of how your loved one or friend might handle the situation. If they’re also highly emotional or hesitant to question the doctor, someone else may be best. A professional patient advocate might be best of all.
Chat with one of our patient advocates to find out how they can help.
How to Respectfully Disagree with Your Doctor
If you are questioning what the doctor’s advising or don’t agree based on your feelings, another opinion or your research, here’s how to handle it:
- Be firm but polite. Thank the doctor and be respectful of their knowledge.
- Express your concerns honestly and ask your questions about the diagnosis or treatment. You might, for example, say: “Can we try another option before using this drug or scheduling surgery?” You’re giving the physician the opportunity to explain the benefits of what they’re advocating, and their concerns about alternatives.
- Share why you disagree or what your concerns are. Talk about your priorities or experiences. Share research or information you’ve found about alternatives. (It’s important to bring information from sources doctors trust such as reputable medical journals and scientific studies. You can also share your past experiences or those of family members since there may be genetic similarities.)
- Ask the doctor to explain their reasoning and provide more information. Take time then to consider what they’ve presented. In most cases, you can go home and review the information without feeling pressured to make an immediate decision. In very few cases, they may feel strongly that you need to start treatment or schedule surgery right away. But you still want to be comfortable and understand why.
- Think of your healthcare as a partnership. Most doctors want to do their best for their patients. Remember, you’re in this together. If you don’t feel like you are getting what you need, see below...
When to Get a New Doctor
Our best advice throughout is to follow your instincts. You should have a trusting relationship with your doctors. They should not mind you seeking more information or asking questions. Of course, there are ways to go about it respectfully as we’ve shared. Doctors have a lot of pressure and they’re reliant on you participating actively in your appointments and care. The patient who truly is “difficult” is the one who withholds information or never follows up as directed.
You should be concerned if your doctor only offers one treatment option, won’t take time to answer your questions or provides no/limited information on pros and cons of options. Even if the doctor is pressed for time, you should be given an option to cover questions or further communicate. Other signs it might be time to leave your doctor include: poor listening, lack of coordination or follow-up, extreme difficulty getting an appointment or timely reply, and rudeness/disrespect. If you find that your doctor does not seem to be keeping up with research and is not open to learning about new findings or treatments, you might be better served elsewhere.
You always have the right to see another doctor or refuse treatment. Additionally, you have the right to review and get copies of your medical records. We recommend asking for a visit summary and test results at the time of appointments and keeping your own healthcare file. But, the doctor’s office can also tell you the procedure for getting records sent to a specialist or new doctor. If seeking a second opinion or additional testing, contact your insurance company to find out about procedures.