Quote:
Originally Posted by Gypsy
Ah. I think you can speak respectfully while asking questions in an inquiring but direct manner.
If someone is offended and thinks you are questioning their knowledge whilst seeking information or discussion on what your reseach has yielded then maybe they're not the doctor for you.  |
I think this is the approach I appreciate most, but I've seen all sorts. I'm always happy to answer questions such as, "How do you know that x is what's going on?" or "Is there anything else that could be causing this?" It makes for a fun exercise in creating and prioritizing my differential diagnosis.
I also welcome "What are my options for treatment?" and "Why did you choose this particular treatment/medication?" Again - it makes me reconsider my current practice and consider at medications which I may not typically use but may be better for my patient. It also opens the door for further discussion os side effects, reason I use treatment "x" vs "y". Some times it reminds a patient to bring up an old medical condition or treatment reaction they had not disclosed previously.
If a doc can't justify his diagnosis and treatment decision he/she needs to take pause to figure out what was missed...
OTOH, there is a call to decrease the cost of health care - sometimes what we would feel is best for the patient medically is not what is best for them financially - I would not order a test that would cost a patient $5,000 out of pocket if it would compromise their financial stability. A physician should discuss this with the patient and let them participate in that decision. There are usually cheaper alternatives that are "good enough."
Thankfully, I have some good trump cards in my practice. I have yet to find an insurance company that will refuse a request for a diagnostic test that I consider "standard of care" for a child who has a chance to be cured from cancer. All I have to do is request the insurance company's name, the names of the people making the decisions about paying for testing or not, and let the person from the company that I'm talking with that I wil document all of those names in my chart as the reasons I am not able to provide appropriate care for the child. It seems they would rather pay for the $5,000 test than have the potential for a multi-million dollar lawsuit.
Whether or not the test should cost $5,000 is another discussion for another day...