This is the second post covering issues with your doctor that could lead you to fire your doctor and look for a replacement. Nobody is perfect, doctors included. If your doctor is incompetent, doesn’t listen to you, and/or treats you rudely, it’s time for a new doctor. But what if the issues you have with your doctor are somewhat less serious but concerning nonetheless. When is it time to change doctors?
Your doctor doesn’t involve you in decision making.
Research has shown that patients who actively engage with their providers in decision making tend to make better decisions about their own care, choosing options they are more likely to adhere to, which can improve the quality of care and lower costs.
To make decisions about your care, you must understand your diagnosis and treatment options. You deserve a doctor who takes the time to clearly explain things, repeatedly when necessary, and who answers all your questions. It’s time to change doctors if your doctor doesn’t make a concerted effort to make sure you understand the medical information presented, and/or doesn’t value your input.
(For more information on shared decision making, read our blog post.)
Bad hygiene and dirty offices.
You can’t see them with the naked eye, but dangerous germs, including life threatening pathogens, can easily spread to and between patients. Doctors, nurses and other medical staff who don’t wash their hands between patients can easily transfer germs, as can contaminated equipment; furthermore, patients can get sick from touching contaminated surfaces.
Since hand washing is a key component of reducing the spread of infection, it’s critical that all medical staff follow good hygiene practices. Does your doctor and his/her staff always wash their hands and/or put on clean gloves before touching you? If not, do they seem annoyed when you politely remind them to do so?
Is the office and/or waiting room dirty? Is there fresh paper on the examining table? Are medical instruments kept in sterilized packages until your doctor uses them? Are there other signs indicating unsanitary conditions?
If you think your doctor’s office does not have high standards for hygiene and infection control, it’s time to find a new doctor.
My unwelcome hand washing request:
My husband felt sick so we went to an urgent care center. The doctor was getting ready to perform a physical exam on my husband without first washing his hands. I politely asked the doctor to please wash his hands or put on gloves. The doctor responded, with a rude tone, that he washed his hands before entering the room. I replied that he may have washed his hands, but he then used the door handle that sick patients had touched throughout day. I insisted he wash his hands again. He unhappily complied. We no longer use this urgent care center.
Your doctor doesn’t look up from his/her computer.
Electronic Health Records (EHRs) are here to stay and have changed the dynamics of medical appointments. Most doctors enter your medical information while they are speaking with you, which can negatively impact appointments. Instead of maintaining eye contact during conversations, doctors’ eyes are often on their keyboards and screens. Every doctor has their own approach to entering and reviewing data. Some doctors manage to connect with patients better than others. If you feel that your doctor’s computer use is negatively impacting your conversations and appointments, you should mention your concerns to your doctor. If the quality of your conversations doesn’t improve, you might want to look for a new doctor.
Your doctor isn’t willing to consider information you bring to appointments.
With the wealth of information available on the internet, and the connection people can make with complete strangers who share a medical condition, patients often bring their own research results with them to appointments. This can create a conflict between patients and doctors. Some doctors don’t want to hear about what your read on the internet or what Sally from Topeka said. Others are open to these conversations. If you want to bring information with you to appointments, and your doctor shuts you down, fire your doctor and find one willing to have these types of conversations with you.
Your doctor’s office doesn’t follow up on test results.
Whether you’ve had a blood test, a chest x-ray or an MRI, you want the results as soon as possible. And you want them presented to you in a way that you can understand.
Many practices have patient portals which maintain records and send email notifications to patients when new results are posted. These systems are great, particularly if your doctor follows up by phone or email to make sure you understand the results and any necessary follow up steps. Some offices don’t use portals to notify patients of test results. Instead, these offices call and/or mail results. Relying on a non-automated notification processes can lead to patients not receiving their test results.
Test follow up after hospitalization is important as well. Research has found that more often than not, medical providers are not following up on tests conducted at hospitals. One study found that no one read the results before patients left the hospital for 47% of tests ordered on the day of patient discharge. 41% of these same test results were still unread two months after discharge. After a hospital discharge, your primary care doctor should provide test results as they become available.
In all situations, patients should never assume that no news is good news. Does your doctor use a portal that notifies you when test results are posted? Does your doctor follow up in a timely manner to make sure you understand the results and any next steps? Do you have to repeatedly call the doctor’s office to ask about results? If it’s difficult to get test results from your doctor, you might want to consider finding another doctor. Or you can grin and bear it. Just make sure you get your results and understand what they mean!
A cautionary tale:
In September, a friend of mine had an appointment with her doctor which included some blood work. The doctor didn’t mention any issues and she went on her merry way. In April, more than 7 months later, she had the same blood work done. This time, the levels for a kidney test were significantly abnormal, likely indicating a serious health problem. Upon hearing this news, she reviewed the test results from September and saw that the earlier blood work showed the same abnormality. Shocked that her doctor had not mentioned this, she asked him why he didn’t discuss this result with her. Her doctor responded that she, the patient, should have noticed the abnormal result when she read the test results herself and should have asked him about it. He implied that it was her responsibility to understand when a result needs attention and to follow up as needed! She now is frustrated and worried that she might be seriously ill and has unknowingly delayed treatment. Needless to say, she is looking for a new doctor.