Don't get me wrong; I am all for being your own advocate in your health care. Everyone should have a clear understanding of what is being done to/for them medically and what the ramifications are. But it does kinda drive me up a wall when patients come into our office having already "diagnosed" themselves (usually via the internet
) and completely shutting off the the assessment/suggestions of the doctor/NP/PA.
IBS is one frequent example. No one wants to hear that that could be their dx. Needs to be something you can cure with atbx and fix RIGHT NOW. Had a gal last week wanting all manner of stool testing done when she was classically IBS. NP ordered what he felt was appropriate and held his ground on all the extra nonsense; said she needed to give the treatment longer than one day to work
. Is it any wonder that health care is so outrageously expensive when people with no medical training want to play doctor and direct what tests are to be done? Regardless of whether or not the tests are clinically indicated, the provider almost feels obliged to order them because we are in such a litiguous society (U.S.) And truly, I don't care what your family member who is in the profession thinks. If they aren't treating you, they aren't ordering the tests. If you want that family member to be your doctor, don't come into our office and ask our opinion.
Feel better, thanks!
Apr 10, '04
I agree with your overall jist. At the same time I wonder, do you think that that kind of attitude in those pts can be turned into a postitive thing? I mean, if they are so interested then maybe they'll be compliant if given some more explanation as to exactly why the providers have determined that their dx isn't it. Like say, what makes you feel that you have Wierd Rare Syndrome X? Then maybe say "Ok I see how your symptoms match that, but we are able to rule out Wierd Rare Syndrome X because people with it all have three eyes and poop purple in addition to the symptoms you described, are you having those problems?". Now ask the IBS questions and tell them exactly why you think it's that, etc. I don't know, it just seems like those kind of people are information hounds and would respond well that way - I think they usually feel like they don't get enough information or that the doctor isn't listening to them fully. But I am not even in your shoes yet, I am just going by people that I know that are that like that. I am that way except I don't actually say what I'm thinking, or if I do I just say something like I was worried I might have "x," is that a possibility?
I just think that alot of those people who "insist" on things need more information (like the abx people must not understand that it isn't going to help them when they have a cold, taking them when not needed leads to more problems with resistance, etc. etc).. when they are just flatly told "no" or not given info or explanation they just see it as resistance or the godlike medical attitude and then *they* get more of an attitude for next time, and so on until everyone is pissed. Some people just don't want to take your word for it - they need to know why, and I don't think that's a bad thing, I think misdiagnosis happens more than we'd like. Then these people develop a mistrust & get the attitude that "I can only trust myself". So they need more explanation & discussion of why things are the way they are. I'm sure I'll be the odd one out here, sorry
Finally, I'm sure some are just nuts or hypochondriacs like my mom and there prolly ain't much you can do unless you want to become a therapist and work miracles!
Last edit by mitchsmom on Apr 10, '04