Patients who want to change doctors after problems

caliotter3 · Mar 3, 2011

I would just say something in the line of, "It is not my place to say, to advise you to go with one doctor or stay away from another, .....that is considered unprofessional or a conflict of interest" and let it go at that.

Horseshoe, BSN, RN · Mar 3, 2011

"This something only you can decide."

BabyLady, BSN, RN · Mar 3, 2011

Hi Nurses.
I have encountered patients and people in my personal life who have had doctors who have misdiagnosed, made grave or preventable mistakes on patients. Patients ask if they should change doctors because of the ordeal and I don't know what to tell them. The doctor definitely didn't do all they could for the patient. Other more vocal visitors in the room sometimes say to the patient "You should sue the doctor/complain to the hospital." I know it is near impossible to NOT make mistakes in the medical field. But I don't want to say to someone, get rid of that doctor. Patients trust the opinion of nurses, but I don't think it is my place to say.
Is it ethical or even legal to denounce a physician to a patient? What do you say in these situations?
In my own life, I have had a doctor speak to me defensively and in an almost frantic manner, and saying things to keep the blame off him. I'm pretty sure he was like that to keep away a malpractice case. When you are sick, the last thing you want to hear is you are ill because it just happens to you, especially when a preventable mistake that had many chances to fix has just occured.

You do not have to denounce anyone in the process, but if someone asks if they can change doctors, even facilities, you have to tell them the truth.

"You have the right to decide if you need to make changes in your choice of health care provider, the decision is up to you. Unfortunately, we cannot make recommendations, so I would suggest that if you feel that you need to make a change, that you obtain references from other family members or friends."

You are not advising them to leave or stay with their physician, nor making a suggestion of who to see, however, it IS OUR LEGAL/MORAL/ETHICAL OBLIGATION to inform them that they do have a choice.

MOST PATIENTS, do NOT realize that they can change physicians while in the hospital.

After all, I work for the patient, not the physician...that is being an advocate for the patient by letting them know what their options are.

LPNweezy · Mar 3, 2011

this might be off-topic, but when i was younger i suffered from PMDD and dysmenorrhea. I went to my OB/GYN and i explained to her my problems and i started to cry because i was upset. she looked at me like she was uncomfortable and disgusted. I composed myself and explained that when i went to the ER (yes my period cramps caused me to go to the ER, i thought my appendix was exploding) i got a prescription of Tramadol. i took the Tramadol PRN only when i was having cramps, i am not a junkie. but apparently, because i was 16, this doctor treated me like one. She said "There is no way i am prescribing a 16 year old Tramadol." she then gave me naproxen, reasonable, except it turns out i'm allergic to naproxen. I went back and asked for reasonable pain meds, she said "why don't you just take an oral contraceptive?" and i said "I'm uncomfortable taking those, i don't think i am old enough or ready to take these kind of pills" She insisted. i cried. she ended up prescribing me Prozac and Oral contraceptives anyway. i hate her so much. seriously the woman is a heartless witch. sorry but its true

CecileSF · Mar 5, 2011

Thanks for the tips. I didn't realize some patients had no idea they had the ability to change doctors, I thought it was common knowledge. Next time I'll let the patients decide but also give them encouragement. I know how angry and in despair patients must be when they are misdiagnosed or aren't treated fairly. Patients trust doctors a lot and when they find out the doctor hasn't been doing all they can, it is heart breaking.

CecileSF · Mar 5, 2011

LPNWeezy Thanks so much for your story. I really hope that you will have good doctors in the future and your knowledge working in the hospital will really help. It really does make me feel less alone about these situations when I hear things like this. Some doctors really lack people skills. It's also so common to prescribe oral contraceptives for very young women who have irregular periods, even my doctor told me to take them but I refused.

linearthinker, DNP, RN · Mar 5, 2011

You should never badmouth a colleague, whether in your or any other discipline, to anyone. Very bad form. That is a gross lack of professionalism. You simply tell the patient it would be inappropriate for you to advise them on such a matter (since it is!) while assuring them that they do in fact have a choice and are free to explore the options.

Fiona59 · Mar 5, 2011

Second that. I usually stick with " I'm not permitted to have an opinion on that. But if you are uncomfortable with any of your medical team, you are allowed to request a change of provider".

Now having said that I know surgeons I wouldn't send my worst enemy too but I'd never tell a patient they'd wound up with them. They usually figure it out for themselves and are very vocal.

But then surgeons are in an "old boys club". You don't like their friend, they don't have to accept you as a patient.

steelydanfan · Mar 6, 2011

this might be off-topic, but when i was younger i suffered from PMDD and dysmenorrhea. I went to my OB/GYN and i explained to her my problems and i started to cry because i was upset. she looked at me like she was uncomfortable and disgusted. I composed myself and explained that when i went to the ER (yes my period cramps caused me to go to the ER, i thought my appendix was exploding) i got a prescription of Tramadol. i took the Tramadol PRN only when i was having cramps, i am not a junkie. but apparently, because i was 16, this doctor treated me like one. She said "There is no way i am prescribing a 16 year old Tramadol." she then gave me naproxen, reasonable, except it turns out i'm allergic to naproxen. I went back and asked for reasonable pain meds, she said "why don't you just take an oral contraceptive?" and i said "I'm uncomfortable taking those, i don't think i am old enough or ready to take these kind of pills" She insisted. i cried. she ended up prescribing me Prozac and Oral contraceptives anyway. i hate her so much. seriously the woman is a heartless witch. sorry but its true

Actually, if you have dysmenorrhea, oral contraceptives are a perfectly appropriate therapy, and often work well. It has nothing to do with sex or sexual activity. She could have been more detailed in her explanations, but her theraputic choice was correct. If you were 16, having an adult present during this discussion might have been helpful.

eriksoln, BSN, RN · Mar 6, 2011

I've had many patients ask me this. :cool:Usually its the patients of a select few certain doctors who ask.

It's simple. I basically quote to them what is expressed to us in nursing 101. We are to mediate for the pt. and support their decisions, with a little bit of education thrown in to make sure said decision is well informed.

What I say is:

"I'm here to support YOU in whatever decision you decide to come to. What exactly makes one doctor right or wrong for you is something personal. If there are any concerns I can help you with at the moment, I'd be glad to. In the meantime, if you decide a change in doctors is necessary, please let me know."

Short, sweet and totally customer care slanted. But the most important thing in it is not what is said, but what is not. Never bad mouth a doctor to patients. Unprofessional and completely out of line. I have doctors I work with that I wouldn't let scrub my car floor mats, but I don't let that show with the pt's. They are stressed enough and don't need some nurse adding anxiety over their assigned attending doctor to the picture.

Just knowing you are there for them regardless of what they decide is enough to calm 90% of them.

allnurses Guide · Mar 6, 2011

I've encountered this so many times! If it's in my personal life, and I'm talking to a friend or family member about my care, they get the unvarnished version. If I overhear a family member say "you ought to sue x y z", I don't say anything. 99% of the time it's just talk. If it's regarding a patient of my employer being misdiagnosed by a doctor at that same place I don't offer an opinion. I remind them that if they aren't happy about an outcome all patients have rights and perhaps give a phone number or tell them to contact their insurance company to get a list of providers. It's amazing what people manage to pick up via nonverbal cues. Most nurses who really like a doctor will say so. If I as a patient mention "doctor blablah is really great" and the nurse agrees, they will say, "oh I know! we just love him!" I find that if you don't say anything or keep a poker face people pick it up loud and clear.

I'm a big believer that rapport with your PCP is really, really important I worked in a large family practice clinic for 8 years. Sometimes people would ask "who is your favorite doctor here?" or "do you think I should switch to ------?" I couldn't answer if I really wanted to. Dr B was hyper-organized, trim, efficient, and had a neat row of highlighters for the daily pile of journals that would arrive - dispensing with his mail that day. His patients loved him. Dr C was a human whirlwind of flying papers, business cards, flapping lab coat, his office looked like a cyclone had hit, he was an hour and a half behind on a good day, and his pants were too short. His patients loved him. Sometimes I would recount characteristics like that, but never would I recommend one over the other.

... i am not a junkie. but apparently, because i was 16, this doctor treated me like one. She said "There is no way i am prescribing a 16 year old Tramadol."

Because 16 year olds don't have pain but when you turn 18 you do? :mad: Totally uncalled for. If that were me, unless I had no choice whatsoever, I would never have gone back. I had the same issue when I was 17, but even if I hadn't, her manner suggests a callous individual. That isn't to say she isn't a good doctor, but it sounds like she went out of her way to make you feel like crap, that goes to the rapport issue I mentioned.