Expressions

How to Break Up with Your Doctor

 

 

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Are you feeling like something is amiss with your doctor? For someone who is experiencing a traumatic illness, having a doctor that you are confident in is paramount.  Sometimes we end up with someone that we feel, deep down, is not the right doctor for us.  I recently went through this myself.  I transferred from a specialist I loved and trusted to a new one in the city I moved to and immediately felt like it wasn’t the right person.  But I went a few more times just to be sure.  The doctor himself was okay, he seemed thoughtful, listened and patiently answered all of my questions.  It was his office’s level of customer service that was an issue. 

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I found my experience with the front office for this doctor incredibly challenging. It took six or more phone messages and a few more emails just to get an answer to a simple question.  Hey, I am a busy person, too!  Nothing bugs me more than no response to an email or phone call. It is very simple to say, “Thanks, got your message, let me check on it and get back to you.”  See?  That wasn’t so hard, right? Strike one.  

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Strike two: the hospital where the doctor was located charged me for the doctor’s office visit AND a “facility usage” fee.  In other words, double billing for the same visit.  I don’t think so.

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Strike three: This doctor is located at a very prestigious hospital’s cancer center. The cancer center billed my insurance for my exam and my blood tests separately. My insurance would not cover 100% of the costs of the blood tests because the lab was not deemed a part of a “clinic” but as a part of the hospital. I imagine that the hundreds of people that go through the doors of that cancer treatment “center” for checkups and tests are also experiencing double charges as well. I have to get blood tests every three months, so having to go to two separate places (so that it would be fully covered by insurance) was the final nail in the coffin. It is already difficult enough to get the time off for a doctor’s appointment.  Having to go somewhere else to get labs done beforehand at a separate appointment is too much (rant over).

I decided to look for a new doctor.  Luckily, I had the good fortune to have lunch with a business contact that had been through the exact same thing with the same cast of characters.  She suggested I meet with her doctor and I set up an appointment.  Before I went, I checked with my surgeon just to be sure that the referral was a good one.  My surgeon highly recommended the new doctor – bonus!

When I went to meet this person, she blew my mind.  She walked into the room and said, “Hello, darling, here is what I know about you.” She may have had me at darling, just sayin’.  She proceeded, not looking at my file, to recite to me my entire medical history for the last three years AND recommend some new forms of treatment.  Hello!  You are hired!!

I did not call my previous doctor to “break up with him,” but to be fair, the last time I saw him, I told him of my issues.  He apologized, and yet it happened again (with the customer service).  That’s it.  I’m out.  The thing is, when it is something so vital to your wellbeing, when this person is quarterback on the playing field of your healthy future, you have to feel like they not only know the plays, but could get out there and call them too (it’s not obvious that we are football-loving Texans, right?!).

My new doctor’s office called the old one for my records, and that was it. I do believe in second chances and that is why I gave my previous doctor an explanation of why I wasn’t happy before I interviewed the new one.  But nothing changed, and I have to be the most vocal and dedicated advocate of my own health.  Now I feel confident that I am back to having an “A” team who will keep me in the game for years to come.

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In an effort to both understand and maneuver through this common problem, we spoke with noted author Jodyne Speyer, who penned “Dump ‘Em, How to Break Up with Anyone, from Your Best Friend to Your Hairdresser”(Harper Collins) about the best approach to ending your relationship with your doctor.

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Photo by Laura Silverman

 

What is it about us that we don’t listen to that nagging little voice inside that is saying something doesn’t feel right? Are we afraid of hurting people’s feelings?

Well, there is something about doctors and lawyers that is very intimidating because they speak a language we don’t necessarily understand.  As such, our relationship with them starts out as fear based – we don’t know how to take care of our health and we are relying on them to guide us.  Much like a parent to a child, we think, “Oh, they’ll take care of me,” so it makes it harder to listen to that voice in your head that is saying something doesn’t feel right.  There is absolutely nothing wrong with saying “I don’t understand what you are trying to tell me.” It is often overwhelming when what we hear is news that we are not prepared for, and you have to take this person’s word for it that this is the best course of action for you.  I strongly suggest that you take someone with you to help you remember everything that is discussed.  You are going to be reacting in an emotional way, and your friend or loved one can help with the specific details.  Also, recognize that communication differences exist, and try to have the doctor speak to you in a language that you can understand.   Women, especially, are trained from birth by their parents to take care of other people and particularly their feelings, so we feel uncomfortable saying something we think might upset someone else.  It really is not a big deal so we have to let that go and speak up.  We have to remember that this is our body and we have to let go of that old school belief that “doctor knows best”.  We need to look at this a relationship between two people, you and the doctor, and so therefore, like any relationship, we have to speak up and design a course of treatment along side our doctor. 

Our doctors, particularly in a time of crisis, are the generals in our army against our illness.  What should we do if we aren’t feeling confident that this is the best person for the job?

Voice your concern.  There is nothing wrong with saying that you aren’t totally confident but you should have an idea why you feel that way.  If it is just bedside manner, that could be one thing.  The hope is that whatever you share makes for a better relationship. If they react poorly to your feedback, then maybe that isn’t the right doctor for you.  Speaking up is important – it is how we do it that counts.  A laundry list of things might be off-putting and make the doctor defensive, but if you go in there with legitimate concerns and talk about it calmly, you are likely to have a better reaction. In the many conversations that I had with doctors while writing my book, they all said that there is always that one patient that asks nonstop questions.  I suggest choosing wisely what your concerns are and address them in a way that is helpful, not like an attack.  Bear in mind that they have so many people to see in a day, only you can know what it is that you want to get answered.  Bring your list of questions and also someone who can help take notes.  One doctor I spoke to told me that he leaves a pad of paper in the lobby for his patients so they can write questions down while they are waiting. He also requests his front desk staff to ask the patients to come in with questions.  What a great way to get the information that you really want to hear!

Finally, patients also have a responsibility to be forthcoming with their doctor.  Even if it is uncomfortable to talk about, you must be honest and really discuss the true issues that are concerning to you.  They can’t help if they don’t know everything that is going on.  Having all of the information helps them to make a more concerted diagnosis.

What is the most appropriate way to end a relationship with your doctor and what is the most inappropriate way?

Well, you could call him Dr. McSteamy and say that you have to end the relationship because you can’t go on in good faith when you have such powerful feelings since you are dreaming about him in the shower.  Or tell him you want to set them up with your mother.  Kidding!

Give them a warning, give them a chance to fix it.  It can be almost like dumping a boyfriend – great guy but something is missing.  Maybe you need to say “we speak a different language and I don’t feel comfortable with how things are going,” or “My time is precious, and every time I come to your office, I wait for three hours.”  I personally had to say that to my dentist, and he had no idea that patients were waiting that long.  He told me later that I was the first person to tell him of this experience, that he never went up front and depended on his front desk staff to handle everything as he was always with patients.  Above all, tell them that you need them to change what you have been experiencing and give them a solution (e.g. if the office is running behind, send a text letting you know so that you arrive a bit later than your scheduled appointment).

The best way to let them know other than in person is to write the doctor a letter. Doctors on average have 15 minutes to see a patient, so the last thing they want to do is make the time to call you and be dumped on the phone.  Acknowledge the good things but also the main reason you are leaving.  You should also ask them to forward your files to your new doctor.  It’s all about closure.  One of things that can cause you stress in this type of situation is lack of closure. It will make you feel better! It often feels worse when we don’t say anything.

I don’t think that telling a doctor that you need them to change is going to work. When dumping a doctor, it’s giving them a warning, telling them what your concern is. He speaks too fast, he’s rushed. You don’t feel he listens to your concerns, etc. If after that they haven’t changed, then it’s absolutely fine to change doctors and let the front desk know why, or if you have a personal relationship with the doctor, send them an email/note letting them know why you are changing doctors. It’s always easier dumping a doctor if you gave them a warning already.

At the end of the day, most doctors aren’t going to change their ways, but some will and this is why you want to say something, to allow the change, not just for yourself but I’m sure a hundred other patients feel the same way, so you are doing them a favor as well by telling your doctor how you experience them. Remember not every patient is alike, so doctors need a little coaching sometimes. But at the end of the day, like a boyfriend, if you don’t have a connection, it’s probably not the best doctor for you.  

Is feedback helpful or are we just another link in a very big chain so our comments go nowhere?

 It depends on the doctor. Sometimes feedback is really just for you, but that’s okay. It feels much better letting someone know why you are leaving than harboring resentment towards them. Remember stress kills, so speak up. 

If you can, take baby steps and give warnings that something isn’t right here and acknowledge that.  You have to be able to say “this is not okay,” then you have this to go back to when you do want to dump them.  A good way to say that is, “Unfortunately, because I haven’t seen a change in this situation, I need to find a new doctor.  If you feel that you have some responsibility in this, speak up. Write a letter, have closure.  It often feels worse when we don’t say anything.

A lot of people say, “Oh, it’s not a big deal, I just won’t go back.” What’s great about letting that doctor know why you are leaving is that you are helping everyone who comes after you.

Many of the doctors I spoke to have no idea that they have done something wrong unless someone speaks up.  They won’t likely notice anything amiss due to the sheer volume of patients they see everyday.  When you don’t say anything, you are confirming that what is happening is okay.  At the end of the day, they are either going to hear your comment or not but you will feel better.

Are there any other possible ramifications that could hurt us in the long run? For instance, will the doctor report us to our insurance if we were referred to them by our primary physicians? 

 The doctor doesn’t have much to do with insurance, as the front office handles that piece of the visit, and they are so busy anyway that they don’t have the time.  The best thing I can recommend is to not have an emotional charge when you have the conversation.  If you feel angry over something, write a letter to yourself first, then write one to them. Get your main point across; you don’t need a laundry list of reasons.  You never know, the doctor could put a note in your file that you complain a lot.

How do you find a doctor that is right for you?

The best way of finding a doctor is from someone you trust, either another doctor on your team or reaching out to a larger network of friends and family and getting one from them. Equally important is knowing what kind of doctor you feel most comfortable with, a man or a woman, someone with beside manners or someone who calls it like it is. Everyone is different. 

The bottom line is don’t be afraid or feel bad for speaking up for yourself.  This is how we learn and grow, and you could possibly be helping your former doctor to learn and grow as well.  Remember, you are your own best advocate, and only you know what is right for your path to wellness and beyond.  

 

Jodyne Speyer’s book “Dump ‘Em, How to Break Up with Anyone, from Your Best Friend to Your Hairdresser (Collins) is available on Amazon.com or at http://www.dumpemthebook.com.