Ep. 23: Stop Asking Physicians for These 7 Things
Physicians enjoy working with our patients to solve problems and prevent future concerns. However, many times, patients decide that something is needed that physicians feel is not medically helpful, medically indicated or potentially harmful. This episode is going to discuss why it is important to stop asking physicians for tests or medications that they do not feel are needed.
Developing trust in your physician is important
Part of the process of selecting a physician is building a rapport or a trusting relationship. Understanding your physician’s credentials and experience will allow you to trust their judgment.
To start with, make sure you choose a physician with the credentials or training that you desire. Perhaps you would prefer to have a younger physician closer to their training. On the other hand, you may want an older physician who has been there and done that. Someone who understands what is supposed to happen but has seen that things do not always go as planned!
There are also other types of healthcare providers, such as nurse practitioners and physician assistants who offer valuable services to the medical team. Each person will have their own experience which will guide them in making a plan of action.
Bottom line, make sure you trust whoever you have chosen to provide your healthcare and then allow them to begin their treatment plan.
To be clear, there is nothing wrong with starting a conversation about something you read or were told about; however, after the subject is discussed and the medical opinion is given, I recommend you stop asking physicians to do whatever you think is needed.
Why asking physicians to do tests may not be a good decision
After 4 years of medical school and a minimum of 3 years in residency training, physicians understand treatment options. But all patients are not the same and should not have a “cookie cutter” treatment plan.
When you ask for a specific test to be done, you change the decision making and orderly approach to treatments. There are many ways to treat problems. but physicians must start somewhere. If tests are done that take the process in a different direction, sometimes the more common problems are not looked for or addressed until later.
It is not wrong for a physician to order whatever test you are requesting; however, it may not make medical sense to do it at that moment. Interpreting labs and xrays must be done while also considering previous treatment results and exam findings.
Often the treatment plan you are requesting is one that you learned from a non-medical friend or relative, or more commonly from an online source which could have been sharing general options.
One of the worst places to get your health information is from the growing number of the non-medical facebook groups. I am a mom blogger and love me some mommy bloggers! Nevertheless, unless these moms are healthcare providers, why are you accepting their healthcare tips over those of your physician? Bloggers may share their personal experiences, but that should not be equal to the science-backed research that physicians base their treatments on.
Why do physicians sometimes order the tests that you request?
Some physicians may order tests they do not necessarily feel are needed because they want to keep you happy and prevent you from going to another physician who will do them! There, I said it.
We want to keep you as a patient and arguing about why we are proceeding in a certain way may not be in our best interest.
But this extra testing increases the cost of our healthcare, and the results may not help us to determine our next course of treatment. If the test is not going to change our treatment plan, why should we order it?
Also, remember that if a physician says that the test should not be at this time, it may be considered later when other results are known.
Any other reasons to avoid asking physicians to do these things?
In addition to trying to provide you with the best possible care, physicians attempt to use honest medical judgment. We do not want to be put in the position of supporting things that are not medically correct.
For instance, some surgeries require children to stay home for a week or more. I happily provide excuses for parents and their children. However, if a child has ear tube surgery and you request a note saying you need to out of work for a week, “just in case”, that is not medically appropriate. This surgery is associated with missing 1-2 days of work unless there are other medical conditions to be monitored.
Of course, I can write any excuse I want, but it will reflect poor judgment or perhaps a lack of integrity. Having a solid dependable reputation is important for new patients as well as for referring physicians.
7 things you should stop asking your physician to do
I belong to many Facebook and Twitter groups with some of the most outstanding physicians imaginable. Be sure to check out my list of impressive social media physicians you need to follow to get healthcare information from reliable sources, based on scientific research.
One of the beautiful things about reading blogs and social media posts created by physicians is that you get the benefit of their interactions with other physicians. As I prepared for this post, I asked thousands of physicians what concerns they had about patients asking for things they did not think were needed.
Immediately I was flooded with things that were asked of them on a daily basis! And daily, they spent a lot of time trying to convince their patients the requested thing was not needed.
So here are the top 7 things that were repeated in many different ways, by many differnt physicians from many different specialties. Things you should not ask your physician for…
1. Give antibiotics
I have beat this topic to death in my posts on ear infections and sinus infections. Many infections are caused by viruses or other causes of inflammation, and antibiotics are just not needed.
Every medical provider knows antibiotics are an option. When you ask if we think an antibiotic would help…well, we have already considered that! And of course asking before a vacation, just in case…NO!
2. Order xrays
Xrays are an important tool for diagnosing a wide range of medical problems. But a physician with extensive experience will understand how to treat many problems without xrays. It is a good thing to avoid unnecessary radiation. Instead of asking for them, you should be happy attempts are made to treat without them.
If xrays will change our treatment plan, we order them. If we are comfortable with our initial treatment plan, and xrays will not change that plan, why would we order them?
3. Order specific blood tests
This category was far and away the most frustrating category for physicians. With so much available health information online, many people have already diagnosed themselves! So when they arrive for their physician visit, there is a list of tests they need to confirm their self-made diagnosis. Pro-Tip: This is NOT how our healthcare system works!
Be sure to listen to the podcast as I share 5-6 frequently requested tests that are not often needed.
4. Recommend emotional support animals
Now I never knew this was a thing to ask for! There are clear legal indications for these animals.
Also, an emotional support animal is NOT the same as a service animal. Once you understand the difference, you will see there is no reason for you to ask. Let your physician recommend this if they think it is needed.
5. Get genetic testing without genetic counseling
When you get genetic testing, you need to know that finding things may have consequences and impact. There should be someone who is going to interpret the tests and tell you what that means to you and your family. It is not just information to store away.
A really common one is the BRCA test…that is breast cancer early onset. It is a gene that predicts a high risk of developing breast cancer. It is a reasonable thing to do if you have a family history but you should have the appropriate counseling before getting the test.
Getting the test “just to see” is not a good idea.
6. Cardiac stress test to establish a baseline
A specific age does not mean this test needs to be ordered. Turning 40, 50 or 60 is not a risk factor. There are always medical indications, so if you have a strong family history or some symptoms, your physician will be all over it, and recommend you get the test.
If we order tests just to see, and there are no risk factors, any slight abnormality might need to be followed up and more unnecessary tests done. There are ranges of what is good and bad and physicians use your symptoms or history to interpret them. Without indications, it can be hard to know what is acceptable and what is not.
7. Referral to specialists without initial work up
This category is near and dear to my heart. I am constantly reminding my patients that I am a specialist, so I assume basics have been done before I move to more complex treatments.
Every day I remind at least a few patients that there are 3 basic levels of healthcare and each has a specific role. I feel so strongly that everyone understand this that I not only wrote a blog post last year about it but I revised it into a podcast earlier this year.
I depend upon my pediatric and family practice colleagues to determine who should progress to see me.
As always, much love for supporting my work. I will be adding many more posts to highlight parenting and healthcare tips, so be sure to consider subscribing to my podcast or to my blog to avoid missing a post!