Top Comments You Need to Avoid Saying To Specialist Physicians

Ep 5: Top Comments You Need to Avoid Saying To Specialist Physicians

Show Notes

This episode of the Dr. Momma Podcast addresses the interactions that people may have with physician specialists and highlights the top comments that you should actually never say!

During my last podcast episode, I shared my opinion about the healthcare system being broken down into 3 basic levels which include Home Care, Primary Care, and Specialty care.

Today, I want to spend a bit of time focusing on what you can expect from visits with specialist physicians. Regardless of the type of specialist, medical or surgical… referral to us means that your primary care physician thinks that it is time for someone with additional training in a particular field to evaluate you.

To give you an idea what you might expect, primary care physicians may say something like, “you should see the specialist for surgery”, or “you should see the specialist to have a scope to look at what is going on inside”. The intent of this discussion is to give you an idea of what you might hear.

But these statements do not mean that you WILL need surgery or a scope. Just that you might, so you can be mentally prepared.  So you have time to get your head in the right space.

As I discussed in my other podcast episode, specialists need to get a complete medical history and perform an exam.  We are just meeting you or your child and although you may have done many home care treatments, had several urgent care center or emergency room visits and your primary care visits…please remember, we are JUST meeting you. We need to collect our own history and evaluate the previous treatments before we make our recommendations.

I have written a blog post entitled “What NOT to say to your Specialist Physician”. So obviously, I have had quite a bit of experience over the past nearly 30 years with patients who had a different expectation about what was going to happen when they are referred to my office.

I want to share with you the top 5 comments that I have received from patients who had different expectations about how the visit was going to go.

In other words, these are…

The Top 5 Comments You Need to Avoid Saying To Specialist Physicians

#1. I don’t know why I am here. The pediatrician just recommended a specialist check out my child. 

Umm, Just no. This is never the case.

Pediatricians can “check out” your child. There has to be some reason why they want you to see a specialist.

Physicians may find problems which do not address your specific concerns. Sometimes I see very large tonsils, but the patient is here for failing a hearing test. I know I am going to ask a lot of questions, but it is important for me to focus on your concerns so I can be sure to address them.

It is very disheartening after a visit when the absent parent calls my office and reports that the issue I addressed was not why they were there! You know that means you need to come back with the patient? I cannot just make a treatment plan based on your phone call to add information.

#2. I don’t know my child’s medical history. My pediatrician puts all the notes in the computer. Can’t you just look at the notes online?

After we are on the same page about why you are here, please know we are going to ask questions about the history of the problem. In fact, this is a good plan anytime you see any physician. We are GOING to ask you questions: When, Where, How…those type questions.

Now to be fair, some patients are confused that every physician cannot see their medical records. If your pediatrician and specialist physician belong to the same large hospital network, they will be sharing the same medical record system. In this situation, the specialist most certain will access the pediatric notes.

However, if the pediatrician or the specialist is in private practice or works in different hospital systems, you WILL need a copy of the medical records to send or carry with you to the office. Or simply be able to answer the questions that we need to understand your previous complaints and treatments.

Medical records are confidential and physicians cannot access the records without your written permission.

#3. Why are we discussing this information? I have been working with the pediatrician already. I am only here to schedule surgery. 

Ummm, No. In fact, that’s a HARD no.

Remember what I said earlier? Pediatricians and Family Physicians may tell you that you might need surgery or that surgery may be the next step. But the referral to the specialist says “Consultation for surgery and further management”.

Specialist physicians often process information differently than primary care physicians; thus, we may interpret the results differently.

Please allow specialists the time to understand what has been done and assess those results before recommending surgery.

And for goodness sake, come prepared to see a specialist! Come ready to share the problem as you see it, the effectiveness of the medications and share the other medical problems that you may not think are important to that particular specialist. We definitely need to know it.

#4. The only reason I want my child to have surgery is that I don’t want to give my child medications anymore.

As a specialist, I would LOVE this to a true statement! Some surgeries result in the ability to stop all medications; however, other surgeries may improve the problem so that medications are now effective.

Kids get ear tubes every day but when they get a runny nose, they may still get ear infections. Understanding the reason for the surgery and the expectations after surgery are CRITICAL things to know!  I always tell parents that ear tubes do not stop ear infections, they just change the symptoms and give a different way to treat them. With antibiotic ear drops instead of antibiotics by mouth.

I am always clear that ear infections usually happen because something else is wrong. By no longer needing to race to the emergency room for an ear infection in the middle of the night, parents now get a chance to see if the cold symptoms go away or if the runny and cough now become the reason to go visit the primary care.

Despite me saying these things, parents hear: Yay! Tubes! End of ear infections! But then they are unhappy when the infections persist.

During your consultation, the specialist physicians will let you know what to expect after surgery. Please pay attention to the risks and benefits that are discussed before surgery or a procedure is performed.

I do not know exactly how this applies to other surgical specialties. Whether or not medications for a problem will still be needed. But your experience surgeon can let you know. This is the reason for discussing your expectations BEFORE surgery.

And finally, the 5^th top statement you should never, EVER say to your specialist is: I do not want my child to have surgery. I am only here because my pediatrician recommended it. No matter what you say, I am not going to agree to it.

Well then. Alrighty.

But just to be clear, please understand that the first visit with a specialist is simply a consultation. I haven’t recommended surgery! So why are you getting so aggressive with me? We need to just calm down and get to know each other.

There is not a good reason to become confrontational with the surgeon before the history is obtained, an examination is done and a recommendation is given.

I am so passionate about this. Seriously, I still get surprised when this happens to me.

Of course, you ALWAYS have the right to refuse surgery or additional medications. However, if you made the effort to come to the specialist’s office, please allow the visit to proceed before you announce your final plans.

Many patients decline my recommended surgery. I let them know how to keep treating the problem with their primary care physician, but let them know the things that will not resolve with medications. When they are ready, they can return.

Dr. Burton’s summary:

Specialist physicians represent an important part of the healthcare team, and it is very important to understand how to get the most out of a visit with them. Please give us the opportunity to assess your situation and make our recommendations.

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