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When Patients Can't Be Assertive with Their Doctors

Posted Jun 08 2012 10:05pm

I am hearing more and more accounts of patients afraid to stand up to their doctors. When a patient is in an HMO, this is a particular problem because many HMO doctors don't order needed tests because they will cost extra dollars.  I don't understand how any physician decides what tests to order on the basis of what the cost will be to the HMO and finally to him or her. Either you practice good medicine or you get out of medicine, as far as I am concerned. If a patient knows that a particular test is needed, but the doctor won't order it, he or she should speak up. Often I have had to push friends or patients, who contact me, in order to get them to request a needed test.

I  recently had an older woman tell me she was having balance problems, which her young G.P. said  was due to a neuropathy. How the woman made this diagnosis without doing a neurological examination or ordering a test called a nerve conduction time or referring the patient to a neurologist is beyond me. Maybe the doctor has a crystal ball that gives her diagnoses? Yet when I pushed the woman to ask for a referral, she hesitated saying it was hard for her to do this.  

Unfortunately with our present medical care, patients are going to have to become more forceful or their medical care is not going to be adequate.  Many doctors these days seem to be driven by the need to make as much money as possible and spend as little time as possible caring for their patients.

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