Well, actually, if you want the best medical care, your personal information is your doctor’s business. I was stunned last week when a new patient in my office told me that his psychiatric history ”isn’t any of your business!” This person was visibly agitated and raised his voice in response to my audacious question about his personal mental history and any treatment he received. I then spent the next 10 minutes of our precious evaluation time calming him down and explaining the rationale behind my offensive behavior.
This led me to reflect that it isn’t an uncommon belief that patients can withhold specific information from their doctors. Apparently, they don’t understand how important all information is to us in guiding our safest treatment plan for them. I believe that patients also don’t realize how their exclusion of such information increases their chances of having an adverse event or complication from treatment. Patients are more responsible for their medical complications that they realize, in this way. Unfortunately, physicians are the “bad guys” when something goes wrong regardless of who really dropped the ball that caused the adverse outcome and all too often, a lawsuit ensues.
I have a list of specific psychiatric diagnoses that I ask all patients whether I believe it might pertain to them or not. As I’ve explained in previous posts, in chronic pain syndromes the brain plays a crucial role in how pain is perceived, alleviated or worsened for all people. Variations in genes and the brain connections also strongly influence how an individual will respond to specific medications. For example, a recent study by Geisinger Health Center in Pennsylvania identifies increased risk factors for pain-killer addiction. In order to assess if those risk factors exist in any patient undergoing treatment, the doctor needs to ask the right questions and the patient needs to give honest answers.
I understand that oftentimes the questions that doctors ask during an evaluation are embarrassing for patients. To be honest, it’s sometimes uncomfortable for the doctor as well; however, we understand that we’re not giving good care if we avoid the tough questions. Likewise, a patient can’t be given good care if he decides to omit pertinent information and thwarts the doctor’s effort by assuming that he knows which information is pertinent. There’s a reason that medical school takes so many years and so much time of one’s life. There’s a lot of information to learn that isn’t gleaned by doing a Google Search.
This is why I believe it is crucial that we work on improving doctor- patient trust relationships. I am happy that people are taking a more active role in their health issues and seeking medical information, but that will never take the place of trusting the advice of a medical doctor with many years of training and experience. Doctors are similarly dependent on their patients for a successful medical practice. We want to care for patients who are intelligent about their health issues and compliant with our recommendations so that it’s a win-win situation. We doctors don’t look good if our patients aren’t doing well.
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The Medical Advocate
Well, actually, if you want the best medical care, your personal information is your doctor’s business. I was stunned last week when a new patient in my office told me that his psychiatric history ”isn’t any of your business!” This person was visibly agitated and raised his voice in response to my audacious question about his personal mental history and any treatment he received. I then spent the next 10 minutes of our precious evaluation time calming him down and explaining the rationale behind my offensive behavior.
This led me to reflect that it isn’t an uncommon belief that patients can withhold specific information from their doctors. Apparently, they don’t understand how important all information is to us in guiding our safest treatment plan for them. I believe that patients also don’t realize how their exclusion of such information increases their chances of having an adverse event or complication from treatment. Patients are more responsible for their medical complications that they realize, in this way. Unfortunately, physicians are the “bad guys” when something goes wrong regardless of who really dropped the ball that caused the adverse outcome and all too often, a lawsuit ensues.
I have a list of specific psychiatric diagnoses that I ask all patients whether I believe it might pertain to them or not. As I’ve explained in previous posts, in chronic pain syndromes the brain plays a crucial role in how pain is perceived, alleviated or worsened for all people. Variations in genes and the brain connections also strongly influence how an individual will respond to specific medications. For example, a recent study by Geisinger Health Center in Pennsylvania identifies increased risk factors for pain-killer addiction. In order to assess if those risk factors exist in any patient undergoing treatment, the doctor needs to ask the right questions and the patient needs to give honest answers.
I understand that oftentimes the questions that doctors ask during an evaluation are embarrassing for patients. To be honest, it’s sometimes uncomfortable for the doctor as well; however, we understand that we’re not giving good care if we avoid the tough questions. Likewise, a patient can’t be given good care if he decides to omit pertinent information and thwarts the doctor’s effort by assuming that he knows which information is pertinent. There’s a reason that medical school takes so many years and so much time of one’s life. There’s a lot of information to learn that isn’t gleaned by doing a Google Search.
This is why I believe it is crucial that we work on improving doctor- patient trust relationships. I am happy that people are taking a more active role in their health issues and seeking medical information, but that will never take the place of trusting the advice of a medical doctor with many years of training and experience. Doctors are similarly dependent on their patients for a successful medical practice. We want to care for patients who are intelligent about their health issues and compliant with our recommendations so that it’s a win-win situation. We doctors don’t look good if our patients aren’t doing well.
Like this: