Choose from what?

And, for what it’s worth, I DO stand behind my professional opinion. I have been to court to defend it.

This is little consolation, though, for those patients who insist that there must be a better “option” and that I am wihtholding it from them for “selfish” reasons. They could not care less that I stand by my opinion, that it is a professional opinion, or that I am a professional. They only want reassurance that their misguided self-treatment is appropriate.

If you don’t have the stones to stand by your professional opinion, then give the patient the option to choose.

Options?

You come to me for my opinion. Based on experience, and knowledge of the current litarature I make a recommendation. I may (rightly) believe that there are no other “options” that are any better than doing nothing at all.

I’ve encoutnered this in my practice – “I don’t want to do that Doc, you have to suggest something else,” or “I don’t want to try that because I read about this side effect…” or “my brother-in-law’s third cousin says that treatment causes liver damage.”

I am sorry, you asked for my opinion, and I gave it. Your dissatisfaction with my professional opinion does not compel me to practice poorly.

Of course, if there is nothing appropriate to offer as an “option,” I could make something up. How about it?

In no case did any of the doctors discuss options. It was “we’re going to do this.” After the 5th skin lesion surgery I began looking researching options myself and, like “they” always recommend, went to the next appt with specific questions about alternative treatments.

The surgeon just said “That doesn’t work” (literally, that was the extent of his response) and continued filling out the paperwork for another surgery.

You can point the finger at malpractice/defensive medicine all you want, but if you’re not going to give your patients any options, you’re directly responsible for contributing to the problem.

It’s the same old, same old. Physicians blaming someone else for their ills, when they should be looking at themselves.

..No? To cite one very small example, almost all inappropriately prescribed antibiotics are prescribed at the demand of the patient. Attempting to argue peer reviewed journal articles showing no decreased length of illness goes nowhere. Withholding antibiotics that the patient wants means you are an “arrogant doctor” of the sort you complain about incessantly, undoubtedly of the sort that leaves the room with “the tail of his coat rapidly swishing down the hall”.

I suggest you read Kevin’s post about defensive medicine to give you a better idea of how it all works, and more importantly, why.