Changing physicians

March 13, 2008

Forbes.com with an article on “firing” your physician. There is a wide spectrum of communication and practice styles, so finding the right “match” is imperative.

If the comfort level isn’t there, by all means, find someone else.



Related posts:

  1. Styles
  2. Changing health care
  3. Accepting Medicaid led to firing
  4. How to find an endocrinologist for your diabetes
  5. Physicians and administrators, Mars and Venus
  6. Physicians’ trump card
  7. The changing face of American medicine


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{ 5 comments }

1 feminizedwesternmale March 13, 2008 at 1:46 pm

Ironic article from Forbes:
Implicit to the discussion is the patient as a consumer, paying for a service. It may be time to fire your doctor if he doesn’t meet your expectations! There is no mention of diagnostic acumen, pursuit of truth, or value of service.
I’m waiting for JAMA to offer a subsection for a paid Forbes supplement. LMAO.

2 Anonymous March 13, 2008 at 3:57 pm

It seems silly to list “doesn’t use e-mail” as one of the criteria for “firing” your doctor.

The multi-specialty clinic where I’m a patient doesn’t do e-mail. It frustrates me no end to play phone tag, leave messages that aren’t accurately conveyed, and wind up talking to a nurse when what I really need is the physician’s opinion.

But you can’t have everything. All things being equal, it’s pretty low on my list of priorities and certainly not something I would “fire” my physician for.

3 Anonymous March 13, 2008 at 8:37 pm

It needs to be explained that if a pt fires his doc, the pt has to find a new one. It is NOT the responsibility of the “fired doc” to provide another physician.

This comes a lot in the hospital; unassigned pt wants to fire the hospitalist for whatever reason.

Well, if you’ve got no to write orders, you have to leave the hospital. And family members don’t get to fire the entire ICU team (nurses and all) – sorry, there is a lot less automomy in the ICU than there is in the outpatient world. That’s jsut how it works…

4 Anonymous March 14, 2008 at 8:02 pm

This article is in Forbes and is written as if it is directed at executives. Some executives it should be noted are egocentric narcissists which works in their job which is essentially to impose their will on others so as to get an enterprise going in one direction. They expect to be catered to by all of their lackeys and servants and that may include their physician. That is an entirely appropriate expectation for them (and all patients) for waiting times, having questions answered, etc.

But that particular personality type is going to have a personality clash with any physician who isn’t a pushover for every demand they make whether appropriate or not. They are going to try to control the interaction the way they exert control over everyone else in their life–and are in effect their own doctor if they do and will get crappy medical care. In fact in my experience, especially if controlled drugs are involved, these guys need a doctor who is strong willed and unimpressed by their “importance” to get good care–someone with whom that type is bound to clash. This type is also very uncomfortable with the doctor-patient relationship, and is prone to abuse electronic communication, demanding answers to things that are best addressed face to face–an interaction with which these guys are typically uncomfortable and therefore seek to avoid.

Which brings us to email. I have some discomfort with email for anything other than making appointments and other peripheral business issues for two reasons. It leaves a verbatim trace of the doctor-patient interaction on God knows what servers indefinitely making it impossible for me to fullfill my fiduciary responsibility to protect my patient’s privacy. Secondly is is half-assed communication at best, leaving out 90% of what is exchanged face to face and 70-80% of what is exchanged in a phone call.

5 Anonymous March 15, 2008 at 8:04 am

E-mail doesn’t work. A specialist and I tried it. He’d be out of town, the clinic had no auto-reply, and I’d be left wondering if my message got through or was being ignored. It offers a chance to think your communications through but not to read tone of voice and facial gestures — inviting misinterpretation. And, your messages may well go places you never intended. Even when appropriate, that can be a surprise. As a patient, I’d never use it again and would politely decline if a doctor offered the service.

As for “firing” your doctor… doctors can and do “fire” patients for no cause, so logically the same freedom must go to patients. However, the criteria listed in that article were awfully rigid. Doubt there were more than two that looked like reasonable cause to me.

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