When To Find A Different Doctor

Today's blog reflects personal recent experience. I hope that it will help my readers.

Recently I visited several physicians concerning a medical problem. My internist recommended selecting two highly competent physicians in the relevant specialty (he did make recommendations). I had long ago learned how difficult it is for patients to evaluate the competency of  physicians to whom they are referred (even when they are, themselves, physicians), so I went about the process methodically, checking with other respected physicians, friends and academic leaders, as well as with the Medical Board of California's web site where I could verify credentials and freedom from serious disciplinary action.

I chose two doctors, one in a well-known group practice (my internist's) and the other at a nearby university medical center.

The first physician briefly reviewed my history (he had a computerized medical record), examined me, and with me and my wife, reviewed the abnormalities on an MRI which had been performed 6 months earlier.  He told me that he could not help me with the presenting pain symptom because the presumed responsible condition was not sufficiently severe to be its cause. He did not discuss several other abnormalities on the MRI, other than to note that they were there and they were not treatable by him because there was no evidence-based literature to support his specialty intervention.

The second physician also took a history, examined me, and reviewed the abnormalities on the MRI  (on his computer screen) done earlier and agreed with the first doctor that the MRI  demonstrated that the presenting diagnosis did not warrant surgery. But he went further to analyze and discuss the other abnormalities in the scan, which were not significantly addressed by the first physician, and to ask the question "why are these abnormalities here and what causes them?" He then,  citing applicable professional standards of practice, sent me for lab, x-rays and an additional MRI after dictating a clinical note in my presence.

When the first doctor showed the abnormalities on his computer screen, I was surprised that he did not give them more than cursory attention and comment. But I decided that if he had little interest or comment about them, I would recognize his professional limitations and demand more interest, attention, analysis and discussion from the second doctor. I didn't have to: the second doctor demonstrated interest, attention, analytical ability and the capacity to ask "why?"

My suggestion to readers is that if your doctor, hearing of an abnormality on taking a medical history, or seeing an abnormality in a laboratory test, x-ray or scan, doesn't ask "why,"  he or she is the wrong physician for you.  The physician who instinctively reaches for the prescription pad or gives a simple reassuring answer to what may be a serious clinical danger signal may not be providing competent care.  Find yourself another doctor who is less anxious to limit choices or exercise professional intellect.  Find a doctor who asks "why."

Sometimes doctors make mistakes. Sometimes patients are wrong, too. But you can protect yourself by asking your doctor "why?"