In the New York Times article, “Letting the Patient Call the Shots,” Dr. Pauline W. Chen describes “patient centered care” as a medical model in which “shared decision making [between doctor and patient] would be made mandatory in all areas of care, with patient preference occasionally putting evidence-based care ‘in the back seat.”
The “patient centered” model has begun to gain recognition as an increasing number of stories have surfaced from patients who feel that their individual experiences are diminished by doctors with little time, who are encouraged to make rushed, clear-cut diagnoses.
At present, however, it remains often difficult for patients with chronic illnesses or rare diseases to find a physician who is supportive and open to considering the patient’s opinions. And this problem is not merely the fault of the doctor; As Dr. Chen points out, the “system around clinicians makes it impossible to customize care the way it needs to be. We don’t have s standard of services or processes that are comfortable for the patients. We have built a technocratic castle, and when people come into it, they are intimidated.”
Although it can be intimidating to stand up to a physician this may be the first step toward optimum care. Here are some suggestions on “How to handle a Difficult Doctor,” courtesy of the WEGO Health Dystonia Community:
- Try to approach the problem with the goal of reorganizing the office appointment to reduce friction, instead of attempting to prove who is right and who is wrong
- Write out questions before an appointment. Acting professionally is crucial to creating an atmosphere of equality.
- Listening is critical, not only to what the physician says but how he or she says it. Sometimes defensiveness is a sign that the doctor is frustrated by results, not that he or she doesn’t acknowledging your challenges.
- Be Assertive. Confront the problem head on without being confrontational. “The first rule of assertiveness is to use your words, not your tone of voice, to express your message. In other words, do not sound angry or annoyed as you assert your point.
- Sometimes a friendly office environment isn’t enough. In this case, it may be necessary to have a formal discussion, or even an intervention, with the difficult physician. If intervention is necessary, consult with a social worker or behavioral health specialist about ways to approach a problem without making the guilty party go on the defensive. Remember, compromise is imperative.
Written by Haley Newman, WEGO Health Intern. Haley Newman is a Community Health and Asian Studies Major at Tufts University. She aspires to someday become a caring physician and anthropologist. For fun Haley enjoys running by the ocean, yoga, guitar, photography, reading, writing, sushi and listening to people tell stories.