More Assumptions Patients Should Not Make

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Having written this blog aboutassumptions patients should not make, I need to revisit the topic toadd a few more assumptions not to make and a few things that it isbetter to avoid. Some of these ideas have appeared in otherpublications.
Never assume you are receivingcontinuity of care. This is more difficult especially whenyou have multiple chronic diseases or illnesses where you need to seea variety of specialists. This is a problem area that requiresvigilance on the part of the patient and/or family members. Thisshould be something that you consult heavily with your pharmacist toprevent conflicts of medications. Some doctors are great in lookingat your records before issuing a prescription, but others can upsetthe best plans and it only takes one to mess it up and put you ingrave danger.
Never insist on self-diagnosis orself-treatment. While we know our bodies better thananyone, self-diagnosis by the patient can be deadly and is notrecommended. It is better to write down all the symptoms that younotice and hand them to the doctor. A diary of symptoms can be alifesaver when doctors put you off and make unwarranted assumptions. Sometimes these assumptions can be correct, but often they may not becompletely correct and the partial treatments may mask the realproblems. Let the doctor ask some questions and start eliminatingpossible problems. The doctor can then order any tests necessary toconfirm or rule out illnesses.
Never assume your doctor is alwaysright.This is a problem for many patients. We do not want to believe that our doctor could be wrong. If you areone of these patients like me, just spend a few months watching the“Discovery - Fit and Health” channel and the “MysteryDiagnosis” program. Yes, most doctors haven't a clue of what isgoing on as we are talking about rare medical conditions, but the waythese doctors handle these cases almost makes you want to reach intothe TV and choke the doctor. Patients are often accused of wantingattention or are letting their imaginations get the better of them. While these are the extreme, I hear stories like this from peoplearound me when they are angry with their doctor for ignoring them ornot taking them seriously.
Do not assume that the doctor haspreformed all the necessary tests.As a patient, this may be impossible toknow whether the necessary tests have been done. This is one timeyou, as the patient, may need to ask some very direct questions. Never mind what the doctor thinks, it is your health and thesequestions may save your life. How do you know what to ask? First,you need to ask what tests have been done and what they determined,if anything. Second, ask what other tests could be run. If thedoctor starts dodging the questions, you know that there are moretests that may be of value, but this doctor does not know enoughabout them to be comfortable using them. This is when you know thatyou may need to seek another doctor.
Do not assume that the doctor isgiving you the correct medication or dosage.Many doctors will give you the bestmedication after evaluating you and your condition. They will askquestions and probably use some tests to make this determination. Ifthe medication is new to you, make sure you get the correct spellingand then look it up in the Internet to determine if this is anestablished medication or whether you are being used as a guinea pigfor a new medication. Some new medications may be excellent for you,but always be alert for unusual side effects and do not be afraid totalk to your doctor about taking you off the new medication and to anestablished medication. Read this by Trisha Torrey as she has somegood discussion points for you to ask the doctor. It may be in yourbest health interest not to be a guinea pig for a new medication.
The next question is whether you arereceiving the correct dosage. Most doctors will start with a lesserdosage and increase the dose if needed. Be cautious if you arestarted on the highest dosage and the doctor does not want to discusshis reasons with you or discuss alternative medications. I wasconsidering changing doctors, but during the first appointment, thenew doctor insisted that all my medications would need to be changed. When he ignored that I received many medications through theVeterans Administration and stated that I would be coming off insulinand go on oral medications for diabetes, I knew this was not a doctorI could work with. When he stated that my A1c of 6.1 was too low andthat I should be between 6.5 to 7.5, I admit I went a littleoverboard when I asked if he had gotten his medical degree as a prizein a cracker jack box. I said that if he objected to onehypoglycemic reading of 63 mg/dl, then he had no understanding ofdiabetes and I would keep my endocrinologist and other doctors. Thatwas the end of my appointment, and I suspect by mutual agreement.
Do not assume that your doctor willgive you a referral if one is needed.This can be a delicate issue. Somedoctors are willing to refer you to a specialist. Other doctors areso puffed up with their own importance that they feel that they arethe only source of medical care you need. Still others will justtell you to find another doctor if you ask for a referral. The lasttwo types are doctors you need to avoid if at all possible. Becautious if you live a long distance from your primary care doctorand it is even farther to the specialist or another primary caredoctor. This article is a good review of possibly how to approachthe topic, but be careful if you suspect you have a doctor mentionedabove. Some doctors may seem hard to approach; however, doneproperly, you may get the referral needed. If you know that thereferral is necessary, then you may need to request it and replacedoctors if necessary. One alternative I have found that works istalking to my medical insurance company and explaining the situation. I was sent a list of acceptable primary care doctors and even a fewspecialists that I could see without a referral. I may have beenfortunate with the person I talked to, but everything worked out forthe best when I needed it.
I will continue to look for additionalideas for another blog on this topic.