How to question your doctor’s recommendation.

Sandy is sitting in her physician’s waiting room.  She’s thinking about an article she read that discussed a medication that she has been taking for over a year.  The article cited recent research showing that, over time, the side effects of this medication may outweigh its value and that, in fact, it may be detrimental over time.  While she trusts her doctor, Sandy wants to know if her doctor is aware of this research and if she is considering the effects of long-term use.


Sandy is concerned that, because her doctor is busy, she may not be familiar with the research and might consequently, feel embarrassed or annoyed if Sandy brings it up with her.  However, Sandy also doesn’t want to continue to take this medication without a strong recommendation from her doctor.


Even been in this position?


Like Sandy, you may have read an article or talked to someone – a friend or a healthcare professional – that provided you with information that raised questions about a medication that you have been prescribed.  Or, about a test, or a procedure, that your doctor has recommended.


And also like Sandy, you may be concerned about asking a question that causes your doctor to feel like you are putting him/her “on the spot,” and that your doctor may feel challenged or offended by your question.  Or not have the answer.  Then what?


Here are some ideas for how to have this conversation with your doctor.


Do some prep work.  Physicians make decisions based on facts and data.  Ideally, that means research.  So come prepared to provide information that your doctor most likely be comfortable with.  If you read about a study, be prepared to quickly summarize what you read, including the name of the study, who conducted it, and the key findings.  Again, data.  To help you have this discussion, write the key points on a sheet of paper and bring it along with you.  It might also be a good idea to print out the summary to give to your doctor.


Caution: Every patient has their own unique experiences and opinions.  So if you are intending to question your doctor based on the advice of another patient, you doctor will probably not find this relevant to your situation.


Adjust your attitude.  While humans communicate with words, we also communicate through our body language, facial expressions and the way that we express ourselves.  Think of this as a conversation between two adults, one who is responsible for managing their healthcare (that’s you) and the other who has an expertise in healthcare (that’s your doctor).  Think of you and your doctor as being on the same side, not as adversaries.


Open the conversation on a positive note.  Tell your doctor that you read about some research that you want to briefly about.  If you know your doctor is under time constraints – and most are these days – reassure him/her that you only need a minute.


Keep the Start with something like, “I recently read about a study that was conducted…” or “I heard that some recent research showed that…”  Limit this to one or two sentences.  Follow this with “Have you read about this?”  Physicians read a lot of research, and your doctor may not have heard about this study yet.  Or he/she may be familiar and have formed an opinion.  Either way, avoid putting your doctor on the spot with questions like, “What is your opinion of …” and then expecting them to have formed an opinion on research that they may not yet have read about.


Be ready to follow up on your doctor’s reaction.  If your doctor has already formed an opinion of the information, ask if he/she can explain their opinion and what they would recommend in your case.  For example: “I’m glad you have also heard about this study.  Can you tell me your thinking about how this relates to me?”  Consider your doctor’s response in terms of what you heard.  If you aren’t sure about whether you are interpreting the information in the same way, let him know how what you read differs from his interpretation and ask if he can add further clarification.


If your doctor has not familiar with this information, then ask if you can briefly summarize what you read.  Use the 15 second rule to provide a quick summary and the concerns that this raises with you.


Keep your expectations realistic.  Your doctor may need some time to digest this information and do some research on his/her own before making a recommendation.  If so, ask when the two of you can have a follow up discussion.  If this means postponing a decision on, for example, a medical test, ask for your doctor’s opinion on the implications of postponing this test.  Keep in mind that you may be left with a decision to make.


Some physicians are more open to questions and suggestions from their patients than others.  If your discussion reaches a dead end before it even begins, then you will also be left with a decision to make, and some additional research to do regarding your treatment options.


Sandy, the patient discussed earlier, provided her physician with a copy of the article she had read.  Her doctor reviewed it and, at Sandy’s next appointment, offered recommendations for two alternative medications.  Sandy was glad that she had taken this step with her doctor, in spite of her initial discomfort.  Her doctor even thanked Sandy for bringing it to her attention.


Remember: this is a professional relationship.  Asking your doctor questions, and keeping him or her “in the loop” about what you are learning, doesn’t have to result in conflict.  In fact, sharing ideas and knowledge can deepen your relationship.  This is all part of being a team.