I think that some patients confuse a doctor's office with a supermarket. They come in with a written or mental list of what they want and are not happy unless they receive what's on that list. I will explain what a visit to a physician is and isn't.
A patient is paying for an evaluation and treatment of a medical condition. It would be a mistake to take your car to a mechanic and tell them you need a new water pump. If they replace it and the car still has the same problem, you would be upset. You should tell your mechanic that your car is overheating and let the expert determine if the problem is the water pump, the thermostat, the radiator or something altogether different. Certainly a car owner with a lot of knowledge about cars can provide thoughts as to what the problem is, but the diagnosis should be left up to the mechanic.
So too should the patient avoid going to the doctor and tell him that you need Nexium for your hiatal hernia. If you are just given the prescription without a proper evaluation and then have a heart attack, you would be upset. You should tell the doctor that you are having indigestion and let the expert determine if the problem is a hiatal hernia, ulcers, angina, or something altogether different. Certainly a patient with a lot of knowledge about health can provide thoughts as to what the problem is, but the diagnosis and treatment options should be left up to the doctor.
The above is not a perfect analogy as diagnosing medical conditions is often an art and not an exact science. If the diagnosis turns out to be incorrect or incomplete on several occasions, you should find a new expert.
The two areas that often bring out the worst in patients are for prescriptions of antibiotics and pain medications. These are the two most frequent situations in which some patients insist on particular medications and will refuse others.
With antibiotics some patients insist on getting one even if they have a condition in which there is no benefit from it. I do not know why someone would expose themselves to the risk of allergic reactions, unnecessary side-effects, and the build-up of resistant bacteria in their system if antibiotics are not going to help them recover from their illness faster.
Other patients insist that they are immune to certain ones. It is often difficult to convince these people that while some bacteria are resistant to certain antibiotics, people are not. An antibiotic that might not have worked for a particular infection in one instance may very well be the best choice for a different infection.
It can be helpful for a patient to notify the doctor if they have had side-effects, allergies, good success, or bad success with a certain antibiotic for a similar infection in the past. The ultimate choice however, should be left up to the expert.
With pain medication, it is one thing to let your doctor know your past experience and results with particular drugs. It is quite another to insist on only one particular medication for your pain. You run the risk of being thought of as a drug-seeker if you are unwilling to try any medication other than strong narcotics.
Just as there are many different types of pain so are there different types of pain medications. One kind may be good for one pain while another might be better for another pain. Your doctor is in the best position to diagnose the cause of your pain and offer the most effective and appropriate medications for the situation at hand.
With any medication that your doctor prescribes, there is a chance that it will cause side-effects or might not be fully effective. That does not mean that the wrong medication was chosen. But your physician needs to be available to adjust a dose or change a prescription if the results are not satisfactory.
While a doctor patient relationship is a partnership, it is not an equal one. They each have their roles and responsibilities to achieve optimal results. The doctor should listen, examine, and advise. The patient should ask questions, choose among reasonable treatment options, and comply with the recommendations. Patients receive better care when they work with instead of trying to be their doctor.
