Doctors lie to their patients all the time, and by lie, I really mean, “lie by omission”.
As I say this, I’m thinking of a patient I had a long time ago that taught me that lesson. She sat in my office, and told me that despite all of the doctors she had seen and all the treatments she’d had for chronic heel pain, both of her heels hurt all the time, for years and years.
So, I took a deep breath. I looked at her and with all the love and kindness I could muster.
And said…
“Sweetheart. Your heels hurt because you’re morbidly obese. They simply weren’t designed to hold up a 400 lb. body.”
She looked at me with total shock and disbelief, and said, “No one has ever told me that. Now hear me, I know I’m a big girl. That’s no secret, but no doctor has ever had the guts to tell me that my feet hurt because I’m fat!”
I said, “Well, I can’t lie to you. That’s why.”
All of the doctors she saw were more willing to give her drugs and procedures to mask the pain, all of which had potentially serious side effects, rather than have an honest and difficult conversation with her about losing weight.
Now flash forward. I’m a mom and a doctor. I doctor my kids fairly regularly, but occasionally, I want a second opinion or another set of eyes on a problem. Case in point: Jules had a lingering cough. Coughs don’t generally bother me, but this was lasting longer and sounded a little more serious than I was comfortable with. So, I took her to my pediatrician whom, by the way, I love very much because he lets me have these difficult conversations with him, and loves me back anyway.
I explained the situation to him, and he said, “Alright, we’ll give her this,” as he proceeds to write her a prescription. My reaction went something like – “Whoa, whoa, whoa. I didn’t come for drugs I came for information.” I was there to make sure I wasn’t missing something, and to find out if he felt strongly whether or not we should intervene in some way.
His reply was, “I think you can safely watch her, and hold off on the medicine unless A, B, and C happen. But quite likely she’ll be better in a week or so.”
I told him, “I’m a little confused. The very first thing you did was tell me to give her medicine, so if she’s quite fine without it, why did you do that?”
To which he said, “Well, I figured you took the time to come in and paid your co-pay, so I assumed you wanted me to do something, as most parents do. Most parents want me to give more than advice. They want me to take action to make their child better.”
I want reiterate that Jule’s pediatrician is not a bad doctor, and the prescription wasn’t a wrong recommendation. It just wasn’t the best recommendation at that time.
He could have said things like:
- “Let’s practice watchful waiting.”
- “I think she’ll be fine, but if she gets worse instead of better, come back and see me.”
- “Try these home remedies.”
I want to make it clear that most doctors practice really good medicine. However, in these days of managed-care and 5-minute office visits, I think to write the prescription first, ask the difficult questions later, is common. I don’t want to be inflammatory, because their intention is to be helpful and to ultimately make their patients better, but to all the moms out there I say this:
Make it your responsibility to get all the information before making a decision, and ask your doctor to be more of a counselor than a prescriber.
