Recently,
an acquaintance asked me what to do when she strongly disagreed with
a recommendation made by their family doctor for her disabled
husband. I've certainly been in that situation. Still each family
is different and what works for us, may not work for you.
Really,
there are no hard and fast answers that I've found. I strongly
prefer a medical practice that encourages dialogue and that is
willing to discuss the pros and cons of alternative therapies. We
can deal with more autocratic practices. It just isn't as pleasant
and straight forward.
Here
are seven things that I've found helpful when considering treatments
other than what Boo's doctor, physical or occupational therapist,
etc. recommends. (Most of the time we do follow the recommendations,
even after looking at other options. Not always, but usually. We do
always clearly communicate our decision to Boo's primary care
doctor. That way he or she is completely aware of what's happening
with Boo.)
If
this is an emergency situation, clearly state your medical wishes,
provide a medical power of attorney and let the professionals save
your loved one's life. This is
not the time to get in the way.
One
If
the medical professional suggests a therapy or medication that seems
out of line, I ask the reasoning behind his or her recommendation.
Many times this simple questioning is all it takes for us to
understand. It also helps to eliminate second guessing on my part
later on.
Once
when I questioned a doctor, with whom we were very pleased, he gave
me a rather blank look, glanced at the prescription he'd just written
for Boo and did a double take. He was in the wrong room. They were
exceptionally busy that day and the doctor mistook Boo for a
different patient.
Two
After
questioning the doctor or therapist and understanding their reasoning
if I still disagree with the treatment, I'll ask what alternatives
there are. The practices I like best will discuss them.
Ultimately this saves a lot of time and a lot of my energy. Many
times the alternatives haven't been chosen for a good reason.
Sometimes I just need to know the reasoning involved.
At
this point, if a medical professional refuses to discuss
alternatives, I ask if a different time would be better. Just for
the record, that has never been the case. Still, I like to ask.
Then, I clearly tell whomever I'm dealing with that I'm uncomfortable
with the recommendations they've made and I tell them why I'm
uncomfortable. I also tell them that I'll be examining alternatives
and that we'll contact their office later.
Three
At
home, I promptly search the internet for alternative
treatments, the effectiveness of the various treatments and the
feasibility of Boo using the different treatments. The Mayo Clinic
and Web MD are two good sources of medical information.
Four
I
call several good friends to ask questions. One is a
retired doctor. Two are nurses and one is an occupational therapist.
Many times insurance companies have hotlines with nurses that will
answer questions. That's not a bad resource to consider. In our
area, we have two large teaching hospitals. Both have public
hotlines staffed by nurses, residents and interns who seem
knowledgeable.
Five
At
this point, I contact the original medical professional again to
discuss what I've learned. This has met with mixed results.
Usually, they are open to some discussion. On one occasion I was
told that, “I don't discuss that type of thing with patients. They
aren't doctors. They need to follow my plan or go elsewhere.” We
went elsewhere.
Generally
this is the point where we come up with a treatment plan that works
for all of us. Rarely, that hasn't been the case.
Six
If
we haven't reached a treatment plan that both the medical
professional and Boo and I are comfortable following, I get a
second opinion. Generally Medicare and insurance companies will
pay for second opinions with little fuss. Locating another doctor
has never been a problem for us. I call the local hospitals. They
have referral services. Another alternative is to call the medical
licensing board in your state and ask for a referral.
Seven
After
I've researched different therapies, considered the feasibility of
them and talked to the doctor again...or gotten a second opinion,
it's time to decide what to do. Make a plan and adhere to it.
Boo's
health is too important to dilly dally around. No treatment plan
will be perfect. If we come up with one that generally works well,
then I'm happy.
