As a patient care provider and someone who is occasionally a patient myself, I am going to provide some suggestions on ways to know when it is time to consider seeking a second opinion or time to seek a new health care provider. This top 10 list is taken from personal experience.
1. The number one reason to seek a new healthcare provider is when the treatment you are receiving is not working. This may seem obvious but sometimes, people continue to remain with the first treatment provider they come into contact with because they “feel bad” that the provider may be offended and sometimes just fall into a pattern where they are going for “treatment” without realizing that their symptoms have remained the same or worse for years. The patient needs to care about him/herself first. With modern healthcare being as busy as it is today, the provider will likely be too busy to get upset about some patient attrition now and then.
2. The healthcare provider is more concerned about discussing himself that talking about you. I will never forget going to see an ear, nose, and throat (ENT) doctor once who literally would not stop talking about himself and his own accomplishments for the first 10-minutes of our interaction. It is a bad sign that the provider will not be sufficiently focused on the patient to provide proper evaluation and management.
3. The healthcare provider does not want to order tests that can aid in better diagnostic decision making (such as magnetic resonance imaging) because they “don’t want to fill out all of the forms.” This is different from not wanting to order tests that would not be helpful. If a surgeon did not want to fill out forms to order a test that can clarify the diagnosis, for example, would you feel confident that this person would take the time to take put the sutures in properly, or would they possibly, leave a scalpel inside of you? I would not want to take the chance.
4. You are rarely being seen by the doctor but are almost constantly being seen by a physicians assistant or nurse. Not that there is anything wrong with physicians assistants or nurses because they do play a very important role in health care, but if you are seeking the care of a specific healthcare provider and are rarely ever getting to see that individual (and you are not getting the care you believe you need as a result) this is a good sign that it may be time to make a switch.
5. The provider becomes defensive and angry when asked polite but challenging questions. No health care provider is always correct with diagnostic decision making or managing treatment. Patients should feel like they can have an open and honest discussion with the provider which includes asking questions about possible alternative diagnoses, treatments, or inquiring about information gathered from popular news sources. Provided that the questions are asked politely and without the intention of being antagonistic, there is no need for the provider to become upset. There is no need for a patient to feel scared to ask questions of their physician, nurse, psychologist, etc.
6. Feeling rushed. Healthcare is best when the provider is able to take the time to listen and understand the patient’s problems. When the provider gives off signals (e.g., frequently checking the clock or a watch, sighing when questions are asked, walking towards the door, cutting off questions) that he/she cannot spend much time with you, it may be time to consider seeking the care of someone who can.
7. When the provider makes decisions that turn out to be harmful. An example of this would be going to a pediatrician for a child with respiratory problems and constantly being told it is probably due to allergies despite the fact that the child has no known allergies and has not improved with allergy medications or a nebulizer. Due to the delay in taking the parental report seriously that the problem is likely more than allergies, the child develops pneumonia and is hospitalized. Situations like these are reasons switch providers. While no health care provider is free from making mistakes, this does not mean you have to stay under that provider’s care.
8. The provider has decided upon your course of care before evaluating you. This one sounds hard to believe but it happens sometimes. I had a situation once when I went to a doctor, he saw my chief complaint, and filled out two medical scripts before talking to me or evaluating me. Medication and other treatments should be based on a discussion with the patient and an evaluation.
9. The provider is not really listening to you. If you go to see a health care provider and he/she is too busy doing other things while you are trying to explain what is wrong with you, it is a bad sign that the provider is not paying sufficient attention to detail to provide optimal care. Examples include writing out another patient’s medical notes or prescriptions, typing text messages, or sending emails when the patient is trying to explain the reason they are there. While some people are good at multi-tasking, attention to detail decreases and errors increase when multi-tasking occurs. The provider should be focused on you, and only you, when you are in the evaluation room together.
10. Lastly, research your healthcare provider on your state’s online licensing board’s website. You would be surprised how many are still practicing despite being the focus of serious investigations, reprimands, and recipients of prior disciplinary charges for actions that violated standards of the licensing board (e.g., improper note keeping, fraudulent billing, poor medical care). An internet search on popular search engines can also be helpful as some physicians move to another state if a license to practice has been removed from a prior state of residence. Online searches can also reveal prior criminal acts or charges. It is important to be careful with on-line searches, however, because you need to be sure that the person you are reading about is the same person as your health care provider and not someone else with the same name. In addition, be wary about information from health rating websites that are purely written by former patients, because they can be biased towards negative reviews which may not accurately reflect the qualities and attributes of the person you are seeing.
-Dominic A. Carone is a neuropsychologist who blogs at MedFriendly.com.