[darlindeb25]

http://www.cnn.com/2007/HEALTH/08/16...doc/index.html

ATLANTA, Georgia (CNN) -- Dr. Jerome Groopman knew he needed to break up with his doctor.


Dr. Jerome Groopman says sometimes the doctor-patient relationship comes down to chemistry.


Five years ago, when he started seeing his internist, everything was fine. But Groopman says that in time, the internist became more popular -- and hence more busy and harried -- right when Groopman needed him most.

"I have a strong family history of high cholesterol and heart disease. Every male in my family has had a [heart attack] in his 50s and 60s," he says. "I was moving into middle age, and I just didn't feel that my doctor was looking at me as an individual, and taking those factors into account."

But Groopman -- a physician and author of four books about doctors and patients -- found it difficult to leave his internist of five years. "It sounds strange, but I didn't want to insult him."

Groopman is not alone. "I really think it's a fear of the unknown," says Robin DiMatteo, a researcher at the University of California at Riverside who's studied doctor-patient communication. "But if the doctor isn't supporting your healing or health, you should go."

Here are five ways to know when it's time to think about leaving your doctor, and the best way to do it.

1. When your doctor doesn't like it when you ask questions

Groopman says after the publication of his book "How Doctors Think," a reader contacted him with her story. "She was seeing an orthopedic surgeon for back pain, and when she asked a question, his response was 'Since when did you get an M.D.?'" Groopman says. "That kind of response is just about a deal breaker."

2. When your doctor doesn't listen to you

Debra Roter, a behavioral scientist at Johns Hopkins and co-author of "Doctors Talking with Patients," says it's a red flag when your doctor doesn't pay attention to what you have to say. "A doctor suggested my friend take a certain drug, but she'd taken it before and she told him it hadn't worked for her," she says. "But her doctor wanted her to try it anyway. He didn't give her any credibility."

3. If your doctor can't explain your illness to you in terms you understand

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"It's really important that a physician be able to communicate in plain speak and plain language," Roter says. "A doctor has to be able to explain things so you can put the information to use to take good care of yourself."

4. If you feel bad when you leave your doctor's office

DiMatteo says sometimes you just have to go with your gut. "For example, if a patient says, 'My pain is still there,' and the doctor says, 'It shouldn't be -- this treatment works for other people,' and you walk out of the office feeling badly, I don't think you should stay."

5. If you feel your doctor just doesn't like you -- or if you don't like him or her

"Sometimes there's chemistry and people click right away, and there are some people you don't click with," Roter says. "If your gut says you're not crazy about your doctor, they probably aren't crazy about you, and that's not good."

Groopman agrees. He says a doctor who doesn't like a patient often stereotypes him or her. "I was terribly guilty of this as a young doctor. One of my patients said she had indigestion, and I got very irritated with her, and thought she was a whiner and a complainer," he says. "It was catastrophic because she actually had a torn aorta."

The woman died. "I have never forgiven myself for failing to diagnose it," he writes in "How Doctors Think." "There was a chance she could have been saved."

So once you've decided it might be time to divorce your doctor, how do you do it? First of all, make sure whatever's bothering you isn't just a one-time thing. "Make sure it's not just a quirk of the doctor's day," Groopman says. "Maybe they're just having a bad day."

If the problems continue, Groopman, Roter, and DiMatteo agree it's best to try to express your dissatisfaction instead of just bolting. "Use the first person plural, such as 'We're not communicating well' as opposed to 'You seem distracted or irritable with me,'" suggests Groopman. "That may cause cause the physician to stop and reflect and shift gears."

When it doesn't, you can be sure it's time to get another doctor, Roter says. She described two friends who wrote letters to their doctor saying they were unhappy with some of the treatments they'd received. "The both got back letters saying, 'Good luck with your new doctor.'" E-mail to a friend

Elizabeth Cohen is a correspondent with CNN Medical News.

I found this a good article and thought I would share it. I can relate to some of this and have recently felt this way.

[BEGLET]

This is so true! If you dont have the confidence and support of your doc you need to move on.... I've had some awful experiences in the past where conditions have been dismissed as nothing - and then ended up in the hospital on several occasions due to the first docs neglect.... Those docs I would never have gone back again to - except one...

He was a resident - and I had called him after taking a routine decongestant - called him when I started feeling strange after taking it - and he reassured me I was just fine - I had just had a physcial.... however, kept feeling worse - finally went to Urgent Care later in the day - and found they thought I was in heart failure (bradychardia - heart rate was 29 BPM and holding there)... they tossed me straight into an ambulance and ended up in CCU in the hospital.... the doc came to me next day - apologized, thanked me for teaching him a very important lesson "listen to your patients".... and I truly believe he meant it.... (oh, as soon as the med wore off - I was ok - but it was taken off the market eventually as it was killing people because it caused heart complications)....

So yes, follow your gut - a doc who is compassionate, willing to listen, especially to patients like us with multiple chronic condtions, are gems.....

[rose]

Thanks for the reminder. I heard the author interviewed and meant to buy the book. Too bad that book can't be handed out to everyone.

rose

[jarrett622]

When I saw this article I was hoping someone would post it here. I've been a tad bit busy so was unable to get to it myself.

Great article and for people with PN an essential one I think. It often takes several tries before finding a doctor that not only truly understands the pain(s) of PN but is well informed about the disease.

Barbara

[MelodyL]

That is the single best interpretation I have ever read on Doctor - Patient relationships.

Kudoes to the guy who wrote it.

and Kudoes to you for sharing it.

Melody