Firing Your Doctor

Dealing with Doctors - May 30, 2014

Prior to starting my business I worked as a Human Resources professional. Doing this work I was sometimes involved in the process of terminating the employment of individuals who were failing to meet their job expectations. Anyone who has ever been a manager knows how uncomfortable it can sometimes be to tell a problem employee that their employment is being terminated. Even if the individual has had many warnings and opportunities to improve and willfully continues to behave inappropriately it's not an easy conversation. It is however a necessary thing to do because failing to take this action when needed has negative consequences for all the other staff, customers, and the employee.

While dealing with major illness you might find yourself in the position of having to terminate your doctor and find a new one. This can be incredibly difficult for some people to do for many reasons. First the very nature of the doctor patient relationship is one where the patient is seeking advice and counsel of the doctor who has more knowledge and expertise. This dynamic can make the patient feel that they are not on equal footing with the doctor and may make them feel timid about expressing dissatisfaction or discomfort. Also it is just generally uncomfortable to tell someone they are doing a bad job or give otherwise negative feedback. This is especially true if it an individual who is highly educated, knowledgeable, and a respected professional; that can be intimidating. You may also genuinely like your doctor and feel that he/she is a nice person but realize they aren't the right fit for your care for some reason. And when you are coping with all the other stresses that are involved in dealing with major illness you may find it easy to put it off because you have so many other issues that require your attention.

If you find yourself in a situation where you are unhappy with the care your doctor is providing and you are considering moving to a new doctor, the first and most important thing to do is to acknowledge your feelings about the situation. Remember, as a patient you need no justification for making the choice to leave a doctor other than it is what you want. It does not matter if this doctor is "the best in the field" or if others have had positive results and experiences with the doctor or the opinions your family and friends have of the doctor. If the patient isn't happy with the doctor and wants to move to someone else nothing else matters. Period. If however the patient is feeling conflicted and unsure about the decision to leave, I highly recommend talking about the problems or concerns you have about your care.

When you plan to talk to your doctor about possibly leaving his/her care, write up a list of specific things that have upset you or concerned you about your care before your next appointment. Try to be specific with what happened or didn't happen that you did not like. Then at your next appointment after your doctor has finished the exam portion of your visit and asks if you have questions tell him or her that you would like to talk about the specific concerns you have. It's helpful to frame your concerns in a non-accusatory way when possible. Use your list to state your observation of what happened previously from your point of view and how you would have preferred it to have been handled. If possible avoid statements that might put the doctor on the defensive. If you focus your complaints on what happened from your point of view, the doctor is less likely to feel attacked. However you don't need to be overly concerned about making him/her feel comfortable, ultimately you are only responsible for expressing your concerns. It is up to the doctor to be professional and understanding about receiving any criticism.

If after talking about it with your doctor you decide to move to another, there are two general approaches you can take to managing the next steps. You can either have a conversation with your doctor during an appointment and discuss your reasons for changing, or you may let him/her know of the change indirectly. It is a matter of personal preference and comfort level. Some people may find it very validating and fulfilling to discuss the problems they have had with the doctor directly and to air their grievances. Others could find that to be very intimidating even if the doctor is extremely receptive to the conversation. You don't have to have a direct conversation with your doctor to explain your reasons. If it is going to cause you stress and anxiety to have the conversation or if you simply would prefer not to, then you can let him/her know by message. You can call the office and tell the administrative staff that you will no longer be seen by the doctor and request that they send your complete medical record directly to your new physician. They may ask you why you have chosen to leave and if you feel comfortable doing so feel free to tell them the problems you have experienced. This could help them to understand some of the problems and possibly make improvements for future patients. However it really is fine if you would rather not answer the questions or explain yourself.

The thing to keep in mind as you navigate your healthcare is that you the patient are the boss of your care. Doctors and other healthcare professionals are there to help you but they are not in charge. If your doctor is no longer a good fit for you it is your absolute right to find another provider who is a good fit. As a matter of fact, you have an obligation to yourself to find the doctor that is a good fit for your clinical and personal needs; it is a vital part of getting the best care.