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This article is reprinted by permission from NextAvenue.org.
After we published “5 Key Questions to Ask Your Doctor” in May 2021 — advice from Dr. Robert Pearl in his new book, “Uncaring: How the Culture of Medicine Kills Doctors and Patients” — we heard from quite a few of readers on Facebook.
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Some who read the excerpt agreed with the five questions Pearl (former CEO of the nation’s largest medical group) said patients should ask their doctors: What’s this going to cost me? Can I email text or virtually visit with you? Who’s going to coordinate my care? Is this procedure or treatment necessary? Can we talk about the end?
Others had recommendations of their own. Here are the questions five Next Avenue readers suggested asking your doctor, along with Pearl’s thoughts about them:
Ask about tests and test results! said Deb Tomsky.
She noted that her doctor suspected she was magnesium deficient due to her symptoms. “The test said ‘no’ — but then he [her doctor] said the test only registered positive if you were 65% or more deficient,” Tomsky noted. “So, if you were 64%, it would not register as deficient, even if you were having symptoms.”
Tomsky said her doctor had her take magnesium supplements anyway “and my symptoms disappeared — as long as I take them.”
She added: “I wonder how many people are told they do not have something due to the test’s limitations.”
Pearl’s response: “Yes, patients can, and should, play a more active role in understanding their test results. To do this, patients need to understand how doctors use laboratory tests.”
Pearl went on to say: “Doctors believe a person’s medical tests and treatments can almost always be determined reflexively, based on lab results. If a biometric number is too high (that’s a measurement of your unique physical and behavioral characteristics), the doctor’s job is to lower it. Too low, the doctor raises it. Success is measured by whether follow-up studies are ‘normal.’”
But, Pearl added, “the line between normal and abnormal is somewhat arbitrary. Therefore, a physician like Deb’s might recommend that a patient take a prescription when the lab results are ‘borderline normal.’”
As a rule of thumb, he said, “you should always ask your physician to explain your lab results and any recommendations based on those results; it’s your health and you have a right to understand it.”
What would you do if it were a member of your family? is the question Lavida Rei recommended patients ask doctors.
She noted: “I’m convinced [asking that] saved my mother’s life. He [the doctor] was compassionate and thought about my question overnight.”
Pearl’s response: “This is a great question that sometimes catches doctors off guard. No doctor will admit it but nearly all physicians feel entitled to special privileges for themselves or their family members that they would not extend to patients.”
For example, Pearl said, “when doctors need to see a primary care physician for a routine problem, they call their colleague directly and get the visit scheduled before the week is over. Compare that to the average patient who waits 24 days for an appointment.”
Also see: Prescriptions alone cost us $5,000 a month: How the health care system fails working Americans
And, Pearl added, “Doctors take great pride in treating patients with empathy, but too often time pressures and cultural norms prevent doctors from showing it.”
This question, about what if it were a member of the doctor’s family, “reminds the physician that you or your family member deserve empathy and to be treated with the best care possible,” said Pearl.
Marilyn J. Roberts offered four questions to ask your doctor: Can I make future appointments online rather than by phone? Is there any way to get some of my care through video rather than in person? How can I check the results of my laboratory tests online? How do I access my own medical record online?
Pearl’s response: “These questions are excellent. Americans have come to expect technologies and conveniences from the retail, travel and banking industries. And yet, patients often tolerate their absence in health care.”
What are the side effects of this new medicine? is what Virginia Haden urged patients to ask.
Pearl agreed, saying: “This question is very important if your doctor fails to tell you the dangers directly. And there are other questions you might ask if you’re unclear about any recommended medications: Do I need this drug? How will it help? Will it prevent me from doing the things I value? Should I worry about taking this drug based on the other medications I’m already being prescribed? Is there a less expensive generic option?”
How does this medicine affect my overall, or other, conditions? is what Susan McLaughlin suggested asking. “I find many specialists are compartmentalized, ignoring the whole person,” she added.
Pearl’s comment: “You are correct that as medicine becomes increasingly specialized, physicians often see patients through a narrower lens. When my mom was in the hospital at the end of her life, she had five different specialists caring for her and none seemed to talk with one another.”
Pearl’s advice about this: “You might ask your physicians, ‘Do you and all my other doctors share a common electronic health record? And if not, how do you exchange vital information? Is there one doctor who will make sure nothing falls through the cracks and none of the recommended drugs and treatments conflict with each other?”
Related: Burnout, depression, denial: How our culture of medicine is killing both doctors and patients
Every football team needs a quarterback, Pearl noted, so “be sure you know who yours is when it comes to your health.”
Richard Eisenberg is the Senior Web Editor of the Money & Security and Work & Purpose channels of Next Avenue and Managing Editor for the site. He is the author of “How to Avoid a Mid-Life Financial Crisis” and has been a personal finance editor at Money, Yahoo, Good Housekeeping, and CBS Moneywatch.
This article is reprinted by permission from NextAvenue.org, © 2021 Twin Cities Public Television, Inc. All rights reserved.
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