Once upon a time, doctors were privilege to a wealth of information that was only available to those with medical degrees. The patient-doctor relationship was more paternalistic in those days because if you didn’t listen to what your doctor said in the same way that a child should obey his or her parents, there were assumed consequences. You could get dropped as a patient. You were putting yourself at risk for that disease they said you might get. You would get reprimanded.
Now, it’s 2017, and some people still have that type of relationship with their provider—which is great for them, but many people (particularly moms) no longer blindly listen to that man in the white coat anymore because, well, they don’t have to. Some don’t want to either, and these are the main reasons.
- Doctors work for paychecks, and you’re not the one signing them.
Yes, your doctor might have chosen his or her profession because they wanted to help people, but they have to play the game in order to stay in the game. You might think that because it’s your insurance that’s paying the doctor that he has to look out for what is best for you, but that’s not necessarily true. Nationwide clinical guidelines set standards each year that doctors aim to meet, and insurance sets up dollar values for specific exams and procedures that patients undergo. This means that each time you agree to a flu shot or pap smear, things that might appear to be routine, your doctor gets a ‘commission’ for ticking something off the checklist and he can cash in on the value set by the insurance companies. Are flu shots and pap smears really needed?
You be the judge on that one, but don’t expect your doctor to help filling out the ‘cons’ column on your list. In an interview with the Washington Post, a clinician stated that it was hard for her to stop doing pelvic exams even after research showed that it was not needed, and actually harmful, because many gynecologists “are not going to get paid if [they] don’t do a pelvic” due to insurance reimbursement rules.
- The Internet is your friend.
While there are those out there who will shake their head at this point, there are others who are nodding their heads right now because they know exactly what I mean. Headaches can be caused by brain tumors but also by dehydration, so (absent other more severe symptoms) try drinking more water. Similarly, that stomach pain could be a gall bladder issue but it shouldn’t take three copays to confirm that you’re not in any real danger. I once had a doctor Google my symptoms while I was in his office then sent me to get X-rays, bloodwork, and an ultrasound for discomfort that came from me not having my eyeglass prescription updated. Bottom line is that doctors don’t know everything (shocker, I know), but the Internet can usually fill in the gaps if you use reputable websites as resources to check symptoms, compare the risks and benefits of a procedure, and even review your doctor’s ‘sponsors’ (companies or individuals that have traded them payments in exchange for them promoting a specific drug or using a particular tool in surgery). The more you know, the better prepared you are to save yourself time and money.
- Patient rights are a thing, even if doctors don’t want to tell you about them.
Some clinics you visit might have a poster in their entryway or a pamphlet on the check-in counter with all their patient rights information described. This poster or pamphlet usually includes a list of all of the clinic’s responsibilities and the specific patient rights they are obligated to respect by law or by clinic policy. Other clinics may choose to not have these plastered on their wall, but they’re available somewhere, if you ask. It makes sense that some clinics do not want to be too public about patient rights because they’re essentially saying, ‘Here are the things you might be able to sue us for or complain about to management’. Yet, the truth remains that a patient has rights and the more familiar you are with yours, the more in control you can be at your appointments.
- Your body is yours, and no means no.
This one seems straightforward, but a large percentage of women feel violated when they undergo pap smears or pelvic exams, yet they continue to consent, because they feel they have no choice. “Undress from the waist down” is not usually enough for a boyfriend or husband to get lucky, so why should it suffice for a complete stranger? Needless to say, a woman’s ‘no’ at a doctor’s appointment should suffice. There are women who are finally refusing invasive screenings, which, according to the U.S. Preventative Services Task Force, come with a host of risks even if your doctor is only explaining the benefits. You have the freedom to choose. Any man or woman that refuses to give you a choice-rather than expressing their suggestions- on matters related to your body is trying to exercise more power than they have been given by nature and by you. Conversely, if you continue to agree to things that you are not okay with, you give them the power to take away your confidence, your comfort, and your choice.
- The law favors doctors, not patients.
You’ve heard of friends and family threaten to report ‘medical malpractice’ before, and in the news, you can find stories about how a doctor lost his license to practice because he was sued for cutting off the wrong leg or overdosing a patient. However, I’m here to tell you that if your doctor makes a mistake in your records, causes you embarrassment during a medical procedure, or vaccinates your newborn without your permission, you have no right to sue in most states. Why? Because the law does not care. Unless either of the circumstances above results in ‘physical harm or injury’, you have no case for malpractice. It is very rare that a court will entertain a lawsuit based on the grounds of emotional distress since the state of someone’s emotion is difficult to prove, much less link to an act that did not physically harm you. Unfair, I know, but that’s the law. Doctors are protected for almost anything they do, and it’s probably why cases of malpractice are typically dismissed or settled outside of court. The lesson here is that you have to make your voice and your preferences known in order to stay control of what happens to you and your records (request a copy of yours to see what your doctor is writing and if all the information is accurate).
If you ever feel guilty speaking up, because you’re not sure, all you have to remember is that you’re the boss. If you want more time before a procedure in order to do your own research, say so. If you don’t want to open your legs on that examining table, then don’t. Doctors sometimes act like bullies because there is so much money at stake for them, and it’s easy for them to undermine you. But if it’s your health and body on the line, be bold. Overcome your hesitation. If you need help, just pretend it’s your mother-in-law trying to force you into raising your kid a certain way. Back off, lady (doctor). My kid (body), my choices!