Question: If a doctor of a particular speciality knows that the patient is being treated for something else by a doctor of another speciality.. and knows another doctor that - shall we say - is more experienced in dealing with the problem, should not doctor one tell the patient of this more experienced doctor?
I guess I asked this because years past my mother was having so many complications from her diabetes. One one complication was that she needed surgery for her cateracs (forgive the spelling). The eye doctor after listening to my explaination of all my mothers problems finally said to me.. something along the lines of Son.. you'd do your mother lot of good if you went to another doctor to take care of your mother's general condition rather than the one you're going to. When I pressed for a recommendation... I was told of one.
But I'll remember that look I got. As if.. He never said anything and I'll never speak of it to anyone in the area.
Somehow, I've always thought back on this episode over the years.
My mother's eye doctor made a recommendation/suggestion that never happened and we benefited by something that I've never admitted advice I heard.
Answer --------------
There are various reasons for changing physicians. The most common are financial (changing into a insurance plan in which the doctor doesn't belong and unable to afford care from the doctor outside of the insurance) or personal problems in the relationship between the patient and the doctor's office or the doctor including lack of confidence in the doctor. Other common causes are change of residence or even "doctor shopping". It is less common for a patient to change physicians because of comments by another physician suggesting that the patient's physician is not as competent as some specific other physician. Usually, best medical care is fostered by not changing doctors, if possible.
Because the relationship between a patient and her doctor should be a very close and trusting one, any change of doctor should be found necessary and desirable by the patient herself and not any family member or other person. If another physician who has been treating the patient (such as your eye doctor) finds that his patient is getting inappropriate or inadequate treatment by another physician, he should talk to the patient directly after communicating with the doctor. He should tell the patient specifically what he finds as inappropriate or inadequate about the other doctor's care. The patient, if she finds any merit to the eye doctor's concern, should be encouraged to talk about these matters to her other doctor. If she is unsatisfied with the responses the other doctor gives, then she might want to ask for a second opinion from an appropriate specialist or then consider changing physicians. One should look with great skepticism, when a physician from one specialty finds fault with the practice of a physician from another specialty particularly if the doctor hasn't really discussed his concerns with the other physician first. You should be cautious about the paternalistic ("fatherly") advice you received.
A good family doctor need not have great experience in all medical matters and can make up for his "inexperience" in an area of medicine by making referrals to specialists. Finally, diabetes is a disease full of complications, some of which cannot be avoided even by the most experienced physicians.
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Maurice Bernstein, M.D. Assistant Clinical Professor of Medicine University of Southern California School of Medicine DoktorMo@aol.com ad547@lafn.org mbernste@hsc.usc.edu ---------------------- Bioethics Discussion Pages: http://www-hsc.usc.edu/~mbernste/
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