Why doctors can’t say no

Often it’s easier to just say yes. But there are ways to say no that are better for both physician and patient

BY RAHUL K. PARIKH at the 28 November 2011 edition of Salon

Doctors routinely meet with patients who make requests for specific medicines, tests and referrals to specialists. In this era of the Internet, consumer-driven healthcare and direct-to-consumer drug marketing, this is no surprise. And while an informed patient is a good thing, what may surprise you is just how hard it is for doctors to say no when a patient makes a specific request for something he or she doesn’t really need.

Right now, Dr. Conrad Murray sits in jail because he couldn’t say no to Michael Jackson when Propofol came up in conversation between them. But even doctors who aren’t tempted by an enormous monthly retainer and access to one of the world’s biggest celebrities are challenged by the word “no.”

American medicine is a business — but a weird one.  In any other sector of our economy, businesses are determined to give their customers what they want, however they want it. But in medicine, the “have it your way” mind-set doesn’t always jive. First, physicians have a duty to avoid doing harm.  The choice of a drug or test based solely on a patient’s request can undermine that.  Second, as everybody knows, we spend a big slice of our GDP on healthcare. Since the person who has control over expensive tests and the prescription pad is your doctor, there’s ever-increasing scrutiny to be responsible stewards of healthcare dollars….

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The lesson here is that it’s best for the doctor and the patient to get everything out in the open, and for a healthcare system that affords the right amount of access and time — especially in primary care — to make that to happen.

Read the entire Salon article

 

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• Dr. Conrad Murray Sentenced to Four Years Behind Bars in Death of Michael Jackson (foxnews.com)
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