How to address patients with "alternative" views

[SpecterGT260]

Ummm...NO!!!
A physician can stop seeing a patient for ANY or NO reason. As long as they do a proper hand-off & take care of any issues for 30 days after firing them, they are covered.

are there any explicit laws/regulations/policies on this? ethics aside, what happens if a doctor shows a patient the door and simply says "have a nice day, F you" ?

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[jdh71]

So a friend of mine is convinced that doctors are corporate schmucks and that any new alternative treatment or diagnosis is supported and confirmed by stating doctors don't know everything. Her new kick is adrenal fatigue. I thought she meant insufficiency but after looking around online I found the voodoo she meant. Any articles I find she discounts as either being written by men or an artifact of lacking medical knowledge and counters with natural med blog articles.

So how do we approach people like this? In some cases it may be harmless to let them think what they want, but in others it may be appropriate to challenge a patients beliefs.

I'm contrarian so I'm always somewhat sympathetic to the unorthodox or "alternative". For me . . . I simply don't lose a lot of sleep trying to prove I'm right. If someone disagree with me, they're not my enemy. I don't have to be antagonistic.

When I run into these situations with patients, I merely tell them, that based on my training I do things a certain way and that means I diagnose disease with tests and treat with medicine. I appreciate that I may not always be correct, but asking me to use "water therapy" or whatever to treat your asthma is like taking your car to the mechanic and asking him not to use his wrenches - he can only use screwdrivers. I have wrenches. That's what I offer and that how I treat disease. If they do not like my method of treatment they do not have to take and they may go see another practitioner.

 

[Droopy Snoopy]

are there any explicit laws/regulations/policies on this? ethics aside, what happens if a doctor shows a patient the door and simply says "have a nice day, F you" ?

Your state's governing medical board will set forth such rules as "Thou shalt not abuse prescription narcotics" and "Thou shalt not willfully/negligently disclose confidential patient information". My state at least doesn't specifically spell out the protocols for firing a patient, however there are numerous entries which make reference to general ethical conduct, doing no harm, etc. Most reasonable physicians would consider what you describe to be contradictory to these, so if that patient filed a complaint with the board then disciplinary action might be taken. Maybe it doesn't sound like a big deal, but stuff like that can really impact your career options down the line.

 

[deleted103644]

Just as an aside, re: vaccines, many of us in the pediatrics community outright refuse to follow patients in clinic if the parents are anti-vaccine. Remember that parents and patients can choose to have alternative views, but we as physicians also have the right to tell them to hit the road too.

Haha, that's a possible answer for one of the USMLEWorld ethics questions.

Just for the record, they say it's wrong.

Personally, I support water-boarding of vaccine-deniers (the parents obviously, not the children, although I'd make them watch).

Muahahahaha....

 

[jcu]

Haha, that's a possible answer for one of the USMLEWorld ethics questions.

Just for the record, they say it's wrong.

Personally, I support water-boarding of vaccine-deniers (the parents obviously, not the children, although I'd make them watch).

Muahahahaha....

Yea I know. Part of why ethics questions on the USMLE are only applicable in some parallel universe.

 

[KTownGT]

Punch the disbeliever in the nose, and fix them. For a charge.

It's called a win-win situation.

 

[deleted103644]

Punch the disbeliever in the nose, and fix them. For a charge.

It's called a win-win situation.

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[FunnyCurrent]

So a friend of mine is convinced that doctors are corporate schmucks and that any new alternative treatment or diagnosis is supported and confirmed by stating doctors don't know everything. Her new kick is adrenal fatigue. I thought she meant insufficiency but after looking around online I found the voodoo she meant. Any articles I find she discounts as either being written by men or an artifact of lacking medical knowledge and counters with natural med blog articles.

So how do we approach people like this? In some cases it may be harmless to let them think what they want, but in others it may be appropriate to challenge a patients beliefs.

You haven't had a class on this yet in medical school? God I am really surprised with many of the posts on Allo lately. Your guys' medical school curricula is in need of upgrade

I am being dead serious

 

[deleted103644]

You haven't had a class on this yet in medical school? God I am really surprised with many of the posts on Allo lately. Your guys' medical school curricula is in need of upgrade

I am being dead serious

It's not like schools give you lessons on every flavor of wacky.

All schools are required to give some exposure to medical ethics and this falls under that category.

 

[SpecterGT260]

You haven't had a class on this yet in medical school? God I am really surprised with many of the posts on Allo lately. Your guys' medical school curricula is in need of upgrade

I am being dead serious

There will always be someone ready to surprise you with their own level of stupidity. A "class in this" isn't necessarily sufficient. Sorry bro
And my curriculum is just fine

 

[surftheiop]

One thing that I do with random folks coming with the doctors being the the lap dogs of the pharma company angle, is to explain how doctor compensation currently works. I explain that yes doctors do have an incentive to do procedures to you, but that they don't actually get paid more for prescribing medications. (Atleast in the context of a family doctor prescribing you something common, Im sure chemo compensation is a whole other beast I don't understand yet).

A lot of people genuinely think its common knowledge that doctors get some sort of percent kickback of every prescription they write.

 

[SpecterGT260]

That's true. Ive heard its hard to overcome this

 

[username456789]

A lot of people genuinely think its common knowledge that doctors get some sort of percent kickback of every prescription they write.

I am constantly amazed and stupefied at how many people actually believe this is how things work.

 

[loveoforganic]

I am constantly amazed and stupefied at how many people actually believe this is how things work.

I've already been exposed to such lack of education regarding the system that I don't think I'll be shocked by pretty much any misbelief anymore. Med school means CNA to some people, with the option to go into internal medicine, 5 grand is "a huge" amount of loans, etc. People that aren't involved with it just don't know about it. How would some guy who does some random unrelated labor for a living learn the workings outside of taking the initiative and searching the internet and whatnot? Plenty of people without that initiative

 

[deleted103644]

I am constantly amazed and stupefied at how many people actually believe this is how things work.

Don't be too shocked - it actually used to work a bit like this. Pharm reps would give stuff to doctors who prescribed a lot of their product. Not just pens, valuable stuff too.