By Richard C. Frank, MD
It is a call that doctors receive from time to time – and it usually takes the doctor by surprise. It can cause a flood of emotions, including shock, hurt, anger, introspection, and denial. The dreaded call I am referring to is when a patient requests a change of doctor. The change may be to another doctor in the same office or hospital, or to another facility altogether.
There are, of course, many valid reasons to change doctors. One article from U.S. News & World Report lists nine of them, some of which are below:
- Your personalities don’t mesh.
- The doctor doesn’t respect your time.
- They keep you in the dark.
- They are rude or don’t listen to you or answer your questions.
- You question their decision making or competence.
By virtue of the nature of cancer, its often life-threatening implications, and the intense emotional toll it exacts, the relationship between cancer patient and oncologist is intense. The patient may look to their oncologist as their lifeline, and the doctor wants to do all she can to make the patient better. When the relationship works, both may get satisfaction from the mutual caring that occurs over time. When the relationship does not work well, there can be friction.
A patient of mine for the past 5 years recently requested a change of oncologist, and this threw me for a loop. I had seen her through her initial cancer treatment and then again, years later, when she developed an isolated brain metastasis. Both experiences were emotionally trying for her, but she remained physically well. Being the sole caregiver to her ill husband at home also challenged her. When the cancer in her brain started to increase in size 2 years later, she was devastated and unsure which way to turn. She came in to discuss the possibility of brain surgery with me, and we talked about the various options and how to choose the best one. A few days later my office got the call: She wanted to change doctors.
This patient and I had a wonderful relationship lasting many years. I had served her well medically. I was shocked and did not understand. So I called her and asked if she would talk about it. She said that she would come in for one final office visit to discuss it. She did come in and explained that at our last office visit I seemed hurried and did not give her the time she needed, this during her time of greatest need. I had always been there for her but let her down this time. So she felt I was not interested in her case.
I apologized profusely. Regardless of whether or not my recollection of that visit was the same as hers, I felt badly that I let her down. All I could say was that in any relationship, there are bound to be times when two individuals do not see eye to eye. Assumptions are made; we want things to go a certain way. Sometimes things go as you’d hoped, and sometimes they don’t. If a relationship, on the whole, has been a good one, then a bad interaction once in a while may not merit breaking it off. This goes for relationships with our friends, loved ones, and health care providers. I said I would fully support her if she wished to have someone else take over her care.
This lovely woman, battling life and death, broke down, cried, and hugged me. She said that she loved me as a doctor and did not want to leave me. She was so glad I talked to her about it, and she accepted that I may have been having a bad day that time. I assured her that I would try to never let it happen again. She also pledged to tell me if it did.
Needless to say, the injured patient-physician relationship is not always reparable. Every physician has experienced the loss of patients who prefer someone else. In defense of doctors, no one can please everyone all the time. On the other hand, if you cannot express your feelings to your doctor, if you feel that she is insensitive, or if you do not trust or feel comfortable with them, then a change of physicians may be for the best.