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5 Things Your Doctor Won’t Tell You Unless You Ask

5 Things Your Doctor Won’t Tell You Unless You Ask

If you want to make the most out of your time with your doctor, you’ve got to be honest. Keeping important details to yourself may harm you in the long run. Doctors also know a lot of things we don’t, so we patients have to ask the right questions.

Armand Leone, Jr., MD, JD, MBA, board certified diagnostic radiologist and partner and co-founder of Britcher, Leone & Roth, shares these five things your doctor knows, but may not tell you unless you ask.

1. Having elective surgery on a Friday or in the afternoon carries a higher mortality and complication rate than earlier in the week or day.

Obviously, when the situation is urgent, surgery can’t wait, but for elective surgery, you might want to consider the timing. Make no mistake about it — ALL surgeries come with risks and complications. “On Monday, everybody there — surgeons, nurses, residents — are regular staff,” Dr. Leone told Care2. “At about 4:00 p.m. on Friday, regular crews leave. When you have surgery at the end of the day, those 12 critical post-op hours happen during the night. Complications occur on the weekends, but it’s more difficult to get immediate action on them because covering physicians don’t know the patients as well and are less quick to intervene for another doctor’s patient.”

2. Fatal medication errors spike by 10 percent every July as new medical residents start taking care of patients (J Gen Intern Med 2010).

Depending on the situation, patients can’t always be aware of what medications they’re given. If you’re conscious and clearheaded, Leone says you should have a rough idea of the medications you’re supposed to get. “Ask the nurses, confirm the details, and if it doesn’t seem right or if the medication looks different from what you’re usually given, ask the nurse to check with the doctor. Be vigilant and, in a nice way, ask questions. You don’t want to become a pain in the ass, but it’s your ass on the line.”

3. A misdiagnosis occurs in at least one out of every 20 patient encounters in doctors’ offices (BMJ Qual Saf 2014).

“Let’s start with this: Most medical errors in a primary care setting don’t make a difference. Primary care docs have less time to talk and examine a patient, so there are certain mental short cuts.” For example, a doctor sees 10 patients with the flu and you come in with flu symptoms. There’s a bias toward diagnosing the flu. Leone says about half of this type of error have the potential for serious injury, but only a small percentage actually result in serious injury. “The good news is that most times, if a doctor sees a patient and gives the wrong diagnosis, with continuity of care, it gets reassessed.”

So, what’s a patient to do? “If you sense your doctor is rushed or not listening, or that the diagnosis may not be right, you need to break the autopilot and focus them. Ask your doctor: ‘If the diagnosis isn’t right, how and when will we know?’ or ‘How will we know if treatment is working?’” Your doctor should respond with something concrete so you have something to gauge and will know when to follow up.

4. Your doctor’s surgical and procedure complication rates and how they compare to the national rates for the same procedure.

It’s not unreasonable to ask. “For any procedure, there are known complications and national averages,” said Leone. “A doctor should have a good idea of their personal complication rate. The surgeon who is dismissive or says it’s ‘not a problem’ or it’s a ‘walk in the park’ bothers me. I want the surgeon who goes in knowing there could be a complication and acknowledging they need to be on the lookout. If I ask a doctor about complication rates, I just want an honest answer. It doesn’t have to be an exact number. At the end of the day, it’s not so much the complication rate, but that they’re aware that complications can occur. I just want to know they’re watching carefully for complications and they’re ready to deal with them.”

5. Doctors know the limits of modern medicine and most don’t choose heroic cancer treatments or end-of-life care.

So what do doctors know that we don’t? Sometimes, they know that heroic treatment won’t change the outcome. “Just because it can be done, it doesn’t mean you should do it,” said Leone. “You have to be realistic about the chances for a cure. There’s a physical, emotional, and financial cost to medical treatment. Treatment is not without risks and drugs are not without adverse effects. When you know that, you can balance the equation differently. Is there a reason to put yourself through the ringer? Is it worth it? Quality of life is as important as length of life. That’s why most doctors opt for less heroic end-of-life care, unless there’s a specific reason to do otherwise.”

Leone believes that when patients are clinging to hope, it may be difficult for doctors to be completely honest about the prognosis. Patients have to ask the hard questions. What is the likelihood of a cure? How long will this treatment lengthen my life and what will my quality of life be?

The bottom line is that we patients should be partners in our own care. If we have a concern, it’s up to us to ask questions. A good doctor won’t mind. If your doctor discourages questions or dismisses your concerns, it’s time to find a new doctor.

Related Reading
5 Ways to Partner with Your Doctor
Does Your Doctor Touch You?
Why This Doctor Struggled as a Patient for a Day

Photo: AlexRaths, photographer | iStock | Thinkstock

Read more: Family, General Health, Health, Men's Health, News & Issues, Women's Health, , ,

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193 comments

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4:39AM PDT on Oct 1, 2014

Theresa K. I was not saying that all doctors did this, I only have one and he spends entirely too much time looking at the computer screen and not enough looking at me. I am getting older and there are some things that I might not mention but he could see. But ONLY if he checks me.

2:52PM PDT on Sep 23, 2014

?

3:21AM PDT on Sep 23, 2014

Excellent. TY.

11:20AM PDT on Aug 26, 2014

Sarah H. -- Sorry, but no. My mom's been a nurse for 33 years, her best friend (my Mom#2) has been one longer than that, and her other best friend (my Mom#3) has been one for about 30 years now. So, needless to say, I've grown up in and around hospitals, doc offices, doctors, nurses, etc., for almost my entire life. And guess what? Doctors have been distracted and/or rushing patients in and out of their appointments for DECADES. It has nothing to do with Obama, Obamacare, Dems, Libs, or any of the other bullshit you'll no doubt come up with. Stop being a delusional fruit loop. Seriously.

9:52AM PDT on Aug 23, 2014

Thank you :)

9:52AM PDT on Aug 23, 2014

Thank you :)

8:48AM PDT on Aug 16, 2014

Interesting article, thank you!

2:10AM PDT on Aug 14, 2014

Thanks for posting.

5:22AM PDT on Aug 13, 2014

I have noticed that the doctor spends more time looking at the computer screen than at me. This has just been since the start of ObamaCare!

2:13PM PDT on Aug 11, 2014

I would add "medication side effects" and "alternative forms of treatment" to things I never hear from a doctor unless I ask them about it. They are generally dismissive of any side effects that are noted, and generally pooh-pooh any alternatives (such as nutritional or herbal approaches) as being unscientific. Most of them seem to be unaware that such alternatives even exist (though some of our younger doctors are beginning to change that). I generally find physicians to be very invested in their own treatment planning and not very interested in hearing what I have to say. For this reason, I tend to go to nurse practitioners or physician assistants when I need something from the standard medical system, but I get most of my healthcare from acupuncturists, chiropractors, and other alternative providers. I also never take any drug or do any procedure without full internet research in advance. Most of the time, I opt not to go with "standard procedure."

--- Steve

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