We’ve all met them: silly patients who think that they know more than a real doctor. These unreasonable people question our judgment, ask for more information, and can make any competent physician want to scream. This week’s commentary is from veteran Orthopedist, Howard Q. Jangler, MD, who offers his philosophy when it comes to navigating interactions with these challenging but simple human beings.
DME: How do you approach the questioning patient?
HQJ – When you get one of these patients, you’ve gotta keep it straight in your head: you’re the doctor and they aren’t. We’ve gone very soft in medicine today and given patients way too much freedom; they get the idea that they’re in charge of their body and their medical care. I say, once you choose to walk into my office, I’m the boss. There’s no “U” in orthopedist. You’ve gotta start by setting clear roles.
DME: What’s your philosophy regarding patients who think they need more information before agreeing to your recommendations?
HQJ – There’s way too much talk about “informed consent” these days. Do people really think that they could ever grasp all of the information and experience that I have inside my brain to try to make their own decision?! They don’t need to know about risks or alternatives; when it comes down to it, the only information that they really need is my recommendation of what’s good for them – that’s the best informed consent they could ever ask for.
DME: How do you deal with people who use the internet to make diagnoses or seek treatment information?
HQJ – The internet makes me want to pull my eyeballs out and use them to plug my ears. People are always bringing up junk they read online, and I just tell them “Google can say whatever it wants, but Google can’t replace your hip; only I can do that.” If they still want to bring up 80 pages of stuff that they printed off of the internet, then I just walk out of the room and tell them to follow-up with me in 6 months after they’ve had a chance to come to their senses. I don’t waste time with nonsense.
DME: Do you ever allow patients to seek a second opinion?
When patients tell me that they want a second opinion, I just repeat the same thing I said the first time; that’s my second opinion. If they’re not happy with that and want a “third opinion,” I tell them not to come back.
DME: Thanks, Dr. Jangler, for being willing to share with us. Do you have any parting advice for younger doctors getting into the field?
Remember that you are a gift to your patients. When people get a gift, they’re not supposed to question it; the appropriate response is to say “thank you for this amazing gift.” If people can’t gratefully receive your gift, they don’t deserve it.
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