Top Docs 2008 Part IV: How to Fight Back

Give It to Us Straight
Dr. Jerome Groopman, author of How Doctors Think, on three potentially tricky patient initiatives.

[sidebar]How to request your medical record. “Every physician knows that this is your property, so you should feel completely comfortable simply asking for it. Especially now with electronic medical records, where errors can more easily be entered and perpetuated, you should ask for it to make sure it’s accurate. And if you’re getting a second opinion, it’s far more efficient for you to hand-carry your record to the other physician.”

How to ask for that second opinion. “If you’ve got a serious diagnosis (lupus, HIV), or if you’re being offered experimental treatment, or if your current treatment is not working—these are all trigger points for second opinions. Be courteous but clear: I very much appreciate your care in this difficult time…I hope that getting this other perspective will help yield the best treatment for my illness…I look forward to returning to you. Optimally, you should go outside your doctor’s practice for a consult, as colleagues may be inhibited from contradicting him.”

How to break up with your doctor. “It depends on where you are in the relationship. If you think you need more expertise, just say, I appreciate the time and effort you put in, but it’s time for me to move my care to Dr. So-and-So. If there’s been a personality clash, there’s no need to have an all-out fight about it: I know you’ve tried your best, I’ve tried, but I don’t feel we’re connecting in a way that’s best for me. Always remember that you’re the one in need. Get complete copies of your records, and move on.”