Sunday, December 15, 2019

'Doctor, What Would You Do?'

There’s a phrase that every physician hears repeatedly from patients, that requires a nuanced response.

Doctor, what would you do if you were me?

There are variations on this inquiry, such as ‘what would you do if I were your father’, but they all are aiming at the same target.  The patient, or often the patient’s family, asks the doctor what advice the physician would choose if he were in the patient’s place.  For example, if the physician were the patient would he opt for:
  • Surgery
  • Chemotherapy
  • Experimental treatment
  • Watchful waiting
  • A second opinion
  • A third opinion
  • Alternative medicine
  • Acupuncture
  • Hospice
'Doctor, what would you do?
Patients erroneously believe that this form of inquiry is the magic bullet of finding out what the physician’s truly best advice is for a particular medical circumstance.  After all, if the doctor would recommend a treatment for his own mom, then surely this must be the best option.

Except, it isn’t.  Here’s why.

Physicians, as members of the human species, cannot be as objective with regard their own families or themselves as they are with their own patients.  This is why wise physicians do not treat family members.  Indeed, every physician has heard vignettes of inferior care that was rendered by a doctor to a close family member.   The reasons for this are beyond what I can express here, but the core of the explanation is tainted physician judgement resulting in delayed diagnoses and incorrect treatments.  When a close relative recently approached me to discuss recurrent stomach aches, I gave her good advice.  Make an appointment with a doctor.

Another circumstance when physicians are known to provide inferior care secondary to judgement lapses is when the doctor is treating a celebrity or VIP.

If you ask your doctor what he would do if he were you, the doctor’s response should be an explanation of why he can’t give you the answer you seek.

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