Tough Questions to Ask Your Doctor

Physicians handle thousands of questions annually. We respond to inquiries from patients, their families, insurance companies, nurses, professional colleagues, pharmacies, our staff and even strangers.  This is, of course, a part of our job, and it consumes a substantial amount of our time and energy.

Questions come via homing pigeon

Questions come via telegraph

Was Alexander Graham Bell Calling his Doctor for a Question?

And, responding to questions is not as easy as you may think.  Words matter and a clumsy word choice or an omission can wound instead of heal.  Here are some of the challenges we face when a medical inquiry is directed toward us.

• We may not know the answer.
• We may misunderstand the question and may misfire with our response.
• We may have incomplete data and need to calibrate our response accordingly.
• We may not be aware of the questioner’s true intent and anxiety.  For example, the question may seem innocent, e.g., “Is it normal to have constipation sometimes?”, when the unspoken concern is fear of cancer.
• We may not have permission from the actual patient to divulge protected patient information to the questioner.  This may be difficult for a close relative to accept.
• We may be reluctant to contradict a colleague to an inquiring patient without first discussing the case with the other physician.  If a patient is scheduled for surgery in a week, and we’re asked our opinion, do we express doubts when the surgeon who knows the case better has recommended surgery?  
• We may have the challenge of confronting questions laced with anger.  “Why did you send my mom home from the hospital too soon?”  “Did you know that medication costs $400?”  “Why didn’t you order the CAT scan sooner?”
• We may have to  re-frame the question.  If a patient is being admitted to the hospital from the emergency room with a heart attack, and we are asked by a family member when discharge is anticipated, we will instead discuss the impending medical plan rather than offer a discharge estimate.
•  Some questions either can’t be confidently or comfortably answered.  “Hey, doc, how much longer do I got?”
• “What would you do, doctor, if you were me?”  This is always tough.  I personally never offer a responsive answer to this question.  We are not you and should never pretend to understand your personal universe – your priorities, life experience, risk tolerance, job issues, family dynamics, financial security, cultural influences, religious tenets and personality style.  It’s your call. 

I think these skills are essential to good doctoring and I do my best to handle these challenges decently.  As critical as these skills are, I don't recall any formal instruction on them during my training years. Yes, we physicians do engage in a good measure of on the job training.