Do I Need a New Doctor?

I am a parsimonious practitioner.  While I can’t cite statistics, I strongly suspect that I order fewer laboratory studies, prescribe fewer drugs and order fewer diagnostic tests than do my peers.  Medical minimalism has always been my medical world view.  This can feel a bit lonely at times in a profession that is rife with over-diagnosis and over-treatment.  I am not suggesting that my approach is the only reasonable medical approach, only that it’s the style that I’m most comfortable with. 

All of us should consider the philosophy of the professionals we engage.  And the professionals need to gauge the goals and risk tolerance of those they serve.  These relationships may need to enter into negotiations from time to time in order to agree on which pathway to pursue.

Physicians, judges, law enforcement professionals, teachers and others are not homogenous philosophically.  While folks may (hopefully) agree on the facts, the interpretations may differ.

Consider two different financial planners.  One advocates for a more aggressive portfolio arguing that this has the promise of a greater financial return.  This approach might allow the client to retire earlier or to retire with greater security.  A different advisor has a different approach, perhaps because he sees the world differently or has been molded by certain experiences.  He counsels for a more conservative approach arguing that earning less over time is worth the added security that the investment will remain secure.

Who has the better argument here?  Folks will disagree here and their response will depend upon their own philosophies.  For example, a very cautious investor will likely be partial to the second advisor I cited above.

Balancing One Philosophy Against Another

It’s the same with medical care.  Physicians over time tend to retain patients who share their doctors’ philosophy.  Let's face it, there are many patients who are not satisfied unless the office visit ends with a prescription or a test.  This action validates their reason for the office visit. They likely regard no action as medically inadequate.  Such a patient may not find my restrained medical approach to be compatible with their needs and likely will find doctors who are more comfortable using the medical gas pedal than the brake.  Some of us feel that less is more while others feel that more is more.

Of course, doctors and others need to be somewhat flexible in order to meet the needs of those we serve. And we are.  But being flexible doesn’t mean abandoning one's core principles.  There are limits to how far any of us can or should bend.  If, for example, you are a reluctant investor who is worried about the health and safety of your retirement money, and your advisor wants you to invest it all in cryptocurrency, then perhaps, you need a different advisor.  Similarly, the same principle may apply to your doctor.