9 signs it's time to break up with your doctor

(2010 Chris Schmidt)

Dreading your next physical? Then it’s time to take a good, hard look at your relationship with your doctor. As a patient, you deserve to feel both emotionally and physically comfortable at all times during every office visit, and throughout all facets of your treatment—and if that’s not happening, you need to speak up.

“I’m a fan of honesty in all instances,” said Dr. Pamela Wible, a physician practicing in Eugene, Oregon and founder of Ideal Medical Care, a patient/doctor assistance organization. “Doctors are people—we’re human, so please don’t be afraid to connect with us as human beings. Explain your values and desires around medical care. If you can’t work well together, maybe it’s not a good match.”

Here are nine red flags that indicate you might need to move on.

1. Your doctor barely listens to you.

You’re explaining the intensity of the pain in your lower abdomen, but your doc’s eyes remain glued to the computer screen; when you finish talking, all you get back is, “Repeat that, huh?” Or you tell your doc you Googled a symptom, and instead of listening to your concerns about a potential illness you read about, she snorts and waves her hand at you like you’re a full-on hypochondriac (which you’re not). Your doctor may be multitasking, or she may feel you don’t have the training or skill to understand how illnesses are properly diagnosed, but that doesn’t give her the right to be inattentive or dismissive. “Whether you just need straight answers or you want to discuss some sort of alternate therapy with your doctor, he or she needs to be respectful of your wish to discuss the topic,” says Trisha Torrey, a nationally known patient advocate and the author of “You Bet Your Life! The 10 Mistakes Every Patient Makes & How To Fix Them To Get The Care You Deserve.” (She also notes, however, “Remember that ‘nice’ doctors aren’t always competent, and highly competent doctors may not be nice,” so you might sacrifice bedside manner for skill, as long as you’re comfortable with that tradeoff.) Tell your doctor straight up that you’d like her full attention—if it’s clear she is unable or unwilling to give it, cut your losses.

2. Your doctor hates it when you ask questions.

Many patients forget this plain and simple truth: Your doctor works for YOU, not the other way around. You’re paying good money for your care, so you have the right to ask about any test, procedure or medication your doctor is recommending. That said, some doctors have better people skills than others—primary care physicians tend to be better one-on-one communicators than specialists, who are often more concerned with medical specifics than face-to-face chats.

“For providers you don’t have to see often, or those who you are only seeing one time, like for a second opinion, then you might be a little more forgiving on their inability to communicate in the style you prefer,” Torrey said. “Learn what you can from them, return if you have further questions, but know you can get the other aspects that are important from someone you’ll be seeing for a longer term, or more important reason.”

If you try this approach and still can’t get the clear answers you need, go elsewhere.

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3. Your doctor gives you a diagnosis on you that doesn’t feel right—and doesn’t want to entertain alternative ideas.

If you’re experiencing blinding headaches that your doc simply chalks up to stress, trust those alarm bells in your gut. Doctors who are crunched for time often look at a young, otherwise healthy patient and opt for the most benign explanation, often not even ordering the most basic tests to confirm what’s going on. You know your body best—pointing that out shouldn’t be an inconvenience or insult to your doctor. Insist on a thorough exam, labs and scans.

“If you’re at this point with a doctor and you cannot work things out between the two of you, then you likely need another doctor,” Wilbe said. (Quick distinction: Seeking a second opinion is always a good and viable option if you either aren’t satisfied with a diagnosis, or want confirmation. That’s no reason to ditch your doc. But if he or she is routinely dismissive, go ahead and write yourself a prescription for a new M.D.)

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4. Your doctor goes straight to the prescription pad every single visit.

Many doctors today tend to overprescribe as a quick fix to a problem, rather than suggest lifestyle changes that would be equally effective (and don’t have potential side effects). If you’ve been diagnosed with a condition like type 2 diabetes, for example, and your doctor hasn’t discussed whether diet and exercise could be a good first treatment step, ask if trying those things might work before going on meds.

Also, know this: A pill-happy doctor may be swayed by drug company representatives. By prescribing certain medications, physicians are compensated by these reps with cash, free meals, and even lavish vacations. Oftentimes this practice is legal, but it is far from ethical. And why would you risk being overmedicated to benefit your doctor’s bottom line? Check out your physician through the website Dollars for Docs, where you can plug in your doctor’s name and directly find out how much financial compensation he or she has accepted from drug companies in recent years. If you don’t like what you see, ask your doctor to explain his/her relationship with the drug company, and how the drug in question would truly benefit you.

5. …But doesn’t ask you what other medications or supplements you already take.

Always bring a full and current list of EVERY supplement, and prescription or over-the-counter drug you take to every office visit; make sure your doc’s nurse or medical assistant logs any changes into your file immediately. Meds and supplements—even herbal supplements that you might not consider, like St. Johns Wort, feverfew, ginko, ginger or garlic—can often interact, sometimes dangerously. If your doctor doesn’t seem concerned about this key fact, don’t trust his or her judgment, period.

6. Your doctor’s staff is a pain.

What’s the overall practice vibe? Is the staff rude or disorganized? Is your wait to see the doctor consistently longer than 45 minutes past your scheduled appointment time? While you’re sitting in the waiting room, prick up your ears: Do you hear staff members gossiping about patients who aren’t present? This can be telling, because often staff members adopt the attitude of a less-than-discreet doctor who might be gabbing about patients to them at lunch—which is completely unacceptable. Do you hear patients at the service window complaining about things like missing or delayed test results? A practice run in chaos simply can’t guarantee safety or quality to its patients; find a better office. And when you leave, it’s also your right to be given your medical records hassle-free—don’t tolerate any delays or run-arounds.

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7. Your doctor’s waiting room is a pigsty.

Do you see dusty surfaces, stained rugs, and heavily handled old magazines? This means germs aplenty. Also, is the bathroom littered with yet-to-be-processed urine samples (SO gross, but it happens)? Anything less than a spotless, bacteria-free environment is completely unacceptable. That goes for the exam room, too. A study from the University of Geneva found that a doctor’s stethoscope, as well as his hands if he’s lax about washing up between patients, can be easily contaminated with the deadly MRSA virus. Ask the practice manager, “How exactly do you clean the office every day? And do all of the staff members, including my doctor, wash their hands before seeing each patient?” All cleaning info you get in response should be in compliance with outpatient guidelines from the Centers for Disease Control, no excuses. And the hand washing is a deal breaker—it either happens, or you’re out of there.

8. Your doctor creeps you out (for whatever reason).

Has your doctor ever been inappropriate during an exam? This can mean a lot of things, such as making suggestive comments, or touching you in a way that made you think twice. It also could mean asking prying reproductive health questions in a way that implies judgment (that could interfere with your treatment), such as why you want birth control when you aren’t married, or whether you are pro-choice. You don’t owe any such explanations. If your doctor does anything to make you feel uncomfortable or unsafe, tell him or her to stop immediately; leave the practice, and complain to your healthcare providing organization.

“If you are in the hospital, there are medical ethics departments, social workers, and chaplains who can advocate for you,” Wible added.

9. Your doctor violates your rights, or seriously endangers your health.

If you’re the victim of bad care or a serious misdiagnosis, you can contact your state medical board to file a complaint against your doctor. In some cases, an independent patient advocate—one who does not work for the hospital or insurer—can help. Independent advocates can be found at www.AdvoConnection.com. Why an independent, private advocate?

“Hospitals and insurers also offer help from a patient advocate, but this person works for the hospital or insurer, most often for the legal or risk management department,” Torrrey explained. “Their job when they work for a hospital or insurer is keep their employer out of hot water and provide only enough help to a patient so it won’t cost the employer any money.”

Don’t hesitate to get legal advice to ultimately help you make the right decisions.

And know this: most doctors have their patients’ best interests at heart. The right physician is out there, to provide you with excellent care AND peace of mind.