Let's face it: Breaking up with anyone, whether it's your boyfriend, hairdresser or dog walker, is no fun. So even if you constantly dread your annual physical or always leave your doctor's office unsatisfied with your care, you may still feel stressed about breaking up with your physician and finding a new one.
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But sometimes it's the best option, both for your physical and mental health. Here are six questions to ask, to gauge whether or not you should make the change.
1. Does It Seem Like Your Doctor Doesn't Listen to You?
It's frustrating when every time you try to broach something with your physician, she's fixated on her tablet. But this is a problem that's becoming more and more common with the introduction of electronic health records. When doctors use them in their exam room, they end up spending one-third of the time staring at the screen, according to a March 2014 study in the International Journal of Medical Informatics.
That's concerning, as 2013 research by Northwestern Medicine found that making eye contact is crucial to the doctor-patient relationship, as it helps build trust.
"It's also simply dangerous to talk to someone who is doing something else, as it means their attention is divided," says Michael Hochman, MD, MPH, an internist in Los Angeles, California and host of the Healthy Skeptic MD podcast. "You're not going to get a good answer, and if they're doing something like sending over a prescription to be filled, they could make a mistake."
By the same token, if your doctor does make eye contact but rolls them when you talk, ignores you, interrupts you or speaks over you, don't just grin and bear it, because it can be damaging to your health.
"Disrespect silences a patient and prevents them from speaking up and letting their doctor know about a symptom or complication from a treatment," Dr. Hochman says.
Surgeons with more complaints for unprofessional or disrespectful behavior, for example, have a 14 percent higher rate of surgical and medical complications, according to a June 2017 study in JAMA Surgery.
If it happens once or twice, it's reasonable to bring it up with your physician, Dr. Hochman says. But if she seems offended or it keeps happening, make the switch.
2. Does It Take Weeks or Even Months to Get an Appointment?
The average wait time for a new patient in a big city to see a family-medicine physician is now 29 days, compared with 19.5 days in 2014, according to physician recruiting firm Merritt Hawkins. Specialty appointments aren't much better: It takes on average now about 21 days to get in to see a cardiologist, and over 26 days to see an ob-gyn.
But if you're really sick — for example, you're running a high fever or are having trouble breathing — you should still expect your primary physician to see you that day.
"It's really important to find out your doctor's office's position on acute care — most offices should have some sort of system in place where you can get in," Dr. Hochman says. Even if the doctor is booked solid, a nurse practitioner or physician's assistant should be able to squeeze you in.
If you're still not happy with the speed of getting an appointment, ask the office to have the physician call you back, or shoot them an email message on their online patient portal, Dr. Hochman advises.
"Email is often your surest bet — your provider may still take a day or two to get back to you, but you may reach them more quickly than playing phone tag," he says.
But if you get radio silence on their end, or it takes a week for them to get back to you, it may be time for a move.
3. Do They Seem to Shame You About Your Weight?
If you feel like your doctor responds to complaints about back pain or fatigue by suggesting you need to lose weight, it may be time to find a new provider.
Weight bias is pervasive in medicine, according to a February 2019 paper in the Journal of the American Medical Association. What's more, November 2014 research in Inquiry showed that doctors spend less time with patients who have overweight or obesity.
"It's one of the biggest complaints we get from patients," says Caitlin Donovan, senior director of the National Patient Advocate Foundation.
There's actually a name for this, she adds: implicit bias, in which a physician makes judgments and decisions based on certain traits.
The best way to deal with this is to express your concern clearly and calmly. "A good way to go about it is to say, I hear you, but that comment makes me think you're saying this because I'm heavy," she suggests. "You're giving the doctor benefit of the doubt that they're not trying to be offensive, but at the same time letting them know they need to be more sensitive."
4. Does Your Doctor Hate When You Ask Questions?
Your doctor should take the time to answer all your questions and concerns thoroughly, says Annette Ticoras, MD, a board-certified patient advocate and owner of Guided Patient Services in Westerville, Ohio. They also shouldn't be cagey about why they're ordering a specific test or recommending a specific treatment, or about sharing your medical results.
"You want someone who engages in shared decision making, which means going over all your options with you thoroughly," Dr. Ticoras says. If you've made clear to your doctor that you want to know all the ins and outs of your medical care, and they still keep you in the dark, it's not a good sign.
Your doctor should also work with you to find a treatment that meets your needs, she adds. That means they should listen to you if you explain that you're having trouble sticking to a new medication because of side effects, for example, or you simply don't feel better.
They also shouldn't be offended if you ask them for a referral for a second opinion. If they do, it's a red flag that you need to find another provider, Dr. Ticoras says.
5. Is Your Doctor’s Staff a Pain?
If you constantly feel like you're pulling teeth to get someone in their office to return your call, or to get a prescription refilled, it's a bad sign.
"If the staff seems like a mess and aren't on top of things, there's also a good chance that they're reflecting the doctor's management style," Dr. Hochman says. It also increases the chances that someone — whether it's the physician themselves or their staff — can make a medical error, he adds.
You should always try to let your physician know what's going on in their front office, so they can try to address these problems, Dr. Ticoras advises. Sometimes, a doctor will even give you their personal cell phone or email, so you can reach them more quickly and efficiently.
But if you've broached your concerns and don't see any change, or if you feel like your doctor is annoyed that you brought it up, it's a good time to consider a switch.
6. Do You Feel Like You Need to Lie to Your Doctor?
Maybe it's not just one alcoholic drink a night — maybe it's three or four. Maybe the stress of a recent job loss or divorce has started your smoking habit again. Or maybe you slipped and had a few encounters of not-so-safe sex.
In all of these cases, it's very important for you to be up front with your physician.
"A good doctor won't judge you, and will instead offer advice to help keep you safe and get you back on track again," Donovan says.
That may involve having you do certain screening tests to check for STIs, for example, or helping you hook up with a new smoking cessation program. But if you've tried, and you've gotten a lecture — or just rolled eyes — then you may want to find a physician who's more simpatico to you.
- International Journal of Medical InformaticsDynamic modeling of patient and physician eye gaze to understand the effects of electronic health records on doctor-patient communication and attention:
- Journal of Participatory Medicine; Nonverbal Interpersonal Interactions in Clinical Encounters and Patient Perceptions of Empathy
- JAMA: Addressing Medicine’s Bias Against Patients Who Are Overweight