Coping with Prednisone, Revised and Updated: (*and Other Cortisone-Related Medicines) by Zukerman Eugenia & Ingelfinger Julie R. M.D

Author:Zukerman, Eugenia & Ingelfinger, Julie R., M.D. [Zukerman, Eugenia]
Language: eng
Format: epub
Publisher: St. Martin's Press
Published: 2013-05-10T00:00:00+00:00

Julie Patients change doctors for various reasons. Doctors know this, and most of the time the decision to switch will not pose a problem, the doctor will be understanding, and the transition will be smooth. Sometimes, however, there can be miscommunication and misunderstanding.

As she described, Eugenia had a list of reasons for switching doctors:

• Her initial doctor was very busy, and the long waiting times were in a busy, uncomfortable, and possibly unhealthful environment.

• She felt that his emphasis was on how ill she was rather than on how well she might get.

• The ancillary staff seemed solemn and gloomy and, what’s more, had some difficulty drawing Eugenia’s blood.

• She didn’t think she’d be confident if she had to be an inpatient in this doctor’s hospital.

Could there have been other, unstated reasons? None of us like bad news. A patient may feel a need to switch doctors just to put distance between the trauma of learning about a serious problem and coping with getting well again. I call this the “shoot the messenger” syndrome, and it may have played a role in Eugenia’s decision. It may be better to work things through with the first doctor if this is the main reason for switching. It can be hard to know whether the motivation for switching is because of the bad news per se. From the physician’s viewpoint, it takes patience and understanding to discuss this issue with a patient. When possible, it can be rewarding for both the patient and the doctor to work through the pain and despair of learning about a tough diagnosis and to develop a strong patient-doctor alliance afterward. If the patient understands the diagnosis and its implications and wants to get well, then the subsequent treatment and course are much easier for all—even if the outcome may be unsatisfactory. So, as a doctor, I try to recognize how the patient feels about his or her diagnosis, so that I can spend appropriate time talking it through. Still, time constraints, attitudes, and circumstances conspire so that this is not always possible.

All in all, the reasons patients switch physicians are many. Doctors expect that some of their patients will change doctors in the course of treatment. In fact, in an era of changes in health-care insurance, switching doctors has become very common for bureaucratic and pragmatic reasons. Furthermore, getting a “second opinion” is important, and it is part of standard care for some diagnoses.

Sometimes patients switch from doctor to doctor very often, seemingly hoping that the next practitioner will “get it right.” Almost invariably, the inveterate “doctor shopper” stays dissatisfied. All the effort of going from doctor to doctor leaves the patient with confusing information overload, a huge time expenditure, and big bills. “Doctor shopping” is unrewarding for all concerned, usually because there is no continuity and because few or none of the doctors consulted get to understand the underlying concerns of someone who is so frantic that he or she is consulting many individuals.

So when should

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