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Doctors and health care teams listen up! I have something to say! Some patients are more fragile than others. What the hell does this mean? It means that you have to be extra careful what you say to them. It means that you have to be extra thoughtful before you speak to them. It means that you need to do your research before you open your mouth and accidentally freak them out. You as the physician are part of a team and the whole team has to communicate with each other so that everyone has the same information. The patient does not need to hear different and/or conflicting information from each source. This only leads to potential panic and confusion and makes it difficult for the patient to follow through and get the care that they need. To you it may seem like a simple oversight. To the patient, it can seem like the end of the world.
This really applies to all patients, but the group I have in mind at the moment are cancer patients. This group of patients literally has their lives in your hands. They hang on your every word. They are depending on you to help them get to the other side of their illness with an intensity that is greater than patients with other diseases. You have a direct impact on their physical AND mental health, both of which are key to their survival. Think about it for a second. Anything you say to them is regarding a disease that could kill them. You tell them if they qualify for clinical trials. You tell them what chemo or radiation they will get. You talk about costs. You have to talk to them if their cancer is not responding like you hoped. Sometimes you have to tell them they are going to die. Every word out of your mouth carries the weight of their future. One bit of discouraging news may not just mean a bad day for them. It may affect the rest of their lives. No. I am not exaggerating. It is really that important.
The bottom line is that the healthcare team has to be a cohesive, thoughtful, compassionate, comprehensive unit. Patient’s lives, mental health, and physical health depend on it.
Dr. Katz


These are words to live by right there. I am always encouraging patients to advocate for themselves. I think that every patient should be master and commander of their own destiny. It is so important that you listen with your eyes and ears open at every doctor’s appointment. Take notes and read everything that your doctors give you. At least attempt to understand what your doctor is telling you or ask questions until you do. Insist on clarification if you don’t. Pay attention, even if you don’t like what the doctor is saying, especially if you are getting news that you don’t want to hear. If you are getting any kind of unfavorable news, it becomes even more important to buckle down and concentrate so that you can be a part of your own management plan. If you disagree with your doctor’s diagnosis and plan, communicate that, in the right way, and talk about it together. Make sure that you have given him or her ALL the necessary information that you can think of, even if you think it doesn’t matter. Ask questions! I never understand when my colleagues complain about patients asking questions. I am like bring it on! I love questions! It means that you are actually interested in your own health and what I am telling you. I am actually more concerned if you don’t ask. Plus, if I have a problem with a patient asking questions, that poorly reflects on me if anything. So, please ask away.
So we have discussed how to advocate for yourself as a patient. Now let’s discuss the difference between advocating for yourself and trying to be your own doctor. When a patient advocates for themselves, they are being an active participant in their own management. They are agreeing to a team participation relationship between themselves and their physician. They are vested in their care. This is a good thing. Sometimes, patients cross the line and try to be their own doctor. This is when things get tricky and potentially harmful. Show of hands: who has done this before? I think we all have at one time or another, myself included. There are many different strategies that we use. 1) We self- diagnose with the aid of our friends or Doctor Google and seek our own treatment. 2) Sometimes we use left-over medication instead of seeking help or advice. 3) Sometimes we are so set on our own self-diagnosis that we call the doctor’s office and insist on a particular course of treatment and refuse to come in because we are sure that we are right. Then we lash out at the doctor for not instantly responding to our requests of convenience and daring to ask us to come for an appointment. 4) Sometimes we convince ourselves that nothing’s wrong and delay our treatment because we are either afraid or “don’t have time to bother with it.” I think that physicians in particular are guilty of this last one. We spend so much time caring for others that we don’t make the time to make sure we care for ourselves. It really is self-defeating because, if we don’t take care of ourselves and assume a patient role at times, we won’t be around to care for others.
All of these strategies have the potential to bite you in the proverbial ass at the end. I strongly advise against it. Mind you, I am all about patients being aware of their own bodies and health history. On top of that, I am always listening when a patient gives me their diagnosis and I take it into consideration. However, the bottom line is, when you are too close to a situation(i.e you trying to diagnose you), it is nearly impossible to always make the right decision. The chances of you being wrong are greater than the chances of you being right. You just can’t be objective. The decisions we make for ourselves are automatically imbued with our own agenda and baggage: We are worried about missing work. We don’t have time to go to the doctor. We don’t have time to stop. There are deadlines that we are worried about missing. We are afraid. When you “let your doctor in” on the decision making process, you bring back the objectivity that is crucial in determining the right diagnosis and treatment. When a patient comes to me with an issue, I am able to evaluate it with a clear head with objective information. My initial job is to get to the root of their issue and come up with a plan. I have the luxury of not having to be preloaded with concerns about their external factors until I have come up with a diagnosis. Let me clarify. I do not mean that I don’t consider their schedules or other life issues, I just mean that I don’t have to let it slow me down in terms of their diagnosis.
Now that we have described what it means to be your own doctor, let’s talk about why it is a bad idea. First and foremost, you just get it your own way. You slow down the path to diagnosis and treatment, if not cure. Second, if you are wrong, and there is a good chance that you could be, it could literally mean the difference between success and failure, life and death, etc. Third, you are not giving your doctor a chance to actually do their job. They did go to medical school after all and it was probably a more thorough training experience that what Dr. Google or your friend has. Let them get their ( and your) money’s worth out of it! Fourth, trying to be your own doctor can be really isolating and frustrating and often you have gone through multiple incomplete treatment options first when you could have just gone to the doctor and gotten the correct treatment the first time. If the risk of wasting time was your deciding factor in not going to the doctor, you just negated it by wasting your own time. Just don’t do it!
I fully realize that doctors need to step it up and not force this situation either. We are not free of accountability here. We need to try to work with your schedule. It’s not always possible though. We need to have same day appointment availability slots if possible. We need to make sure our staff is answering phones regularly when you call with questions when we are busy with patients. We need to make sure that we answer our phones when you have after hours concerns. I get that. It’s not just a one-sided issue. I make every effort to fulfill all of these criteria. But, none of these convenience and safety steps can make any difference unless you at least try to reach out in the first place.
Have a great day everybody!
Dr. Katz