How to break-up with your doctor

Source: Web exclusive, August 2011

Life’s full of break-ups, but one of the trickiest relationships to terminate is with your doctor. When it seems that your general practitioner isn’t looking out for your best interests, the decision to sever ties is fraught with stress, emotion and uncertainty. During this difficult situation, you need to review your options, and make smart choices that won’t jeopardize your health. Reasons for considering a doctor switch are varied, but when is it time to finally take that leap?

Overcrowded waiting rooms, delayed appointments’according to Durhane Wong-Rieger, president and CEO of the Institute for Optimizing Health Outcomes, these issues don’t warrant finding a new GP. Often these problems are created by challenges mired deep in Canada’s health care system. "There are circumstances that conspire against physicians to do their best," she says. There’s a lot of pressure in terms of the number of patients they have to see, and a doctor who takes time with each patient can end up with a congested waiting room. Appointments may back-up as a result of their thorough care. A decision to split from your GP based on a packed reception area is not the smartest move.

Valid reasons for changing doctors are much more significant. Wong-Rieger says the top patient complaint is communication difficulties. "Doctors aren’t natural communicators. We often hear ‘my doctor doesn’t listen,’ and ‘has no bedside manner’." Patients also mention GPs who dismiss symptoms, fail to follow-up on test results and rush through appointments. Before these problems spiral out of control, Wong-Rieger suggests speaking with your physician. Be respectful and voice your concerns clearly.

"It’s a challenging relationship," she says, “The doctor does work for you. You’re a client and the doctor is providing you with a service.” Patients should say, "Here’s what I expect, need and want," suggests Wong-Rieger. In the end, if clarifying your needs with your GP doesn’t help, or you discover even more worrying concerns such as a hesitance to provide referrals, ignorance regarding the latest treatments or worse’you suffer health repercussions as a direct result of their care’then it’s definitely time to move on.

Explore your options

Do some research to ensure that another physician is available. Ask friends and family about their primary physicians, and search www.RateMDs.com to read patient reviews. Once you’ve selected a possible replacement, call the GP’s office to see if he’s accepting new patients. "Hang out in the waiting room," says Wong-Rieger. "See how people feel about this doctor."

To confirm that this new doctor is a good fit for you, book an appointment. "Lay out your expectations," she says. "It’s a bit of an interview on both sides."

End the current relationship

Step two of the process: end the soured doctor-patient relationship in person. "Leave on good terms in a non-confrontational way," says Wong-Rieger. "Be clear [about] why you’re leaving, and present the issues factually." It’s important not to let emotions or judgmental feelings taint your message. If you need assistance, bring "a family member, a friend or an advocate from a patients’ group," she says. “Sometimes we need that little extra support.”

Meeting your GP under these circumstances can be stressful, but it’s necessary to guarantee completion of the third, and final step.

Take your history with you

Obtaining your complete set of medical records is an important final step. "Some doctors may put up roadblocks. [They may] claim their private notes aren’t part of your records, or charge you [for] photocopying," says Wong-Rieger. But remember, you have a right to your records. Remain polite, and specify that you want everything in your file, including notes, test results and x-rays. Taking the entire file will ensure that your new doctor will have your complete medical history. Once you’ve obtained your records, you’re ready to move on to your new GP.

What if I can’t find a new doctor?

Unfortunately, not all patients will be lucky enough to find a new doctor right away. If your research doesn’t lead to a new doctor, it’s best to remain with the one that you currently see. Having a so-so relationship with your GP is better than having no doctor at all. And don’t forget about the unsung heroes in the office’the receptionist and nurse. "You can work with them," says Wong-Rieger. "The receptionist can help you get a double appointment, or [one] when the physician [isn’t] in a hurry. The nurse can interpret where the doctor’s coming from."

By taking a more proactive role in your health care, you can turn a difficult situation into one that works in your best interests.

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