{"id":5790,"date":"2024-01-11T08:05:06","date_gmt":"2024-01-11T06:05:06","guid":{"rendered":"https:\/\/medicalmanage.gr\/when-the-patient-wants-to-be-the-doctor\/"},"modified":"2024-01-16T13:15:04","modified_gmt":"2024-01-16T11:15:04","slug":"when-the-patient-wants-to-be-the-doctor","status":"publish","type":"post","link":"https:\/\/medicalmanage.gr\/en\/when-the-patient-wants-to-be-the-doctor\/","title":{"rendered":"When the Patient Wants to Be the Doctor"},"content":{"rendered":"<p><strong>When was the last time a patient told you how to practice medicine?<\/strong><\/p>\n<p>Odds are it has happened in the past week.<\/p>\n<\/p><div id=\"medic-3478548117\" class=\"medic-mesa-sto-article medic-entity-placement\" style=\"margin-left: auto;margin-right: auto;text-align: center;\"><script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-3269445924940809\"\r\n     crossorigin=\"anonymous\"><\/script>\r\n<!-- medical en mesa sto arthro -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-3269445924940809\"\r\n     data-ad-slot=\"8662865328\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script><\/div>\n<p><strong>With increasing frequency, patients arrive at their physicians\u2019 office demanding a specific test or treatment.<\/strong><\/p>\n<p>You shouldn\u2019t always honor your patients\u2019 wishes, but you do need to know how to respond to common situations in a respectful but firm way that emphasizes what\u2019s best for patients.<\/p>\n<p>Here are four principal drivers of patient-driven healthcare:<\/p>\n<p><strong>1. The internet<\/strong><\/p>\n<p>There seem to be no limitations to the medical advice patients digest on the internet.<\/p>\n<p><strong>2. The media<\/strong><\/p>\n<p>Reports of a medical study or a celebrity\u2019s novel cure will generate a sudden spike in patient interest.<\/p>\n<p><strong>3. Direct-to-consumer advertising<\/strong><\/p>\n<p>Big pharma hopes to have patients tell you what medication to prescribe.<\/p>\n<p><strong>4. Alternative healthcare<\/strong><\/p>\n<p>In many markets, providers of alternative healthcare are referring patients to primary care physicians for specific tests or therapies.<\/p>\n<p><strong>When in these situations, you must determine whether the requested test or therapy is indicated by the standard of care for a reasonable physician.<\/strong><\/p>\n<p>In other words, would a reasonable physician prescribe the course of care sought by the patient?<\/p>\n<p><strong>If the answer is no, then you should not acquiesce to the patient\u2019s demands.<\/strong><\/p>\n<p><img decoding=\"async\" class=\" size-full wp-image-5788\" src=\"https:\/\/medicalmanage.gr\/wp-content\/uploads\/2020\/04\/images_partnershiptrustandethic_556026.jpg\" alt=\"It is clear that physicians cannot abdicate their role in deference to a patient\u2019s request.\" width=\"100%\" height=\"NaN\" title=\"It is clear that physicians cannot abdicate their role in deference to a patient\u2019s request.\" srcset=\"https:\/\/medicalmanage.gr\/wp-content\/uploads\/2020\/04\/images_partnershiptrustandethic_556026.jpg 800w, https:\/\/medicalmanage.gr\/wp-content\/uploads\/2020\/04\/images_partnershiptrustandethic_556026-300x200.jpg 300w, https:\/\/medicalmanage.gr\/wp-content\/uploads\/2020\/04\/images_partnershiptrustandethic_556026-768x512.jpg 768w, https:\/\/medicalmanage.gr\/wp-content\/uploads\/2020\/04\/images_partnershiptrustandethic_556026-585x390.jpg 585w, https:\/\/medicalmanage.gr\/wp-content\/uploads\/2020\/04\/images_partnershiptrustandethic_556026-263x175.jpg 263w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><\/p>\n<p><strong>It is clear that physicians cannot abdicate their role in deference to a patient\u2019s request.<\/strong><\/p>\n<p>Physicians must be more than an enabler for a patient\u2019s desires, even at the risk of a damning Healthgrades review.<\/p>\n<p><strong>If a patient requests a test that is not clinically necessary, you should review the risks, benefits and alternatives with the patient.<\/strong><\/p>\n<p>The patient should be advised that her insurance company may not cover the test.<\/p>\n<p><strong>And if the test has no therapeutic or diagnostic benefit in your estimation, do not order it.<\/strong><\/p>\n<p>That is better medicine than padding your documentation in an effort to obtain insurance coverage.<\/p>\n<p><strong>If you are not familiar with a test, the indications for it or how to interpret and treat the results, then you should not order it.<\/strong><\/p>\n<p>A physician who orders a study is responsible for interpreting the results and providing appropriate care, even if it was done as a favor to another provider.<\/p>\n<p><strong>If a patient requests a specific form of treatment, such as a particular name brand medication, you are obligated to inform the patient of your best medical judgment.<\/strong><\/p>\n<p>If you routinely prescribe the drug and it is the best clinical choice, then there should be no problem.<\/p>\n<p><strong>If you do not routinely prescribe the drug or it is not the appropriate clinical choice, then you should advise the patient.<\/strong><\/p>\n<p>Again, the determination for how to proceed hinges on what a reasonable physician would prescribe under the circumstances.<\/p>\n<p><strong>The prudent course is for you to stay within your usual practice.<\/strong><\/p>\n<p><img decoding=\"async\" class=\" size-full wp-image-5789\" src=\"https:\/\/medicalmanage.gr\/wp-content\/uploads\/2020\/04\/images_171631860-56aae7f53df78cf772b4a4cb.jpg\" alt=\"Documentation is always important, including in instances where you go against your patients\u2019 requests.\" width=\"100%\" height=\"NaN\" title=\"Documentation is always important, including in instances where you go against your patients\u2019 requests.\" srcset=\"https:\/\/medicalmanage.gr\/wp-content\/uploads\/2020\/04\/images_171631860-56aae7f53df78cf772b4a4cb.jpg 500w, https:\/\/medicalmanage.gr\/wp-content\/uploads\/2020\/04\/images_171631860-56aae7f53df78cf772b4a4cb-300x210.jpg 300w\" sizes=\"(max-width: 500px) 100vw, 500px\" \/><\/p>\n<p><strong>You should not undertake managing an unfamiliar treatment if you have no training or experience in doing so.<\/strong><\/p>\n<p>Just as importantly, you should not let a patient\u2019s insistence overcome good clinical judgment, especially when the potential for harm is high.<\/p>\n<p><strong>This advice should still be followed by pediatricians and family physicians who daily face parents expecting an antibiotic prescription for a child\u2019s viral infection.<\/strong><\/p>\n<p>In these instances, insurance coverage may be a prime deterrent for patients.<\/p>\n<p><strong>Documentation is always important, including in instances where you go against your patients\u2019 requests.<\/strong><\/p>\n<p>Document what was discussed and why you declined the request.<\/p>\n<p><strong>The same goes for when you recommend alternatives and patients decline.<\/strong><\/p>\n<\/p>\n<p><strong>You are the doctor. It is your responsibility -your protected responsibility- to provide your patients care to the best of your abilities.<\/strong><\/p>\n<p>Acquiesce only when you believe what your patients want is actually in their best interest.<\/p>\n<p><strong><a href=\"http:\/\/www.medicalmanage.gr\/en\/\">www.MedicalManage.gr\/en\/<\/a><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>When was the last time a patient told you how to practice medicine? Odds are it has happened in the past week.&hellip;<\/p>\n","protected":false},"author":2,"featured_media":5787,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[107],"tags":[],"ppma_author":[274],"class_list":["post-5790","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-patient-service"],"aioseo_notices":[],"aioseo_head":"\n\t\t<!-- All in One SEO 4.9.10 - aioseo.com -->\n\t<meta name=\"description\" content=\"When was the last time a patient told you how to practice medicine? Odds are it has happened in the past week. With increasing frequency, patients arrive at their physicians\u2019 office demanding a specific test or treatment. 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You shouldn\u2019t always honor your patients\u2019 wishes, but you do need to know how to respond to common","twitter:image":"https:\/\/medicalmanage.gr\/wp-content\/uploads\/2020\/04\/images_ts_110627_doctor_patient_interaction_300x225.png"},"aioseo_meta_data":{"post_id":"5790","title":null,"description":null,"keywords":null,"keyphrases":null,"primary_term":null,"canonical_url":null,"og_title":null,"og_description":null,"og_object_type":"default","og_image_type":"default","og_image_url":null,"og_image_width":null,"og_image_height":null,"og_image_custom_url":null,"og_image_custom_fields":null,"og_video":null,"og_custom_url":null,"og_article_section":null,"og_article_tags":null,"twitter_use_og":false,"twitter_card":"default","twitter_image_type":"default","twitter_image_url":null,"twitter_image_custom_url":null,"twitter_image_custom_fields":null,"twitter_title":null,"twitter_description":null,"schema":{"blockGraphs":[],"customGraphs":[],"default":{"data":{"Article":[],"Course":[],"Dataset":[],"FAQPage":[],"Movie":[],"Person":[],"Product":[],"ProductReview":[],"Car":[],"Recipe":[],"Service":[],"SoftwareApplication":[],"WebPage":[]},"graphName":"","isEnabled":true},"graphs":[]},"schema_type":"default","schema_type_options":null,"pillar_content":false,"robots_default":true,"robots_noindex":false,"robots_noarchive":false,"robots_nosnippet":false,"robots_nofollow":false,"robots_noimageindex":false,"robots_noodp":false,"robots_notranslate":false,"robots_max_snippet":null,"robots_max_videopreview":null,"robots_max_imagepreview":"large","priority":null,"frequency":null,"local_seo":null,"breadcrumb_settings":null,"limit_modified_date":false,"ai":null,"created":"2022-12-16 13:11:52","updated":"2025-08-29 00:13:39","seo_analyzer_scan_date":null},"aioseo_breadcrumb":"<div class=\"aioseo-breadcrumbs\"><span class=\"aioseo-breadcrumb\">\n\t\t\t<a href=\"https:\/\/medicalmanage.gr\/en\/\" title=\"Home\">Home<\/a>\n\t\t<\/span><span class=\"aioseo-breadcrumb-separator\">&raquo;<\/span><span class=\"aioseo-breadcrumb\">\n\t\t\t<a href=\"https:\/\/medicalmanage.gr\/en\/category\/patient-service\/\" title=\"Patient Service\">Patient Service<\/a>\n\t\t<\/span><span class=\"aioseo-breadcrumb-separator\">&raquo;<\/span><span class=\"aioseo-breadcrumb\">\n\t\t\tWhen the Patient Wants to Be the Doctor\n\t\t<\/span><\/div>","aioseo_breadcrumb_json":[{"label":"Home","link":"https:\/\/medicalmanage.gr\/en\/"},{"label":"Patient Service","link":"https:\/\/medicalmanage.gr\/en\/category\/patient-service\/"},{"label":"When the Patient Wants to Be the Doctor","link":"https:\/\/medicalmanage.gr\/en\/when-the-patient-wants-to-be-the-doctor\/"}],"authors":[{"term_id":274,"user_id":2,"is_guest":0,"slug":"charamis_medical","display_name":"Charamis","avatar_url":"https:\/\/secure.gravatar.com\/avatar\/13548bee49946b2d932987c7cde930a0b1367bb1b57c039d17eda32396547b84?s=96&d=mm&r=g","author_category":"","first_name":"Charamis","last_name":"","user_url":"","job_title":"","description":""}],"_links":{"self":[{"href":"https:\/\/medicalmanage.gr\/en\/wp-json\/wp\/v2\/posts\/5790","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalmanage.gr\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalmanage.gr\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalmanage.gr\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalmanage.gr\/en\/wp-json\/wp\/v2\/comments?post=5790"}],"version-history":[{"count":1,"href":"https:\/\/medicalmanage.gr\/en\/wp-json\/wp\/v2\/posts\/5790\/revisions"}],"predecessor-version":[{"id":17874,"href":"https:\/\/medicalmanage.gr\/en\/wp-json\/wp\/v2\/posts\/5790\/revisions\/17874"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medicalmanage.gr\/en\/wp-json\/wp\/v2\/media\/5787"}],"wp:attachment":[{"href":"https:\/\/medicalmanage.gr\/en\/wp-json\/wp\/v2\/media?parent=5790"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalmanage.gr\/en\/wp-json\/wp\/v2\/categories?post=5790"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalmanage.gr\/en\/wp-json\/wp\/v2\/tags?post=5790"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/medicalmanage.gr\/en\/wp-json\/wp\/v2\/ppma_author?post=5790"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}