How to maximize the effectiveness of Doctor's appointments?

SplotBoi · 2019-12-22T02:35:41+00:00

Be more assertive, “okay take these meds, and I’ll see you next time” “no, you’re not listening to my concerns, blah blah blah”. You’re paying them, you have the right to get the treatment/answers you want. However I’ve personally gave up on american healthcare. I’m originally from ukraine, so I go back there to doctors I know that will listen to my concerns and take them into account. It’s usually a lot cheaper than here in the states

jajahhssgxka · 2019-12-22T03:34:14+00:00

Try to find a doctor around you that can see you within a week.

They are usually a lot better and not conveyor belts

clon3man · 2019-12-22T01:50:51+00:00

It occurs to me that the same knowledge about dealing with rejection can be used here. I just have to make 10 Doctors appointments per day :P

theUnBannableHulk · 2019-12-22T11:49:17+00:00

Healthcare is a giant scam to get you addicted to painkillers and make you a victim of the opioid crisis.

Stop going to doctors unless you need surgery

manofoneway7 · 2019-12-22T12:22:18+00:00

Doctors generally view patients who disagree with suggested treatment regimens as “difficult” (which they very well may be). Assertiveness wouldn’t help in this case since you basically have no leverage. The key is to not be viewed as a patient from the get-go.

To approach this right, you need to do your due diligence first in preparing for your appointment. Doctors often follow pre-defined guidelines to formulate a treatment plan. You have to study these guidelines over and over until you can basically predict what treatment plans might be offered (i.e. standard of care) for your particular condition. For instance, one popular treatment guideline used for Major Depressive Disorder (MDD) is: https://annals.org/aim/fullarticle/2490527/nonpharmacologic-versus-pharmacologic-treatment-adult-patients-major-depressive-disorder-clinical

You need to find the defacto standard treatment guidelines used for your conditions and study all of them.

After studying these guidelines, read the studies for the standard treatments being suggested (usually in the form of journal articles). Note down the performance numbers** of said treatments and the associated patient count for these studies. Re-apply this approach for the alternative treatments you want to propose. To find promising new treatments, you usually have to scour the web for studies in top-ranked medical journals. You can find these journals by either asking doctors/researchers in the area of medicine that covers your condition or by relying on ranking websites (e.g. https://www.scimagojr.com/journalrank.php?category=2701).

Note down all the relevant numbers for both standard and alternative treatments in a properly referenced document. Provide reasons as to why you think these alternative treatments might provide favorable outcomes compared to the defacto standard, and always back this up by empirical evidence (i.e. response rate, patient count for the study, etc.).

During the session with your M.D. always be succinct, remain composed, and describe your symptoms as objectively as possible. For mental illness, this can be challenging, but if you have already done this drill multiple times, you'll usually have an idea of what your symptoms/condition is like. This step is important! If you act like you’re completely undermined by this illness, the doctor’s pattern recognition machine will automatically clump you in the category of “patient”. Avoid being dramatic. Rehearse your lines prior to your appointment.

After describing your case and getting an initial assessment/diagnosis, you can lay down the facts as to what treatment regimen you think might be effective. Prepare to defend your case. Before referring the doctor to a particular study, mention the journal name and the PI (Principal investigator) of said study. If the doctor is up-to-date with the research literature, he should be able to glean the rest and, even if not, he’ll at least understand that you’re referencing a study from a quality journal (i.e. you did your homework). This should help keep him engaged.

If you want to vet doctors that might be more responsive to your treatment suggestions, you can send them your manuscript containing your suggested treatments beforehand and ask them for their scientific opinions. If they follow-up and indicate interest, they might be willing to discuss this in more detail during a consultation session. This should also address the issue of appointments being too short, as the doctor will already have a pre-established idea of what you're suggesting.

Note that, if the treatment regimen you're proposing hasn't been approved by the FDA for human use, your only bet is to enroll in a clinical trial. In this case, you can search directly for clinical trials that are currently recruiting patients on this page: https://clinicaltrials.gov/. On the other hand, if your suggested drug is not approved by the FDA for your particular condition (but accepted by the FDA for human use), your doctor might still be able to prescribe it.

Also note that this answer assumes that your doctors have diagnosed your condition correctly (which may or may not be the case). For mental illnesses specifically, the rule of thumb is to never self-diagnose. You have to rely on your doctors to do this right. Treatments, however, are a different beast, since they primarily rely on empirical evidence and it is possible that doctors/treatment guidelines are lagging behind the state-of-the-art.

** Refer to the treatment guidelines to find the performance metrics used to evaluate drug efficacy. You'll often find metrics such as response rate (RR). For specific conditions, such as depression, you might find more specific metrics (e.g. The Montgomery-Åsberg Depression Rating Scale (MADRS)).

Title	How to maximize the effectiveness of Doctor's appointments?
Author	clon3man
Upvotes	3
Comments	5
Date	December 22, 2019 1:46 AM UTC (4 years ago)
Subreddit	Posted in /r/askTRP
Original Link	https://old.reddit.com/r/asktrp/comments/edyp0q/how_to_maximize_the_effectiveness_of_doctors/
Archive Link	https://theredarchive.com/r/askTRP/how-to-maximize-the-effectiveness-of-doctors.302543 https://theredarchive.com/post/302543