Going to the doctor can be confusing. Doctors make recommendations based on what they know, and patients are conditioned to trust their doctors. While I think it's wonderful that patients trust their doctors, there are times when patients want more input into their health care, and if this is the case, then let me make some suggestions as to what might be important questions to ask. There is nothing specific to psychiatry about my recommendations, so feel free to have these types of discussions with any doctor or prescriber.
If you go to the doctor for a routine visit and it is suggested that you have routine health maintenance tests or treatments and you are fine with that, then there is not much to ask. If you have a concern about the necessity of a test or procedure, try to figure out what your concern is so you can verbalize it. One example might be: Will routine vaccinations cause my child to become autistic?
- Why do I need this test?
- What is the risk of this procedure?
- If a medication or supplement is being offered to decrease the risk of a specific illness later, then it's reasonable to ask if studies show that this treatment is known to be effective. This may sound silly, but sometimes we just don't know things: so people took statins to lower their cholesterol, but it was a while before it was clear that they also lowered the risk of heart disease. And now the thinking is that Vitamin D and Calcium supplements may not lower the risk of osteoporosis in post-menopausal women (they may have other benefits however) but they do increase the risk of kidney stones.
- What are the risks of not taking this medicine/supplement/having this vaccine?
If you go to the doctor with a specific problem, things are a little different.
- If the doctor orders a diagnostic test, you may or may not want to ask what he is looking for or trying to "rule out." The answer may be something scary that is very unlikely and perhaps you may not want to know to worry about something that's not likely to be the problem.
- Is it an option to treat a presumed illness without having a diagnostic test first? If the treatment is something easy or benign or cheap or a lifestyle change, maybe it would make sense to try that before having an expensive or painful procedure. If the test is being done to rule out a treatable form of a serious illness, then usually doctors do not like to delay a test.
- If the doctor recommends a specific treatment, it's reasonable to ask "How long it will take to work and when do you want to hear from me if things are not better?" This is important, if you're supposed to be better in 3 days, you don't want to come back in 6 weeks saying you're still sick or hurting or very much worse. And if the treatment is going to take 6 weeks to work, he doesn't want to hear that you're not better in 3 days.
- If you don't want the treatment your doctor recommends (or you're not sure), it's reasonable to ask: Are there other treatment options available? What is the expected course of this illness/injury/problem if I don't have this/any treatment? Sometimes the doctor won't know because different people have different courses with an illness and this can be especially true in psychiatry.
- It's reasonable to say "I am worried that I have X, how can you be sure that I don't?"
- You might then ask, "Would it make sense to order X test?"
- You might also ask, "If I continue to have these symptoms, are there diagnostic tests or treatment options that might be reasonable to try?" And then ask for a time frame.