Doctors Aren't Always Right and How To Say "No"

Let me ask you this question. Do you know someone who is perfect? I mean, absolutely perfect; Never gives a wrong answer, never guesses wrong, never slacks off at work or procrastinates, and never misspeaks or gets frustrated. Ever.

I think we all know the answer to that question is “no.” No one is perfect and gets everything right all the time, so why do we think our doctors are somehow immune to this well-known truth?

Why is self-advocacy so hard?

For some reason, most people seem to believe that once a human being dons a white lab coat and a stethoscope, they suddenly turn into a walking google robot with all the answers right at their fingertips. When I write it out like that, it sounds absurd. So why do we instantly revert to a child-like state when the doctor begins giving us instructions like we’re suddenly back in 4th grade and are getting scolded for eating all the freshly-baked chocolate chip cookies that mom made for the whole class?

It’s bizarre how we can walk into the doctor’s office saying to ourselves, “OK, I’m gonna tell the doctor this isn’t working, and I want to make a change, and I’m not taking no for an answer!” Then we walk out going, “Well, I guess we can try it for another few months and see if it starts working.”  What the heck just happened? What kind of voodoo witchcraft did the doctor perform to turn me from an assertive adult of sound mind into a compliant baby who wants to please my doctor-parent?

Doctors aren't always right

Let’s be honest – it’s not as if doctors can’t be wrong. Anyone who has been dealing with rheumatoid arthritis and other chronic illnesses for any prolonged period of time has definitely run into situations where the doctor was just plain wrong, probably more than once! It even happened to me again recently.

I was visiting with a doctor last week, and I showed him a symptom I was having on my body- a body part we had discussed before. He had initially told me the symptom was due to a side-effect of medication, and I had been going with that assumption for years. In the most recent visit, though, he told me this particular side effect was due to a completely unrelated-to-medication physical ailment that was probably caused by years of rheumatoid arthritis.

Wait, what? You told me this was caused by medication, and for over a decade, I would determine how bad my side effects were by how much this particular side effect was hurting. Now you are saying that it’s completely unrelated to medicine? Well, which one is it, doc? They can’t both be right.

Most of us have our own stories

The above is just one of many examples where my doctors got it wrong, and that’s just a minor example. One time a nurse during a hospital stay got things so bad that I had to be rushed to the ICU half-dead, and I have heard similar stories from many long-term RA patients. Yet despite this massive pile of evidence staring us in the proverbial face, we still have the urge to nod and say “yes” when a doctor tells us to do something. So how do you overcome this almost-overwhelming impulse to agree?

How to stand up to your doctor

Unfortunately, there isn’t some magic wand I can wave to give you the power to assert yourself. As the old riddle goes – “How do you get to Carnegie Hall? Practice.” That’s the key – like any other skill, you have to practice asserting yourself. The problem is that you can talk to yourself all day long in the mirror, but when you are sitting there in the exam room, it’s not so easy.

In addition, doctors love to push back when you tell them you know your body best. They say things like, “Well, why don’t we just try it?” or “It’s only been a few months.” or “I’m not sure if that’s right for you.” That’s when you have to steel yourself and say “no,” and reiterate that you know your body best, and while you value the doctor’s advice and experience, you also know that this particular thing isn’t right for you. It sounds simple but takes practice, so try to assert yourself whenever you can.

Becoming the "difficult patient"

There’s one other thing that needs to be said, and that’s the rare case where the doctor is completely intractable, and you end up in a stalemate. At this point, some doctors may decide to stop treating you outright, but more likely, you will get the dreaded “difficult patient” mark made in your file.

I have been branded with that particular scarlet letter more than once in the long tenure of my illness because I don’t do anything I don’t think is right for my RA. You must be prepared for this and understand that there’s always a small chance you will have to find a new doctor.

Weigh the pros and cons first

If you live in a place where there is an abundance of docs like I do, then it isn’t much of an issue. On the other hand, if you live in a more rural area with limited access to doctors and even less access to specialists, you have to consider that. If you are in the “limited access” category, you must be careful not to alienate the only doctors available. As much as I hate to even write these words, you may need to temper your assertiveness until you can find an alternative doctor.

As you can see, saying “no” to your doctors is an important skill to learn when you have rheumatoid arthritis or any other chronic illness. It takes practice and can be a little awkward, but you know your body best. Fight for it! Talk soon.