Fire Your Doctor? Maybe.

I have a doctor I really like.  But she's never around.  She only works three days a week and they're never the days I need a prescription filled or a question answered.  I have to call her office a couple of times to get a prescription renewed.  My last one waited five days before she refilled it, and I ran out.

So, should I fire her?  That's a question Kristen Gerencher asks in her WSJ article on the subject.  She writes, "If you're frustrated with communication problems, a disorganized staff or a doctor's poor bedside manner, a change may keep your health—and health costs—from suffering."

Gerencher gives as the main reasons patients switch doctors (which actually doesn't happen very often, due to the hassles):

• Unclear explanations
• Delays in getting test results
• Hard-to-resolve billing issues (my all-time favorite: the man charged for a hysterectomy)
• Rushed office visits 

"Like in any relationship, sometimes the chemistry just isn't right.," Orly Avitzur, medical adviser at Consumer Reports and a neurologist in Tarrytown, N.Y., tells Gerencher.

Is picking a doctor like picking a spouse?  Maybe a little.  You want someone who can be patient in helping you understand complex treatment options.  When I was diagnosed with breast cancer, my surgeon took an hour to talk about what was next.   

Talk about delays in getting test results.  It was over a week before I got my initial diagnosis.  "It can't be bad news if they wait a week," friends kept telling me.  Wrong.  The pathologist needed to study my cells to make sure I didn't have invasive cancer, and that took time.  But waiting those days was worse than hearing yes, I had cancer. 

I've learned to become aggressive (that's how I got my husband, too).  I pick up the phone and call the next day to see if my results are in.  I've had some stubborn kidney stones for a while and though my urologist was convinced they were too big to pass the normal way (I'd had several tests to prove it) and felt doing nothing was the way to go, I was still in pain so I didn't give up.  I went back and we talked about surgery, which, at the size they were, was the only option.  And then, miraculously, the pain went away! ;-)

Fortunately, he's a great guy and didn't get annoyed with me.  But once you've had a major illness, you want your doctor to take you seriously.  Even when it's nothing.

There are solutions, though, if you're unhappy with your doctor.  Gerencher suggests trying to talk to your doctor about your frustrations, or switching to another one in the same practice if it's a group. 

Of course, there are serious reasons to leave your doctor.

• Your doctor doesn't want you to get a second opinion.
• Your doctor isn't board-certified. 
•  You leave with more questions than answers.
• And the big one -- your doctor misdiagnoses you.  (My former oncologist missed my second cancer.)

So, it's really up to you about when to change doctors.  Switching is, of course, a major hassle.  But your doctor is an important person in your life and you have to feel comfortable with her, and confident she can help you heal.