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Ask Dr. Gott 5/22
Patients need to insist on answers
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    DEAR DR. GOTT: I am amazed at the experiences of some of your readers who appear to have very incompetent physicians. The people are complaining of an ailment, yet the doctors don't seem to take the time to do testing to determine the cause or to refer them to a specialist. I used to think this happened only to older people, where some doctors may not be concerned. However, I just read about a 28-year-old woman who has pain in her lower abdomen and her doctor only tested her for a urinary-tract infection. I had a similar problem and had many tests to rule out cancer of the reproductive organs. Do you think it has to do with the type of insurance a patient has?
    DEAR READER: Yes and no. Many of my questions come from readers who are either too afraid or too embarrassed to ask their primary care physicians. Or, as is often the case, they have asked time and time again to no avail.
    Doctors can have a bad day, as can anyone. A visit you've waited days or weeks for with great anticipation turns out to be a waste of time, and you know less than when you got to the doctor's office. When this occurs, it is time to clear the table, ask straightforward questions and request straightforward answers. Tell your physician if you are dissatisfied with the visit and need better responses. If you have tried this approach and you are still unhappy, request a referral to another physician or specialist who can take the time to work with you and order appropriate testing.
    You are correct that older people often appear to be misdiagnosed or are not listened to by some doctors. Fortunately, some physicians limit their practices to geriatric patients. When a senior doesn't get a fair shake, can't be understood or is simply confused about medications, perhaps a change to a geriatric specialist is appropriate. In this instance, don't be afraid or embarrassed to ask for a referral. Health is an important issue.
    Insurance and managed-benefit programs are often a major consideration for people of any age. A patient might demand to know everything but refuse to undergo any testing, or, in the case of managed benefits, might be restricted in what testing can or cannot be performed. When these issues occur, a physician is put on the spot and must gather all his or her diagnostic skills to make an appropriate decision and recommend treatment based solely on symptoms and a patient history. Hopefully, for both the patient and the doctor, the choices are correct.
    To give you related information, I am sending you a copy of my Health Report "Choosing a Physician."
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