DRHOOK- Are you sure? Skeptics always question the doc

"Na-uh! I don't believe you." 

How many times have people questioned facts? This is an especially common phenomenon in this age of Internet information and misinformation. Mistrust. Misunderstanding. Miserable.

People used to think the world was flat and Christopher Columbus was an idiot to sail off the edge of the world. Instead he brought syphilis to the New World and more disease back to Europe! (Is this where Elton John sings, "The Circle of Life"?)

Are we that skeptical?

In medical school, I was taught to be skeptical of all new medical information, to employ critical thinking, and that's a vital skill because we don't want doctors to believe in snake oil.

The problem with some patients is they just don't trust anything the doctor says. 

Pretend scenario: Patient: "I don't have high cholesterol."

Doctor: "Your labs for the past five years show an LDL of 240. Your current LDL goal is less than 100." 

P: "The labs are wrong." 

D: "Then why do you bother checking your cholesterol twice a year?" 

P: "To finally get a real reading to prove my cholesterol's fine." 

Isn't this like the vignette in Woody Allen's Annie Hall about a guy who tells a psychiatrist that his brother thinks he's a chicken. When the psychiatrist asks the patient why he doesn't get some help for his brother, the patient says he doesn't because he needs the eggs.

On the other hand, some folks walk through a storm with full evidence of a problem but don't want to admit it. 

Pretend scenario: Doctor: "You have a huge hydrocele, which means fluid in your scrotum. Why did you wait this long to be seen?" 

P: "Because I can't walk anymore." 

D: "Ok, how about seeing a urologist to have this fixed?" 

P: "Do you think maybe my blood pressure medicine is causing this? The warning label says my medicine can cause the following 800 things." 

D: "No, I don't. Nonetheless, you need to have this fixed since you can't walk." 

P: "How do you know for sure there's fluid in there? Maybe my scrotum looks swollen because I'm so skinny." 

Mm, hm...

Some people seem to understand what's discussed in the doctor's office but then do a 180 when they get home. 

Another pretend scenario: Patient: "Doctor, why did you give me this medicine. I don't have diabetes." 

D: "Remember your labs show your fasting blood sugar is always 300, and your HbA1C is in the poorly controlled diabetic range?" 

P: "No, you never told me that, and you said I was peeing all the time because I drink too much Coke. I don't have diabetes like my parents, brothers, sisters, and cousins." 

D: "But you came to me out of concern that you might have diabetes." 

P: "Well, can we redo the lab tests? I think since I didn't drink my Coke this morning, everything will turn out normal now." 

Dealing with family members can be equally challenging, especially when all the family members hate one another. I've heard of a family who all wanted to change the diagnosis of the patient to best suit their own needs. So they all ended up arguing with the doctor and questioned every medicine, order, and test. (I wonder if they would lose on Family Feud?)

I think there's a healthy balance between following your doctor's advice and making your own choices. On the other hand, I heard a saying a long time ago, "A doctor who tries to doctor himself is a fool." 

Sometimes it's just better to have an objective opinion and guidance.

~

Dr. Hook cracks a joke or two, but he's a renowned physician with an interesting website, drjohnhong.com. Email him with your questions.

#