Does Your Doctor Share Your Goals?

When it comes to your health and wellness, it’s vital that you and your health care provider are driving towards the same goal. Get clear with yourself and with your doctor. Remember, doctors are limited by their available information. Most pathologies have optional treatment strategies from which to choose, but if the prescriber doesn’t know the goal, realizing that goal is no more than a game of chance.

A client of mine, Sam, complained to me that his doctor keeps prescribing different kinds of anti-inflammatory drugs. “He prescribed this one thing and I told him it upset my stomach and it didn’t work, so he prescribed another one and the same thing happened. My knee still hurts”. Sam doesn’t like to take drugs unless absolutely necessary. I know this because Sam talks to me. “Besides”, said Sam, “they don’t even work. I’m in so much pain I can’t sleep at night and I’m getting out of shape. So, I quit taking them and went back to running. I’m still in pain, but at least I’m tired enough at the end of the day to fall asleep for a little while.”

Sam and his doctor have different goals. Sam wants to be able to run, take as few drugs as possible, and still sleep at night. Sam’s doctor wants to make the pain go away, without surgery. It may not be possible for Sam to continue to run, without surgery. Their goals may be at cross-purposes.

Another client (Joe) told me his cardiologist wants him to get in better aerobic shape to strengthen his heart. She suggested Joe take up a regular walking routine, starting slowly and working up to a more vigorous pace. “But my osteopath says I should limit my walking to a leisurely stroll, in order to make my hip implants last longer. What should I do?”

In this age of specialization, our various physicians can easily find themselves at cross-purposes with each other, or with their patient, without even knowing it. I know, it’s a lousy health-care system in which that is so, but that’s where we are. In theory, your primary care physician is supposed to coordinate all that, yet they are so stretched it may not be realistic to expect them to be on top of everything.

That means it is up to us. It’s up to us to be our own advocate.

If you find yourselves differing about the goal…you have a decision to make. Change the goal or change the physician.

If you had an outside advocate representing you in any situation, the first thing you would do is make sure they know the goal. “I’m paying you to make sure I ______. Fill in the blank: make it possible for me to run again; improve my heart health; eliminate my pain at all costs; do whatever it takes to postpone surgery for as long as possible, etc. You get the idea. Then, make sure your physician is willing to sign up to your goal.

She may not be. It may be that your physician says, “I’m sorry, but it’s not possible for you to run again.” Or, “the risk is too great. I cannot endorse that.” If that’s the case, you have a decision to make. Change the goal or change the physician. But you’ll never know, if you don’t first talk about the goal.

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