On Her Own

Breaking up is hard to do: Healthcare edition

We talk about advocating for your health quite a bit here, because it’s a first line of defending your body and mind against itself and against some of the people with the most intimate access to us that is possible. The boundaries that are clear with most strangers are much less distinct when it comes to medical care because by definition, we must allow doctors and other healthcare providers to see us and to touch us at our most vulnerable. We invite them in, and entrust them with treating the parts of us that are broken and bruised, that we normally would want to protect against anyone who could hurt us more. It’s important that we do so, because by healing ourselves, we will become stronger and more resilient against physical attacks along with psychological ones. Starting at closer to 100% means that we have more in the tank to fight with, and that it is harder to hurt us past the point of no return.

The problem is that not everyone we invite to help us improve our health is going to do that. Some don’t bring the right knowledge and skills to the table. Some are willing to settle for results that we don’t find acceptable. Some are just a bad personality fit. As with creeps, we might not always be able to identify or articulate why we don’t like a doctor, or don’t like them anymore. Sometimes we stick with them because our choices are limited by the specialty needed, geography, or finances. Sometimes, we stick with them because they, individually, are wonderful caregivers, smart and compassionate, but grit our teeth when we deal with their staff. Sometimes we stick with them purely out of habit or familiarity, because we’ve always gone to them or we don’t want to start over with someone else, who might be just as bad or worse. Sometimes we stick with them because we don’t know how to break up with them, or because we’re uncomfortable with how leaving a doctor might make us seem ungrateful or mean.

It’s certainly a problem I’ve faced, as recently as this year, and something I’ve discussed with a few of my doctors, even ones that I really like. They had some insights that I thought were really helpful and that might be encouraging for you too.

First, it’s okay to fire your doctor. Your health and well-being are more important than stroking the ego of a doctor, or being nice to a professional you have paid to help take care of you. Ultimately, they are service providers you have hired, and if that relationship isn’t working out for you anymore, then you can end it. It’s true that an excellent doctor may tell you things you don’t like, or suggest a treatment plan you don’t agree with, and they may be right. It’s also true that they may be wrong, or that your faith in them is so damaged that it doesn’t matter if they were right. I’m not saying that you should doctor shop until you find one who tells you want you want to hear, but I’m also not saying that you should believe everything a doctor has to say to you or that they are the right ones to say it to you.

A good doctor will, of course, want to know why you want to move on. You have the choice on whether you want to tell them, and the way in which you want to do that – in person, via phone, via online messaging or a letter. If you like the doctor, maybe you want to tell them that their front office is horrible to deal with, or that it really is you and not them. It’s possible that they can find a solution that will lead you to un-fire them, or at least result in closure for both of you so that you know you’ve made the right choice for you, and in a way that helps you know you did everything you could to preserve what might have been a good relationship otherwise or to end it kindly.

But you don’t owe a doctor – or anyone else – that explanation. Maybe they’re so awful that you don’t want to have one final conversation with them. Maybe you don’t have the mental energy to manage that communication. Fortunately, doctors are someone you hire and no matter how close you might have grown to them, what you have with them isn’t precisely the same as a fully personal relationship. You have zero social or professional obligation to have a break-up conversation with your doctor or notify them that you’re done with them. You can simply not schedule that follow-up on your way out the door, ignore the reminders to get in for your regular checkup, or cancel your next appointment. Avoid ghosting entirely if you are expected to be in at a certain date and time, if only to avoid being the no-show charges, but leaving the door open and never coming back? That’s fine.

If you are currently undergoing active treatment for a condition, it can be logistically complicated to fire that doctor. I get that. Depending on your relationship with other medical professionals, you have a few choices though. Another part of your medical team might be able to step into the gap of prescribing and coordinating care until you find a new provider specific to your condition. You might be able to set up matters with the doctor you are leaving to refer you to another, who might be a better fit, or to provide enough support to tide you over until you replace them. If the decision is a long time coming, you might start seeing a new specialist before you fire your old one. It’s also possible that you might not be able to leave until your treatment is complete. In those cases, still do the work to prepare to go by researching new possibilities and collecting as many records as you can, so that you can act on that decision as soon as it’s realistic to. If nothing else, setting yourself up for next time, and knowing that you aren’t stuck forever, are both pluses here.

Speaking of records, that doctor you don’t like doesn’t have ownership over yours. You own your medical records, and with very few exceptions (primarily relating to certain mental health records) you have the right to request a copy for yourself to bring to a new doctor personally, or to request that a copy be sent to a new medical office on your behalf. You can even run that request through your new doctor, or make it via letter or other form of communication that allows you to avoid direct, real-time interaction with the office you are leaving. It doesn’t matter if you owe money to your old doctor, though there are some nuances about charges that may be allowed to make the copies of your records. However, you can still go to a new healthcare provider without your old records. Bring them the history you have available, either from your own notes or perhaps what you are able to download from a patient portal, and start fresh if you need to. It still can be better for you than staying with a doctor who isn’t otherwise a net positive to your health.

When your healthcare providers are doing you more harm than good, or even if you just don’t like their bedside manner while they are doing you good, you don’t have to stay with them. In fact, I urge you to move on and find someone who treats you better. It’s another step in learning how to protect yourself from all who might do you harm.

Hi, I'm Annette.

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