Wednesday, July 24, 2024

Is It Ever Worth Asking Your Doctor About a Medication You Saw on TV?

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Photo: Drazen Zigic (Shutterstock)

There is a uniquely American phenomenon anyone living in or visiting the states is familiar with: A commercial full of happy, smiling people appears on television. A narrator declares that a brand-name drug is changing the lives of people with, say, psoriasis. A faster voice runs down a list of potential side effects of the drug while the actors keep smiling and laughing, maybe dancing (for some reason). The narrator returns with a clear directive: “Talk to your doctor today about [the medication].”

The thing is, though, that talking to your doctor about medication can be kind of fraught, especially if you plop down in the exam room with a brand name you heard on TV, but no real clue what it’s all about. Is that how this is supposed to work? They’re the one with years’ worth of education and experience, after all. Is it OK for you to suggest to them that you want medication?

It is OK, but there are no guarantees you’ll get the medication. That might be OK, too. Let’s go over how you can talk to your doctor about medication options.

Do not be afraid to bring medication up with a doctorIf you are having symptoms and did your own research, you might worry that a doctor will be dismissive of you if you bring up your interest in medication, since you’re not, well, a doctor. To be clear, they might be—doctors are human and bias in healthcare is definitely a thing—but there is no reason you shouldn’t advocate for yourself. You might not be a medical expert, but you are the expert on your own body.

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Dr. Yoni Freedhoff, associate professor of family medicine at the University of Ottawa, said he’s noticed patients can be “cautious about suggesting to doctors that they have a medication that they think they should be on or they’d like to try.” That can come from negative experiences with healthcare providers in the past or a feeling of sheepishness about coming out and saying they think they need medication.

Dr. Joseph Thomas, a hospitalist in New York, agreed that “there certainly is some hesitancy at times because they don’t want to come off as pushy, like they’re being demanding … but I think if patients are curious or if they have questions, if there’s something they would like to ask about being started on, then yes, absolutely bring that up.”

The bottom line, Freedhoff said, is this: “If a person has a desire to discuss something with their doctor, regardless of what that thing is, ideally, they should be able to have that discussion with their doctor. A doctor’s job is pretty straightforward. Our job is to inform people about their treatment options and the risks and ramifications of doing things and not doing things, but never to judge people on the treatment they decide for themselves.”

The doctor’s job is to listen to your concerns and answer your questions, so you have every right to share them.

If a doctor says no to medication, ask follow-up questionsDid anyone ever tell you, “God answers all our prayers, just not always with a ‘yes?’” Doctors can be kind of like that (but they’re not God). They don’t get to make executive decisions about your treatment and—also unlike God—they are available for follow-up questions when they give you a “no.”

“There will definitely be times where people will bring up medications that are not necessarily appropriate,” Freedhoff said. You’re not a doctor, so you might not know that a certain medication won’t work for your symptoms or isn’t advisable at this point in your treatment. You might not realize you don’t meet the clinical criteria for a certain prescription or your insurance won’t cover it. That’s fine; you’re not the doctor here, so how could you know? The doctor’s job in this situation is to explain all of that to you. A good doctor, Freedhoff said, “would be able to explain that—hopefully in a way that doesn’t upset the patient.”

If the doctor says you don’t meet the clinical criteria, ask why not and ask about what options exist that you do qualify for. Freedhoff recommended asking what criteria are utilized in determining a medication’s appropriateness, for instance, and Thomas pointed out that a doctor might have insight they can share about your particular tolerances. At the heart of any visit to the clinic are your health, your body, and your life. You should feel empowered to ask as many questions as it takes until you have a solid understanding of your treatment.

Consider a second opinionWe’re not saying you should hop from doctor to doctor until you find someone who agrees with your self-diagnosis, but you can absolutely consult someone else, provided there are doctors in your area who are available to you.

Seeking a new doctor could be a solution to a number of problems beyond the fact that your current one isn’t prescribing a certain medication. As Freedhoff said, “If you have a doctor and you do not feel comfortable bringing up a discussion around medication or treatment options, that should be a sign that you need to either discuss your relationship with your doctor and discuss the fact that you don’t feel comfortable, try to explore why, and get past that, or get a new doctor.”

Thomas added, “I’ve unfortunately heard too many stories of patients kind of being dismissed by their doctors, [saying things like] ‘Oh, that’s why you shouldn’t go to Dr. Google’ and that sort of thing. That happens, and it’s a thing I think myself and other folks in my profession should discourage. If people are bringing up these questions, it’s usually because they want to be engaged in their own health and they want to do the best they can to be better and to feel better.”

See? There are doctors out there who want to talk and listen. You should feel confident in sharing the truth about your symptoms and what you’re going through, no matter what treatment option you decide on. If a doctor is dismissive, won’t answer your questions, or shows any signs of bias, you should always feel free to look elsewhere.

Be reasonable in these conversationsAll of that being said, have reasonable expectations here. In an instance where you’re being treated poorly or a doctor is being very dismissive, sure, push back and advocate for yourself, but use your judgment. If a doctor is telling you you’re not a candidate for something and seems willing to have ongoing conversations about what could work for you, hear them out.

“Is there bias in healthcare? No question,” said Freedhoff, but there will be times a drug just doesn’t work for you, and that won’t be due to bias. “Respecting the fact that there are clinical criteria for prescription medications is worthwhile.”

Remember that, as we’ve established, doctors aren’t God—but they do have training and insights most patients don’t. Thomas pointed out, for example, that while the media raised significant awareness of monoclonal antibodies as part of a treatment for COVID-19, patients may not realize those don’t work as well on the latest variants. There is a lot you can find out through your own investigations, and while you should feel empowered to bring all of that up, be open to learning new things from doctors, who have more expertise here than the average journalist or marketing person.

“It’s worth having these discussions because medical care, at this point, is a team effort between doctor and patient,” he said. “It’s not the paternalistic relationship that it once was decades ago.” So, it can’t hurt to ask.

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