When a physician proposes a course of action, how do you decide to accept or not to accept the recommendation? The easy way is to say the physician is a physician and is always right. Doing so risks a clash of expectations once the treatment is under way. Inappropriate trust in the physician is bad for the patient, and treacherous for the physician.
 

This set of questions is a script which applies in every circumstance.
 

1. What will happen if the condition isn’t treated at all?
 

2. How does this treatment compare to doing nothing?
 

3. What other treatments are there for this condition and what will the outcome be if I choose them?

There it is no need to be shy about asking these questions. At some point your physician has gone through these same steps.  Most physicians will not be threatened by you gently asking these questions. You’ll be surprised about the level of uncertainty in most of the answers. Take, for example, the treatment of Meniere’s disease, one of the inner ear problems. There’s not a great deal of information in the books about how the disease the changes the inner ear over time. It’s difficult to say with great precision what any treatment will accomplish in altering the course of the disease. The answers to the three questions in such a case can only be expressed as a set of probabilities.

You’ll get answers as statements of probability in response to most questions you might ask.  It’s the nature on medicine. The doctor, in addition to using the knowledge in the books...which you could look up  yourself...includes his/her experience with  the particular, as well as related disorders in formulating the answers. It’s that experience you’re paying for.

When it’s surgery, how can you tell if this is the doctor for you?

When evaluating a surgeon, it’s important to compare apples to apples. It’s common to ask how many times the doctor has performed an operation. To appreciate the answer, you need some idea how many times the operation you’re considering is performed in your setting. Ask if it’s a common operation say, appendectomy, just about any general surgeon in the community can be trusted. In an academic setting, by contrast, these common operations are not done as often, and the professor of surgery may be doing them rarely. I wouldn’t want the average surgery department chairman taking out my appendix. The key with any operation is to go where it’s routine if you can or if such a place exists. You really do want to be just another something- ectomy. You don’t want to be the only one this year!

If you don’t receive satisfactory answers, you may you may be experiencing a mismatch between you and the physician. Physicians are, by and large, honest. Most disputes between physician and patient happen because of miscommunication and personality mismatches. Understanding clearly what you’re after, cure and relief, will make your experience less stressful for you and your physician.