Questions to Ask Your Doctor

A friend recently sent me a great TED Talk titled: 4 Questions You Should Always Ask Your Doctor (by Dr. Christer Mjaset*). She knew I’d be interested because I speak to community groups about how to talk to your doctor.

The 4 questions Dr. Mjaset recommends we ask our doctors are:

1. Is this really necessary?
2. What are the risks?
3. Are there other options?
4. What happens if I don’t do anything?

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These questions work in all sorts of situations:

• Prescribing a new medication
• Recommending surgery
• Whether to get an MRI or other medical test
• Deciding on a new treatment option

Your concerns may be medical/clinical (e.g., are there side effects?) or they may be financial (e.g., will my insurance cover it or will I have to pay out of pocket?). While you may not think you can question your doctor’s advice, trust me, you can! 

Examples:

• Several years ago, I had unexplained vertigo-like symptoms for months. No doctor could figure out the problem (or frankly, seemed that curious, but that is perhaps a topic for another newsletter!). Several doctors wanted to prescribe migraine medication for me. However, I did not have migraines and the side effects of the medication included dizziness and lightheadedness - which were exactly the symptoms I was complaining about! So after asking questions and evaluating the responses, I chose not to take the medication and instead kept searching for an answer. 
• An elderly client had stage 4 lung cancer. The doctor ordered an MRI. My client was extremely anxious at the thought of having to lie still for the MRI considering she coughed nonstop whenever she was lying down. It was also challenging for her to get to the hospital for the test. I called the Radiology department and spoke to a manager/technician about whether there were any options that would allow my client to be more comfortable during the test. I then called the oncology nurse navigator to discuss how important the test was and whether it would change any of the care my client was receiving. It was decided and agreed upon by all parties that there was no benefit to my client undergoing the MRI. 
• My son broke his finger a few months ago. It hurt badly enough that he actually asked me to take him to the doctor. The doctor looked at my son’s finger, said “yep, it’s broken” then proceeded to tape it up with a splint. He then said I should take my son for an x-ray. I’m on a high-deductible health insurance plan, and it was late on a Friday afternoon, so I told the doctor that and asked “what will you recommend we do differently based on the x-ray?” He said he wouldn’t do anything differently, thought for a moment, then said that if it’s still bothering my son in a week, THEN I should take him for an x-ray. (Note that I love and take care of my kids and if the doctor said my son definitely needed the x-ray, I would have taken him for one!) Meanwhile, the next day, my son untaped his fingers, took off the splint, and went out and played football with his friends. I would not have been happy if I had spent hundreds of dollars on an x-ray!

As I emphasize when I speak to community groups, it is okay to ask your doctor questions! It is extremely important to understand what is being prescribed or suggested, the risks and benefits of it, and whether it fits with your goals and preferences.

*Christer Mjåset, M.D. is a neurosurgeon, author, columnist and lecturer who currently works as a Harkness fellow in Health Care Policy and Practice at Harvard T.H. Chan School of Public Health in Boston studying value-based health care models.